Alcoholic cardiomyopathy pathophysiology: Difference between revisions
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Excessive use of [[alcohol]] has a direct toxic effect on the [[heart muscle]] cells. The heart muscle becomes weakened, subsequently dilates, and cannot pump [[blood]] efficiently. The lack of [[blood flow]] affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also simultaneously be causing direct damage to the [[liver]].<ref name="pmid12006456">{{cite journal |author=Piano MR |title=Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology |journal=[[Chest]] |volume=121 |issue=5 |pages=1638–50 |year=2002 |month=May |pmid=12006456 |doi= |url=}}</ref>. | Excessive use of [[alcohol]] has a direct toxic effect on the [[heart muscle]] cells. The heart muscle becomes weakened, subsequently dilates, and cannot pump [[blood]] efficiently. The lack of [[blood flow]] affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also simultaneously be causing direct damage to the [[liver]].<ref name="pmid12006456">{{cite journal |author=Piano MR |title=Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology |journal=[[Chest]] |volume=121 |issue=5 |pages=1638–50 |year=2002 |month=May |pmid=12006456 |doi= |url=}}</ref>. | ||
Proposed mechanisms of myocardial injury in alcoholic cardiomyopathy include: | Proposed mechanisms of myocardial injury in alcoholic cardiomyopathy include:<ref name="pmid20308914">{{cite journal |author=Iacovoni A, De Maria R, Gavazzi A |title=Alcoholic cardiomyopathy |journal=[[Journal of Cardiovascular Medicine (Hagerstown, Md.)]] |volume=11 |issue=12 |pages=884–92 |year=2010 |month=December |pmid=20308914 |doi=10.2459/JCM.0b013e32833833a3 |url=}}</ref> | ||
* Ethanol induced [[apoptosis]] | * Ethanol induced [[apoptosis]] | ||
* Impaired contraction of [[myocardium]] due to direct toxicity | * Impaired contraction of [[myocardium]] due to direct toxicity | ||
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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.
Pathophysiology
Alcoholic cardiomyopathy is a type of dilated cardiomyopathy. Both acute and chronic alcohol consumption, in excessive amounts, has been associated with adverse effects on the myocardium leading to non-ischemic dilated cardiomyopathy. The maximum recommended dose of alcohol consumption in US men and women is 14 drinks and 7 drinks respectively. Consumption above these levels has been shown to be associated with the increased risk of alcoholic cardiomyopathy. [1]
Excessive use of alcohol has a direct toxic effect on the heart muscle cells. The heart muscle becomes weakened, subsequently dilates, and cannot pump blood efficiently. The lack of blood flow affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also simultaneously be causing direct damage to the liver.[2].
Proposed mechanisms of myocardial injury in alcoholic cardiomyopathy include:[3]
- Ethanol induced apoptosis
- Impaired contraction of myocardium due to direct toxicity
- Inhibition of protein synthesis
- Activation of renin-angiotensin system (RAS)
- Inhibition of oxidative phosphorylation
- Fatty acid ester accumulation
- Nutritional deficiency of thiamine
- Free radical damage
- Inflammation
- Inhibition of calcium-myofilament interaction
References
- ↑ Thun MJ, Peto R, Lopez AD; et al. (1997). "Alcohol consumption and mortality among middle-aged and elderly U.S. adults". The New England Journal of Medicine. 337 (24): 1705–14. doi:10.1056/NEJM199712113372401. PMID 9392695. Unknown parameter
|month=ignored (help) - ↑ Piano MR (2002). "Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology". Chest. 121 (5): 1638–50. PMID 12006456. Unknown parameter
|month=ignored (help) - ↑ Iacovoni A, De Maria R, Gavazzi A (2010). "Alcoholic cardiomyopathy". Journal of Cardiovascular Medicine (Hagerstown, Md.). 11 (12): 884–92. doi:10.2459/JCM.0b013e32833833a3. PMID 20308914. Unknown parameter
|month=ignored (help)