Relation between alcohol intake, myocardial enzyme activity, and myocardial function in dilated cardiomyopathy. Evidence for the concept of alcohol induced heart muscle disease.

Abstract

SUMMARY Detailed drinking histories were taken in 38 patients in whom dilated cardiomyopathy was diagnosed by cardiac catheterisation and left ventricular biopsy. On the basis of the drinking history twenty patients were classified as being in an abstinent or light drinking group and eighteen patients as being in a heavy drinking group (daily alcohol intake in excess of 80 g or cumulative lifetime intake exceeding 250 kg). Activities of myocardial creatine kinase, lactate dehydrogenase, a hydroxybutyric dehydrogenase, malic dehydrogenase, and aspartate aminotransferase were all higher in the heavy drinkers and myocardial enzyme activity correlated with cumulative lifetime alcohol intake, maximum daily intake, and recent daily intake. Activities of creatine kinase, a hydroxybutyric dehydrogenase, and malic dehydrogenase correlated with ejection fraction, irrespective of the alcohol intake of the patient. These findings were not altered by exclusion of patients with hypertension.The results indicate that among patients with dilated cardiomyopathy there is a group characterised by a high alcohol intake and raised myocardial tissue enzymes which supports the concept of alcoholic heart muscle disease as a distinct entity.Although the association between excessive alcohol consumption and congestive (dilated) cardio-i myopathy has long been known,1 2 a causal relation remains controversial.3 There are no studies that relate quantitative alcohol intake to myocardial damage, as there are for alcoholic liver disease.4" Indeed the clinical diagnosis of alcoholic heart muscle disease merely reflects the coexistence of global myocardial dysfunction in a heavy drinker in whom no other cause for myocardial disease has been found.Requests for reprints to Dr P J Richardson, Cardiac Department,

Functional proteomic analysis reveals sex-dependent differences in structural and energy-producing myocardial proteins in rat model of alcoholic cardiomyopathy

“…Increased complex I protein content, as observed in males receiving the chronic alcohol diet, may be indicative of an increased flux and subsequent oxidative stress. The observed increases in mitochondrial enzyme activities reported herein are consistent with previously reported results of a study investigating the relationship between alcohol intake, myocardial enzyme activity, and myocardial dysfunction (33). In that study, activities of mitochondrial enzymes were all reported as higher in heavy drinkers and were correlated with alterations in functional parameters (e.g., cardiac output).…”

Point mutations in mitochondrial DNA of patients with alcoholic cardiomyopathy

“…All patients satisfied the previously established criteria for excessive alcohol consumption (i.e., mean daily ethanol intake Ͼ80 ml and drinking duration Ͼ10 years). 20 These patients also met the diagnostic criteria of DCM, except for the daily intake of alcohol. None of the patients had hypertension, diabetes mellitus, or symptoms of myocarditis.…”

Evaluation of CK and CK-MB in Alcohol Abuse Subjects with Recent Heavy Consumption

“…Although women ap pear to be as susceptible as men to subclinical alcoholic cardiac dysfunction, there is a greater predilection of men to the development of severe cardiomyopathy for reasons yet unexplained [2]. Richardson et al [3] found signifi cant correlations between myocardial enzyme activities, indicative of myocellular damage, and total lifetime etha nol consumption, maximal daily ethanol intake and re cent daily intake. A significant correlation was shown between CK activity and myocardial impairment (p < 0.01).…”