Alcoholic Cardiomyopathy

ABC

Case Report

Reversal of Left Bundle Branch Block Following Treatment in Alcoholic Cardiomyopathy

Manuela Cristina Ribeiro Dias Barroso et al. Heleutério da Conceição Nicolau Madogolele Deborah de Sá Pereira Belfort Bruno Biselli … Silvia Moreira Ayub-Ferreira Edimar Alcides Bocchi

Introduction

Left bundle branch block occurs in the context of several cardiomyopathies; however, its reversal is rarely described. We describe a case of alcoholic cardiomyopathy with left bundle branch block that presented reversal after institution of targeted treatment and alcohol cessation.

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ABCHF

Review Article

Toxic Cardiomyopathies: Alcohol, Amphetamines, and Anabolic Steroids

Humberto Villacorta et al. Monica S. Avila Germano Emilio Conceição Souza Simone Louise Savaris … Gustavo Arruda Braga Wolney de Andrade Martins

Abstract

Toxic cardiomyopathies include those caused by drug abuse, as well as chemotherapy agents. This review addresses cardiomyopathies induced by alcoholism, amphetamines, and anabolic steroids, focusing on their pathophysiology, clinical presentation, treatment, and prognosis. Alcoholic cardiomyopathy is frequent and predominates in males. It is dose-dependent, with a probable genetic predisposition. Women are susceptible at lower doses of alcohol intake. The disease ranges from a subclinical asymptomatic form to the typical form of dilated cardiomyopathy with systolic dysfunction and heart failure with reduced ejection fraction (HFrEF). Diagnosis is based on history and exclusion of other etiologies. Treatment is similar to other forms of heart failure, and prognosis depends on cessation of alcoholism. The use of amphetamines has increased, as has the incidence of secondary cardiomyopathy. The majority of patients are young and male. The pathophysiology is multifactorial. Diagnosis is based on history. During the acute phase, there is adrenergic hyperactivity. Treatment is similar to other etiologies of HFrEF. Not infrequently, patients progress to cardiogenic shock and require circulatory support and indication for heart transplantation. Cardiomyopathy secondary to use of anabolic steroids usually occurs in young men. Anabolic steroids have a direct or indirect impact on the cardiovascular system, through their risk factors. Presentation can range from asymptomatic to cardiogenic shock. It is imperative to discontinue anabolic steroid use and institute guidelines-based therapies, usually with reverse remodeling and favorable prognosis.

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ABC

Artigo Original

The significance of alcohol abstinence in alcoholic cardiomyopathy with moderate left ventricular dysfunction

Francisco Manes Albanesi Fº et al. Márcia Bueno Castier Silvia Helena Cardoso Boghossian Tatiana Tavares da Silva

PURPOSE: To evaluate the role of a 12 month alcohol abstinence period in patients with moderate left ventricular dysfunction treated with anticongestive therapy. METHODS: Prospective observational study with 20 patients with alcoholic cardiomyopathy (ACM), 9 (45%) in functional class (FC) II and 11 (55%) in FC III, 16 (80%) men, mostly black (55%), from 35 to 56 (x=45) years old, heavy alcohol users (>80g ethanol for 51 to 112 (x=88) months. At the beginning, all agreed to participate with psychotherapy and clinical evaluation. After 12 months, they were divided in G-I, formed by those who remained abstemious and G-II of non-abstemious. RESULTS: After 12 months, among the 11(55%) who remained in psychotherapy, 8 were in G-I, among those who did not 9 (45%), only 2 (22,22%) remained abstemious (G-I). At the end of the evaluation period, both groups had the same number of patients. Comparing them, we observed: a) lower mean systolic and diastolic left ventricular diameters in G-I; b) more hospitalizations in G-II (3); c) more patients with stable or better clinical evolution in G-I. CONCLUSION: Despite the initial will, only 50% reached abstinence. When it was reached, patients had a better evolution in left ventricular systolic diameter and abstinence should always be tried even in the presence of moderate left ventricular dysfunction.

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Reversal of Left Bundle Branch Block Following Treatment in Alcoholic Cardiomyopathy

Introduction

Toxic Cardiomyopathies: Alcohol, Amphetamines, and Anabolic Steroids

Abstract

The significance of alcohol abstinence in alcoholic cardiomyopathy with moderate left ventricular dysfunction

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