[Reversibility of alcoholic myocardiopathy with abstinence: presentation of 2 cases]

The sustained alcohol intake results in the development of a dilated cardiomyopathy; its pathogenesis and prognostic and evolutive factors have not yet been completely defined. It is classically considered that alcoholic cardiomyopathy has a poor prognosis, as two thirds of patients die within three years. However, in recent years some isolated cases of clinical reversibility after short abstinence periods have been reported without identification of the involved factors. Two chronic alcoholic patients are reported with congestive heart failure at admission; a diagnosis of alcoholic cardiomyopathy was made after cardiac catheterization and endomyocardial biopsy. The morphometric study of endomyocardial biopsy showed a preservation of the myofibrillary fraction with mild fibrosis. The clinical outcome was favorable: after three months of alcoholic abstinence, a complete clinical recovery with definite improvement of echocardiographic parameters and left ventricular ejection fraction in the radionuclide ventriculography were observed. Finally, the factors that appear to be involved in the presence or absence of reversibility of this type of cardiomyopathy are discussed.