Alcoholic cardiomyopathy: literature review
AbstractAlcoholic cardiomyopathy (ACMP) is the most common form of myocardial damage caused by ethanol. The effects of ethanol on the myocardium are diverse and multi-faceted. Ethanol affects the composition and permeability of the plasma membrane, the functioning of cell channels, the activity of connexin and desmosomal contacts, the sensitivity of sarcomeres to calcium ions, and the structure of the cytoskeleton of myocytes. Particular importance in the pathogenesis of ACMP is connected with the ability of ethanol to cause structural and functional changes in mitochondria, induce apoptosis and autophagy, and disrupt protein synthesis.
ACMP is a variant of secondary dilated cardiomyopathy of current genesis with all the clinical manifestations and consequences of the latter: enlargement of the heart chambers, low ejection fraction and progressive cardiac insufficiency, various cardiac arrhythmias. A distinctive feature of ACMP is the potential reversibility of structural and functional changes in the myocardium when abstaining from ethanol consumption. Abstinence, along with the duration of the QRS interval, the level of systolic blood pressure, the functional class of heart failure according to the NYHA classification, and the presence of pulmonary hypertension, are considered as predictors of an unfavorable prognosis.
The treatment of ACMP consists of heart failure and arrhythmic syndrome correction in accordance with existing clinical recommendations provisions. In the terminal stage o f the disease, the possibility of installing a cardioverter defibrillator and heart transplantation is considered. New strategies for the treatment of patients with ACMP are being developed, aimed at reducing myocyte hypertrophy, interstitial fibrosis and persistent apoptosis, as well as stimulating cardiomyocyte regeneration.
Keywords:alcoholic cardiomyopathy; ethanol; review
Funding. The study had no sponsor support.
Conflict of interest. The author declares no conflict of interest.
For citation: Klemenov A.V. Alcoholic cardiomyopathy: literature review. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2024; 12 (1): 44–9. DOI: https://doi.org/10.33029/2309-1908-2024-12-1-44-49 (in Russian)
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