Alcoholic cardiomyopathy natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Hardik Patel, M.D.
Overview
In patients who continue to abuse alcohol, 4 year survival rate is 50%. On the contrary, abstinence is associated with regression of symptoms and overall improvement. Improvement in cardiac function evident from echocardiographic findings can also be noted.
Natural History, Complications and Prognosis
Natural History
Natural course of alcoholic cardiomyopathy depends on the ability of the patient to abstain from alcohol after being diagnosed. Many case reports and small studies have shown that abstinence from alcohol lead to marked improvement in the clinical condition of the patient. Similarly, conditions of a few patients worsened with continued alcohol intake.[1][2][3][4] Estruch et al found that a positive correlation exists between alcoholic cardiomyopathy and cirrhosis. The study stated that alcoholics who were hospitalized solely for cardiomyopathy had a higher prevalence of cirrhosis than those without heart disease.[5]
Complications
Common cardiovascular complications of chronic alcohol abuse include:
- Congestive heart failure
- Arrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardias and premature ventricular complexes)
- Hypertension
- Stroke
- Sudden death
Prognosis
The prognosis of alcoholic cardiomyopathy is better compared with that of idiopathic dilated cardiomyopathy; approximately 2/3 of the patients are stable. Poor prognostic factors include atrial fibrillation, wide QRS, and lack of beta blocker therapy.[6]
Studies have shown conflicting results regarding the effect of abstinence or reduction in alcohol intake on clinical outcomes in alcoholic cardiomyopathy.[6][7] The four-year survival rate in patients who continue to consume alcohol was reported to be 50%.[7]
References
- ↑ Guillo P, Mansourati J, Maheu B; et al. (1997). "Long-term prognosis in patients with alcoholic cardiomyopathy and severe heart failure after total abstinence". The American Journal of Cardiology. 79 (9): 1276–8. PMID 9164905. Unknown parameter
|month=ignored (help) - ↑ Masani F, Kato H, Sasagawa Y; et al. (1990). "[An echocardiographic study of alcoholic cardiomyopathy after total abstinence]". Journal of Cardiology (in Japanese). 20 (3): 627–34. PMID 2131353.
- ↑ Agatston AS, Snow ME, Samet P (1986). "Regression of severe alcoholic cardiomyopathy after abstinence of 10 weeks". Alcoholism, Clinical and Experimental Research. 10 (4): 386–7. PMID 3530014. Unknown parameter
|month=ignored (help) - ↑ Mansourati J, Forneiro I, Genet L, Le Pichon J, Blanc JJ (1990). "[Regression of dilated cardiomyopathy in a chronic alcoholic patient after abstinence from alcohol]". Archives Des Maladies Du Coeur Et Des Vaisseaux (in French). 83 (12): 1849–52, discussion 1853. PMID 2125195. Unknown parameter
|month=ignored (help) - ↑ Estruch R, Fernández-Solá J, Sacanella E, Paré C, Rubin E, Urbano-Márquez A (1995). "Relationship between cardiomyopathy and liver disease in chronic alcoholism". Hepatology (Baltimore, Md.). 22 (2): 532–8. PMID 7635421. Unknown parameter
|month=ignored (help) - ↑ 6.0 6.1 Guzzo-Merello G, Segovia J, Dominguez F, Cobo-Marcos M, Gomez-Bueno M, Avellana P; et al. (2015). "Natural history and prognostic factors in alcoholic cardiomyopathy". JACC Heart Fail. 3 (1): 78–86. doi:10.1016/j.jchf.2014.07.014. PMID 25458176.
- ↑ 7.0 7.1 Skotzko CE, Vrinceanu A, Krueger L, Freudenberger R (2009). "Alcohol use and congestive heart failure: incidence, importance, and approaches to improved history taking". Heart Failure Reviews. 14 (1): 51–5. doi:10.1007/s10741-007-9048-8. PMID 18034302. Unknown parameter
|month=ignored (help)