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Differences of disease progression in congestive heart failure due to alcoholic as compared to idiopathic dilated

P Prazak1, M Pfisterer, S Osswald

  • 1Department of Internal Medicine, University Hospital, Basel, Switzerland.

European Heart Journal
|February 1, 1996
PubMed

Insights

Alcoholic cardiomyopathy shows better long-term survival than idiopathic dilated cardiomyopathy, even with severe heart failure. This suggests different disease progression mechanisms and potential therapeutic implications.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Toxicology

Background:

  • Alcoholic cardiomyopathy (AC) and idiopathic dilated cardiomyopathy (IDC) present with heart failure.
  • AC reversibility is debated once structural changes occur.
  • Long-term prognosis comparison is crucial for therapeutic strategies.

Purpose of the Study:

  • To compare the long-term course and survival of congestive heart failure in patients with AC versus IDC.

Main Methods:

  • Retrospective comparison of 23 AC patients and 52 IDC patients with overt heart failure.
  • Analysis of clinical data, heart failure class (NYHA), left ventricular ejection fraction, and end-diastolic volumes.
  • Evaluation of overall and transplant-free survival rates.

Main Results:

  • No significant difference in heart failure severity (NYHA class, ejection fraction, LV volumes) between AC and IDC groups.
  • Significantly better 1, 5, and 10-year overall survival for AC (100%, 81%, 81%) versus IDC (89%, 48%, 30%) (P=0.041).
  • Transplant-free survival was also significantly better for AC (P=0.005).

Conclusions:

  • Mortality in severe heart failure with left ventricular dilatation is significantly lower in AC than IDC.
  • Disease progression differs between AC and IDC, despite similar structural changes.
  • Findings may inform therapeutic choices for alcoholic and idiopathic dilated cardiomyopathy.

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