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Alcoholic cardiomyopathy presenting with severe circulatory failure requiring mechanical circulatory support: A

Hideya Itagaki1, Tomoyuki Endo1

  • 1Division of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan.

The American Journal of Emergency Medicine
|May 1, 2026
PubMed

Insights

Alcoholic cardiomyopathy (ACM) can be reversible even in severe cases requiring mechanical circulatory support (MCS). Patients showed significant left ventricular function recovery after treatment, highlighting ACM

Area of Science:

  • Cardiology
  • Internal Medicine
  • Toxicology

Background:

  • Alcoholic cardiomyopathy (ACM) is a reversible form of dilated cardiomyopathy linked to excessive alcohol intake.
  • Recovery of left ventricular function post-abstinence is known, but outcomes in severe circulatory failure requiring mechanical circulatory support (MCS) are unclear.

Purpose of the Study:

  • To evaluate survival and myocardial recovery in ACM patients with severe circulatory failure needing MCS.

Main Methods:

  • Systematic literature search in PubMed, Web of Science, Google Scholar, and Ichushi-Web.
  • Included studies on ACM patients with cardiogenic shock or severe circulatory failure requiring temporary MCS (ECMO, Impella, IABP, LVAD).
  • Extracted data on patient characteristics, support type, survival, and left ventricular function recovery.

Main Results:

  • 10 patients from 5 studies (3 case reports, 2 case series) were identified; 90% were male, median age 43.
  • Median baseline LVEF was 15%, with 30% experiencing cardiac arrest.
  • All patients survived; median LVEF improved to 55% with MCS, showing significant functional recovery.

Conclusions:

  • Published data suggest alcoholic cardiomyopathy is reversible even in severe cases needing MCS.
  • Awareness of this reversible phenotype is crucial for timely diagnosis and management of severe circulatory failure.
Abstract

Keywords:
Alcoholic cardiomyopathyCardiogenic shockExtracorporeal membrane oxygenationMechanical circulatory supportMyocardial recoverySystematic review

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