Reversibility of Alcoholic Cardiomyopathy with Abstention from Alcohol

Abstract

A 46-year-old chronic alcoholic patient with typical and severe congestive cardiomyopathy was studied hemodynamically on two separate occasions. The second study followed after a 1½-year period of virtually complete abstention from alcohol and revealed that the left ventricular dysfunction had disappeared. Despite persisting atrial fibrillation, the response to moderate exercise and to plasma volume expansion was within the normal range. When last seen, 29 months after initial hospitalization, the patient was symptom-free and was not given any treatment.

Improvement of Left Ventricular Function in Chronic Alcoholics following Abstinence from Ethanol

“…Experimental stud ies in animals are in accordance with our interpretation; the impairment of uptake and binding of calcium by the sarcoplasmic reticulum and the decrease in left ventricular diastolic compliance related to interstitial collagen accumulation diminish myocardial contractility [33,34], These changes reverse after some months of abstinence [33]. It is also of interest that, following a prolonged period of abstinence in chronic alcoholics, left ventricular function is not impaired [35]; furthermore, in previous case reports, alco holic cardiomyopathy improved after stop ping alcohol intake [15][16][17][18].…”

“…-7% ; t = 1.3) did not change. In conclusion, in chronic alcoholics, the abstinence from alcohol can be followed by an improvement of left ventricular function.A cardiac disorder is frequently found in chronic alcoholics; it has a wide range, from preclinical cardiac malfunction [1][2][3][4][5][6][7][8] to an overt cardiomyopathy [9][10][11][12][13][14], Anecdotal reports on patients with car diomyopathy who improved after absti nence from alcohol are found in various pub lications [15][16][17][18]; however, the effect of alco …”

Reversibility of alcoholic cardiomyopathy

“…On the other hand, this case shows also that, although the initial clinical improvement can be rapid, the restoration of cardiac performance during abstinence either may remain incomplete or can take a much longer time than suggested by the previous case histories (Schwartz et al, 1975;Baudet et al, 1979;Hung et al, 1979). On clinical grounds alone, without the use of echocardiography, the rapidity of myocardial recovery would have been greatly overestimated in the present case.…”

“…By abstention from alcohol, the patients seemed to benefit so that 61% of abstaining patients were clinically improved in contrast with only 10% of those who continued heavy drinking. Moreover, three previous case reports (Schwartz, Sample and Wigle, 1975;Baudet et al, 1979;Hung et aL, 1979) have objectively shown that even severe degrees of congestive failure due to alcoholic heart muscle disease are potentially totally reversible. The recovery from overt failure to normal cardiac function in these patients took from 8-18 months.…”

Point mutations in mitochondrial DNA of patients with alcoholic cardiomyopathy

“…The prognosis, however, is not as poor as with DCM because abstinence from alcohol often improves the cardiac function. [4][5][6][7] Histologic analyses may support this difference, since we determined on using endomyocardial biopsies 8 that the degree of fibrosis, myocyte hypertrophy, or degeneration was milder in ACM than in DCM. These clinical and histologic characteristics may contribute to the reversibility of the cardiac dysfunction in ACM.…”