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Alcohol and dilated cardiomyopathy: incidence and correlation with clinical outcome
R Wang1, J Mallon, A I Alterman
1Veterans Administration Medical Center, Philadelphia, Pennsylvania.
Insights
Chronic heavy alcohol consumption is linked to heart failure in veterans. Abstaining from alcohol improved cardiac status in patients with alcoholic cardiomyopathy, but not all heavy drinkers.
Area of Science:
- Cardiology
- Toxicology
- Geriatrics
Background:
- Dilated cardiomyopathy is a significant cause of heart failure in elderly populations.
- Alcohol consumption is a known risk factor for cardiovascular diseases, including cardiomyopathy.
- Identifying specific etiological factors is crucial for effective heart failure management.
Purpose of the Study:
- To investigate the role of chronic heavy drinking as a cause of heart failure in elderly veterans.
- To assess the impact of alcohol cessation on cardiac status in patients with alcohol-related cardiomyopathy.
- To explore the relationship between alcohol consumption patterns and heart failure outcomes.
Main Methods:
- Retrospective analysis of 28 elderly veterans with dilated cardiomyopathy attending a heart failure clinic.
- Assessment of alcohol consumption history, including habitual heavy drinking.
- Evaluation of cardiac status and treatment outcomes in relation to alcohol intake and cessation.
Main Results:
- Half of the patients had a history of habitual heavy drinking.
- Chronic heavy drinking was identified as the sole cause of heart failure in 3 patients.
- 11 patients had heavy drinking as a potential factor alongside coronary artery disease and/or hypertension.
- Only 3 patients with confirmed alcoholic cardiomyopathy fully abstained from alcohol, showing marked cardiac improvement.
- Reduced alcohol intake, but not complete abstinence, was observed in most heavy drinkers.
- No significant cardiac improvement was noted in heavy drinkers who did not abstain or in those with a history of moderate drinking.
Conclusions:
- Chronic heavy alcohol consumption is a significant etiological factor in dilated cardiomyopathy among elderly veterans.
- Complete alcohol abstinence is crucial for improving cardiac status in patients with alcoholic cardiomyopathy.
- Further research is needed to understand the long-term effects of reduced alcohol intake on heart failure management in this population.
Abstract:
Among a group of 28 elderly veterans with dilated cardiomyopathy regularly attending an outpatient heart failure clinic, half had a history of habitual heavy drinking. It was concluded that chronic heavy drinking was the only identifiable factor responsible for the heart failure in three of these patients. Eleven other patients also had chronic heavy drinking as a possible etiological factor of their heart failure in addition to Coronary Artery Disease and/or hypertension. Less than 50% of the heavy drinkers totally abstained from alcohol after seeking medical treatment although they reduced their drinking significantly. All three patients with clear alcoholic cardiomyopathy discontinued drinking and showed marked improvement in cardiac status. The discontinuation of drinking did not appear to be associated with improvement in the remaining heavy drinkers and those patients who reported a history of moderate drinking.