A Mediterranean diet, based on monounsaturated fats from olive oil, fruits, vegetables, whole grains, and legumes/nuts, has been demonstrated to be beneficial for primary prevention of global cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes) 80,141,142. However, alcoholic cardiomyopathy since it includes moderate alcohol consumption of red wine, this aspect should be clearly avoided in subjects affected by ACM. The exact mechanism by which an increased adherence to the traditional Mediterranean diet exerts its favorable effects is not known. According to current knowledge, prolonged and excessive alcohol consumption plays a significant role in inducing oxidative stress within the myocardium.
Enlarged heart, in heart failure
The sarcomere complex is early affected by ethanol, decreasing the titin content, a protein that is responsible for sarcomere relaxation and LV distensibility 130. This damage first induces diastolic dysfunction, which is initially subclinical and later clinically apparent 57. In addition, contractile sarcomere proteins such as Myosin, Actin, and Troponin are also affected by ethanol, causing the functional progressive depression of myocyte contractility, inducing progression to heart failure 56,104,131. Myocyte apoptosis, based on assessment of TUNEL staining and caspase activity, has been demonstrated to be an active phenomenon leading to myocyte loss in diverse cardiomyopathies 113,114 and also in chronic high-dose ethanol consumption both in experimental 109 and clinical models 101. Apoptosis may be induced by ethanol through mitochondrial membrane permeabilization and the release of pro-apoptotic factors (cytochrome c) from the mitochondrial inter-membrane space to the cytosol. Chronic ethanol exposure, in combination with other stress signals, provides a trigger for cardiac apoptosis through activation of the mitochondrial permeability transition pore by physiological calcium oscillations 111.
Prognosis of ACM
A person may not be able to withstand the amount of exercise or activity as they had previously. As a point of reference, consuming 80 grams of alcohol daily for at least 5 years can significantly increase the risk of ACM. Alcoholic cardiomyopathy is a leading cause of non-ischemic dilated cardiomyopathy in United States. Myocardial depression secondary to alcohol is initially reversible however prolonged sustained alcohol use leads to irreversible dysfunction. Let your healthcare professional know if you have a family history of the condition.
Quebec‘s beer drinker disease
- LCFA uptake was evaluated in isolated cardiomyocytes obtained from ethanol-fed rats and was increased in a dose-dependent manner (i.e., greatest in 18% ethanol group) (33).
- Chronic alcohol consumption can cause multi-organ damage including myocardial dysfunction.
- According to the NIAAA, many people with AUD recover, although setbacks are common among those receiving treatment.
- Summary of studies using pharmacologic inhibition or genetic manipulation to suppress ethanol-induced changes in cardiac structure and function.
Despite this clear epidemiological evidence of ethanol’s unsafe consumption and increased health risk, results of consumption policies are not effective enough. Therefore, the need to establish a more effective control on ethanol consumption has been repeatedly claimed 2. Alcoholic cardiomyopathy (ACM) is a type of heart disease that can result from chronic alcohol consumption.
- This includes a combination of beta-blockers, an angiotensin-converting enzyme inhibitor, diuretics, aldosterone receptor antagonist and angiotensin blocker-neprilysin inhibitor (if LVEF is less than or equal to 40%).
- He compared the prevalence of different polymorphisms of the angiotensin-converting enzyme gene in 30 ACM patients and in 27 alcoholics with normal ventricular function.
- Although only examined in the 18% ethanol group, ATP production was significantly decreased (5.18 ± 0.54 pg/ml) compared to the control group (7.40 ± 0.64 pg/ml) (33).
- The effect measure for each outcome was conducted using the mean differences effect measure, where the outcomes were assessed in identical units across the various literature reviews used in the study.
Differential Diagnosis
In the 16th century Paracelsus Theophrastus Bombastus from Hohenheim used this term for distilled liquor and called it alcohol 15. G., in medieval times, when people took advantage of the vasodilating properties of alcohol to treat angina pectoris or heart failure. So Hildegard von Bingen (1098–1179), one of the most prominent mysticians of her time, recommended her heart wine https://ecosoberhouse.com/article/celebrating-the-first-year-sober/ as a universal remedy.
- Extensive physiological studies have revealed that oHCM is caused by sarcomeric hypercontractility resulting from an excess of actin–myosin cross-bridges.
- Studies have shown an increase in reactive oxygen species (ROS) level in myocytes following alcohol consumption and thus causes oxidation of lipids, proteins, and DNA leading to cardiac dysfunction.
- There is also an established link between the development of ACM and apoptosis because of myocardial cell death, which contributes to heart pathology and dysfunction.
- In fact, mitochondrial structural changes have been described in chronic alcohol consumers, with swollen megamitochondria and the distortion of inner cristae 107,108.
Treatment of ACM
Due to page limitations, we recognize that we have not included all the excellent scientific work completed in the area of alcohol and the cardiovascular system. Biomarkers of heart failure such as NT-proBNP and of myocardial necrosis such as the troponins and CKMB indicate heart failure or myocytolysis. The source was identified to be the filter of choice for wine and beer, i.e., diatomaceous earth 36. The German word for it is Kieselguhr, a beige powder made up of the skeletons of diatoms. The trace amounts of arsenic have not been comparable to the arsenic-in-beer endemic in Manchester but may still reach up to 10-times the amount admitted for arsenic in drinking water in the European Union and the US. This review assembles and selects pertinent literature on the ambivalent relationship of ethanol and the cardiovascular system, including guidelines, meta-analyses, Cochrane reviews, original contributions, and data from the Marburg Cardiomyopathy registry.
