Recent data favored a role for micro RNA, such as the involvement of miR-378a-5p in cardiomyocyte apoptosis and ACM development through ALDH2 gene suppression [120]. Another curious hypothesis from Germany suspected that some ethanol additives, such as anti-foam beer products with arsenic or cobalt content, produced cardiac toxicity and development of ACM [71]. Therefore, it is evident that ACM may develop with normal serum thiamine and electrolyte levels [38,66]. Consumption of other drugs such as cocaine or tobacco may interact with ethanol and potentiate the final ethanol-related cardiac damage [22,72]. Before recognizing that ethanol itself is the etiological factor of ACM, different theories and hypotheses emerged [1,66].

Epidemiological studies

The liver is the most affected organ, since ethanol is mostly metabolized there [11,13], but gastrointestinal, central, and peripheral nervous systems; the heart and vascular system; endocrinological systems; nutrition; and musculo-skeletal systems are clearly affected [10]. In addition, ethanol is an immunosuppressive drug that is pro-inflammatory and pro-oncogenic [14,15,16,17]. Another nutritional factor classically involved in the pathophysiology of AC was cobalt excess. The ‘Quebec beer drinkers’ cardiomyopathy’ was related to cobalt supplementation to beer that was made in the past. It was described as a form of DCM with severe pericardial effusion, low cardiac output, and purplish skin coloration.

Differential Diagnosis

• Between 40% to 80% of people who continue to drink heavily will not survive more than 10 years after receiving this diagnosis.
• The point at which these abnormalities appear during the course of an individual’s lifetime of drinking, such that the abnormalities can be called a DCM, is not well established and is highly individualized.
• Along with developing heart damage, patients with ACM may also damage other organs, such as the liver, central and peripheral nervous system, skeletal muscle, pancreas, and digestive tract, and are exposed to an increased risk of cancer [24,63,64].
• There are no specific targeted histological or immunological biomarkers for the diagnosis of alcohol-induced cardiomyopathy.

Furthermore, alcohol consumption has also been classified in the literature by ranges of consumption as mild, moderate, and heavy drinking.11 In this regard, these categories have the following consumption thresholds that also differ according to sex. Elevations in troponin can signify heart damage or an increase in cardiac output that results in demand ischemia. This is where the heart has an increased need for oxygen that exceeds the body’s ability to supply it. In patients exhibiting chronic alcohol use, other causes of dilated cardiomyopathy need workup.

Is there an immediate risk of alcohol intake?

• If the disease is caught early, stopping alcohol use completely and taking certain medications can help restore the heart’s function.
• Various pathophysiological mechanisms have been postulated in the development of cardiomyopathy however one key factor undergoing active research is the role of genetic mutation and susceptibility to develop cardiomyopathy.
• Finally, it should be noted that a large majority of studies on the long-term prognosis of ACM used the cut-off point of 80 g/d for a minimum of 5 years to consider alcohol as the cause of DCM.
• According to recent data, a genetic form of DCM could be present in up to 50% of idiopathic DCM cases, and other specific forms of DCM such as peripartum cardiomyopathy have been shown to have a genetic basis in a significant number of cases[68].
• For comparison, the mean annual beer consumption in Bavaria is nowadays estimated to be 145 l and in the rest of Germany around 100 l beer per person and year [24].

The outlook for people with alcoholic cardiomyopathy varies depending on how long alcohol was abused and how much alcohol was consumed during that time. In cases where the damage to the heart is severe, the chances of complete recovery are low. Once the damage is considered irreversible, it’s difficult for the heart and rest of the body to recover.

• The quantity of alcohol consumed daily and the duration of alcohol misuse are linked to the development of ACM, although the precise thresholds for causing cardiac dysfunction remain unknown.
• However, consistent heavy drinking strains those protective processes — especially in your liver — making them less effective.
• This can cause heart inflammation, leading to an atypically fast heart rhythm, such as atrial fibrillation (AF).
• In addition, acetaldehyde is able to interact with proteins and produce protein-adduct compounds that are highly reactive and may induce additional inflammatory and immunologic heart damage [78].
• Alcoholic cardiomyopathy treatment may include medications, surgery, or a combination.
• There is also an established link between the development of ACM and apoptosis because of myocardial cell death, which contributes to heart pathology and dysfunction.

As a net effect, negative inotropism may result and contribute to heart failure. One of the few papers analysing genetic susceptibility in ACM was published by Fernández-Solà et al[64] in 2002. He compared the prevalence of different polymorphisms of the angiotensin-converting enzyme gene in 30 ACM patients and in 27 alcoholics with normal ventricular function. Furthermore, 89% of the alcoholics with a DD genotype developed ACM, whereas only 13% of those with an II or ID genotype developed this condition. However, this individual susceptibility mediated by polymorphisms of the angiotensin-converting enzyme gene does not appear to be specific to ACM insofar as several diseases, including some that are not of a cardiologic origin, have been related to this genetic finding[65]. Continued heavy alcohol use, on the other hand, will continue to make https://ecosoberhouse.com/ worse.

Basic studies on molecular mechanisms of myocardial damage

• Germany with a total population of 81 million inhabitants is a permissive society with respect to the drinking of alcohol.
• Complete alcohol withdrawal is usually recommended to all patients with ACM.
• Even in cases where people can undergo a heart transplant, individuals with a history of alcohol-induced cardiomyopathy are more likely to face other health problems down the road.
• It is crucial to exercise caution and be aware of individual tolerance and personal health circumstances when making decisions about alcohol consumption.
• Other lifestyle changes a person will likely need to make include reducing the amount of fluid they drink or salt they eat.