Effects of alcohol on the heart

Abstract

Some evidence suggests that light to moderate alcohol consumption protects against cardiovascular diseases. However, this cardioprotective effect of alcohol consumption in adults is absent at the population level. Approximately 20 to 30% of patients admitted to a hospital are alcohol abusers. In medical practice, it is essential that patients' levels of consumption are known because of the many adverse effects that might result in the course of routine care. Ethanol damage to the heart is evident if alcohol consumption exceeds 90 to 100 g/d. Heavy ethanol consumption leads to increased risk for sudden cardiac death and cardiac arrhythmias. In patients with coronary heart disease, alcohol use was associated with increased mortality. An early response to drinking was an increased ventricular wall thickness to diameter ratio, possibly proceeding with continuous drinking to alcoholic cardiomyopathy, which had a worse outcome compared with idiopathic dilative cardiomyopathy if drinking was not stopped or at least reduced (< 60 g/d). In the ICU, patients with chronic alcoholism have more cardiac complications postoperatively. These complications probably are caused by biventricular dysfunction, particularly with the occurrence of severe infections or septic shock, events that are three to four times more frequent among chronic alcoholics than occasional drinkers or nondrinkers. To prevent further complications from drinking and for long-term management of drinking, patients with alcohol abuse and heart failure should be treated in brief intervention and follow-up programs. Prognosis is good even in patients with New York Heart Association class IV heart failure caused by cardiomyopathy if complete abstinence is accomplished. Noncompliance to smoking and alcohol restrictions, which are amenable to change, dramatically increases the risk for hospital readmissions among patients with heart failure.

624 Acute Ethanol Exposure Increases the Susceptibility of the Donor Hearts to Ischemia/Reperfusion Injury after Transplantation in Rats

“…The resulting plasma ethanol concentrations were approximately 375, 185 and 0 mg/ 100 ml at 1 h, 6 h and 24 h respectively and were similar to pathological levels occurring clinically [15,16]. It has been shown that ethanol damage to heart becomes evident if alcohol consumption exceeds 90 to 100 g/day in humans [3], which can be transpired to a dosage of ,1.5 g/kg for an adult weighing 70 kg. In the present study we therefore used the single dose of 3.45 g/kg of ethanol which corresponds to a state of excessive ethanol consumption, given that rodents are less sensitive than human to intoxicating effects of ethanol.…”

“…Episodic excessive alcohol consumption commonly referred to as ''binge drinking'' is common cause of accidental death, violent behaviour as well as suicide, and may be associated with compromised myocardial contractility [1], cardiac arrhythmias, most frequently atrial fibrillation [2] and sudden death [3]. The mechanisms of alcoholic cardiomyopathy, including a) direct cardiotoxicity of ethanol and its major metabolite acetaldehyde, specifically inducing ischemia [4], b) increased production of reactive oxygen species such as hydrogen peroxide [5], c) disturbance in the intracellular calcium homeostasis [6], d) accumulation of fatty acid ethyl esters [7] and e) impaired mitochondrial function may be precipitating events.…”

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

“…The protective effects of beta blockade in the latter settings may in part be due to the inhibition of calcium influx into myocytes. The relationship between alcohol ingestion and VT/SCD is indisputable; what is controversial however, is its exact nature (876). A number of studies claim a J-shaped relationship with risk lowest in individuals with low alcohol intake (i.e., 2 to 6 drinks per week) compared with those who rarely or never consume alcohol (877) and those with a high alcohol intake (i.e., more than 3 to 5 drinks per day) (878,879) and binge drinking habits, the "holiday heart syndrome" (880 -883).…”

Alcohol‐induced Ventricular Fibrillation in Brugada Syndrome

“…1) But, to our knowledge, a clear relationship between Brugada syndrome and alcohol has not been reported.…”