Normalization of variables of left ventricular function in patients with alcoholic cardiomyopathy after cessation of excessive alcohol intake: an echocardiographic study

Pavan, Daniela; Nicolosi, Gian Luigi; Lestuzzi, Chiara; Burelli, C; Zardo, Francesco; Zanuttini, D

doi:10.1093/oxfordjournals.eurheartj.a062314

Cited by 38 publications

(19 citation statements)

References 2 publications

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“…There are currently no studies of specific pharmacotherapies in patients with alcoholic cardiomyopathy other than the standard therapy for HF; however, numerous reports detail the reversibility of depressed LV function after the cessation of drinking. 95 Even if the depressed LV function does not normalize completely, the symptoms and signs of HF improve after abstinence. Unfortunately, the overall prognosis remains poor, with a mortality rate of 40% to 50% within 3 to 6 years if the patient is not abstinent.…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Treatmentmentioning

confidence: 99%

“…In patients with alcoholic cardiomyopathy, total abstinence is recommended (Level of Evidence C). [88][89][90][91]94,95 Cocaine-related Cardiomyopathy…”

Section: Key Management Strategies For Alcoholic Cardiomyopathymentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

View full text Add to dashboard Cite

show abstract

“…29 In addition, cessation of excessive intake may result in improvement of depressed systolic function. 30 In cases of heart failure clearly not associated with alcohol abuse, however, the psychological consequences of depriving patients of the pleasure of a modest amount of alcohol probably outweigh the questionable long term benefits of abstinence, especially in countries where moderate wine drinking during meals is a widespread habit.…”

Section: Avoidance Of Harmful Habitsmentioning

confidence: 99%

How do changes in lifestyle complement medical treatment in heart failure?

Soler‐Soler¹,

Permanyer-Miralda²

1994

Heart

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“…Experimental stud ies in animals are in accordance with our interpretation; the impairment of uptake and binding of calcium by the sarcoplasmic reticulum and the decrease in left ventricular diastolic compliance related to interstitial collagen accumulation diminish myocardial contractility [33,34], These changes reverse after some months of abstinence [33]. It is also of interest that, following a prolonged period of abstinence in chronic alcoholics, left ventricular function is not impaired [35]; furthermore, in previous case reports, alco holic cardiomyopathy improved after stop ping alcohol intake [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…-7% ; t = 1.3) did not change. In conclusion, in chronic alcoholics, the abstinence from alcohol can be followed by an improvement of left ventricular function.A cardiac disorder is frequently found in chronic alcoholics; it has a wide range, from preclinical cardiac malfunction [1][2][3][4][5][6][7][8] to an overt cardiomyopathy [9][10][11][12][13][14], Anecdotal reports on patients with car diomyopathy who improved after absti nence from alcohol are found in various pub lications [15][16][17][18]; however, the effect of alco …”

mentioning

confidence: 99%

Improvement of Left Ventricular Function in Chronic Alcoholics following Abstinence from Ethanol

1989

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Preclinical abnormalities of left ventricular function are frequently found in chronic alcoholics. In 12 chronic alcoholics without cardiomyopathy and in 12 healthy controls, systolic time intervals and echocardiograms were investigated before and after 12 months of abstinence from alcohol. In chronic alcoholics, an increase was found in the PEP/LVET ratio (0.31 ± 0.06; in controls 0.24 ± 0.05; t = 3.11; p < 0.005), the diastolic interventricular septal thickness (6.0 ± 2.0 mm/m²; in controls 4.1 ± 1.0; t = 2.95; p < 0.01), the left ventricular wall thickness (6.3 ± 1.0 mm/m²; in controls 4.9 ± 1.0; t = 3.43; p < 0.005) and the left ventricular diastolic dimension (29 ± 4 mm/m²; in controls 26 ± 3; t = 2.08;p < 0.05). The left ventricular mass (135 ± 33 g/m²; in controls 113 ± 40; t= 1.47) did not differ from the controls. After 12 months of abstinence a significant decrease was found in the PEP/LVET ratio (0.26 ± 0.05, i.e. -16%; t = 3.59; p < 0.005), the diastolic interventricular septal thickness (4.7 ± 0.9 mm/m², i.e. -22%; t = 2.73; p < 0.02), the left ventricular posterior wall thickness (5.6 ± 1.0 mm/m², i.e. -11 %; t = 4.08; p < 0.001) and the left ventricular mass (109 ± 24 g/m², i.e. -21 %; t = 6.53; p < 0.001). The left ventricular diastolic dimension (27 ± 2 mm/m², i.e. -7%; t = 1.3) did not change. In conclusion, in chronic alcoholics, the abstinence from alcohol can be followed by an improvement of left ventricular function.

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Normalization of variables of left ventricular function in patients with alcoholic cardiomyopathy after cessation of excessive alcohol intake: an echocardiographic study

Cited by 38 publications

References 2 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

How do changes in lifestyle complement medical treatment in heart failure?

Improvement of Left Ventricular Function in Chronic Alcoholics following Abstinence from Ethanol

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