Skip Navigation

European Heart Journal 2000 21(4):306-314; doi:10.1053/euhj.1999.1761
Copyright © 2000 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (22)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Fauchier, L.
Right arrow Articles by Fauchier, J.P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fauchier, L.
Right arrow Articles by Fauchier, J.P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Comparison of long-term outcome of alcoholic and idiopathic dilated cardiomyopathy

L. Fauchiera, D. Babutya, P. Poreta, D. Casset-Senonb, M.L. Autreta, P. Cosnaya and J.P. Fauchiera

a Service de Cardiologie B et Laboratoire d'électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Tours, France
b Service de Médecine Nucléaire et Ultrasons, Centre Hospitalier Universitaire Trousseau, Tours, France

revised June 11, 1999; accepted June 16, 1999

Abstract

Aims The outcome of alcoholic cardiomyopathy is thought to be better than idiopathic dilated cardiomyopathy if patients abstain from alcohol. The aim of this study was to compare the long-term clinical outcome of alcoholic and idiopathic dilated cardiomyopathy.

Methods and Results Of 134 patients with dilated cardiomyopathy and normal coronary angiography, 50 had alcoholic cardiomyopathy; they were compared serially to 84 patients with idiopathic dilated cardiomyopathy. Left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiac index, severity of ventricular arrhythmias, measurement of heart rate variability and results of signal-averaged ECG were similar in both groups. Although alcohol withdrawal was strongly recommended but observed in only 70% of patients with alcoholic cardiomyopathy, both groups had similar outcome in terms of cardiac death after follow-up treatment of 47±40 months. Multivariate analysis in the entire cohort demonstrated that increased pulmonary capillary wedge pressure (P=0·003), alcoholism and lack of abstinence during follow-up (P=0·006) and decreased standard deviation of all normal-to-normal RR intervals (P=0·02) were independent predictors of cardiac death.

Conclusion In contrast with previous studies, patients with alcoholic cardiomyopathy did not have a better outcome than patients with idiopathic dilated cardiomyopathy. Alcoholism without abstinence was a strong predictor of cardiac death. This suggests that a more aggressive approach to alcohol cessation is needed in these patients.

Key Words: Alcohol, cardiomyopathy, heart failure, prognosis

Correspondence: Laurent Fauchier, MD, Service de Cardiologie B, Centre Hospitalier Universitaire Trousseau, 37044 Tours, France.

References

  1. Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med. 1994;331:1565–1575
  2. Demakis JG, Proskey A, Rahimtoola SH. The natural course of alcoholic cardiomyopathy. Ann Intern Med. 1974;80:293–297[CrossRef][Web of Science][Medline]
  3. Prazak P, Pfisterer M, Osswald S, Buser P, Burkart F. Differences of disease progression in congestive heart failure due to alcoholic as compared to idiopathic dilated cardiomyopathy. Eur Heart J. 1996;17:251–257[Abstract/Free Full Text]
  4. Guillo P, Mansourati J, Maheu B. Long-term prognosis in patients with alcoholic cardiomyopathy and severe heart failure after total abstinence. Am J Cardiol. 1997;79:1276–1278[CrossRef][Web of Science][Medline]
  5. Coignard E, Blanchard B, Jault F. Alcoholic cardiomyopathy and cardiac transplantation. Arch Mal Coeur. 1998;91:45–51
  6. Richardson P, McKenna W, Bristow M. Report of the 1995 World Health Organization/International Society and Federation of Cardiology. Task force on the definition and classification of cardiomyopathies. Circulation. 1996;93:841–842[Free Full Text]
  7. Lown B, Wolff M. Approaches to sudden death from coronary heart disease. Circulation. 1971;44:130–142[Abstract/Free Full Text]
  8. Breithardt G, Cain ME, el-Sherif N. Standards for analysis of ventricular late potentials using high resolution or signal-averaged electrocardiography. A statement by a task force committee of the European Society of Cardiology, the American Heart Association, and the American College of Cardiology. Circulation. 1991;83:1481–1488[Abstract/Free Full Text]
  9. Hinkle LE, Thaler JT. Clinical classification of cardiac deaths. Circulation. 1982;65:457–464[Abstract/Free Full Text]
  10. Ponikowski P, Anker SD, Chua TP. Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1997;79:1645–1650[CrossRef][Web of Science][Medline]
  11. Fauchier L, Babuty D, Cosnay P, Autret ML, Fauchier JP. Heart rate variability in idiopathic dilated cardiomyopathy: characteristics and prognostic value. J Am Coll Cardiol. 1997;30:1009–1014[Abstract]
  12. Nolan J, Batin PD, Andrews R. Prospective study of heart rate variability and mortality in chronic heart failure. Results of the United Kingdom Heart Failure Evaluation and Assessment of Risk Trial (UK-Heart). Circulation. 1998;98:1510–1516[Abstract/Free Full Text]
  13. Di Lenarda A, Secoli G, Perkan A. Changing mortality in dilated cardiomyopathy. Br Heart J. 1994;72:S46–S51
  14. Komajda M, Jais JP, Reeves F. Factors predicting mortality in idiopathic dilated cardiomyopathy. Eur Heart J. 1990;11:824–831[Abstract/Free Full Text]
  15. Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO, Frye RL. The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol. 1981;47:525–531[CrossRef][Web of Science][Medline]
  16. Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV. Factors influencing the one year mortality of dilated cardiomyopathy. Am J Cardiol. 1984;54:147–152[CrossRef][Web of Science][Medline]
  17. Diaz RA, Obasohan A, Oakley CM. Prediction of outcome in dilated cardiomyopathy. Br Heart J. 1987;58:393–399[Abstract/Free Full Text]
  18. Sugrue DD, Rodeheffer RJ, Codd MB, Ballard DJ, Fuster V, Gersh BJ. The clinical course of idiopathic dilated cardiomyopathy: a population-based study. Ann Intern Med. 1992;117:117–123[Abstract/Free Full Text]
  19. Hofmann T, Meinertz T, Kasper W. Mode of death in idiopathic dilated cardiomyopathy: a multivariate analysis of prognostic determinants. Am Heart J. 1988;116:1455–1463[CrossRef][Web of Science][Medline]
  20. Urbano-Marquez A, Estruch R, Navarro-Lopez F, Grau JM, Mont L, Rubin E. The effects of alcoholism on skeletal and cardiac muscle. N Engl J Med. 1989;320:409–415[Abstract]
  21. Kupari M, Koskinen P. Relation of left ventricular function to habitual alcohol consumption. Am J Cardiol. 1993;72:1418–1424[CrossRef][Web of Science][Medline]
  22. Ettinger PO, Wu CF, De La Cruz C Jr, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the ‘Holiday Heart’: alcohol-associated cardiac rhythm disorders. Am Heart J. 1978;95:555–562[CrossRef][Web of Science][Medline]
  23. Buckingham TA, Kennedy HL, Goenjian AK. Cardiac arrhythmias in a population admitted to an acute alcoholic detoxification center. Am Heart J. 1985;110:961–965[CrossRef][Web of Science][Medline]
  24. Pochmalicki G, Genest M, Jibril H. Late ventricular potentials and heavy drinking. Heart. 1997;78:163–165[Abstract/Free Full Text]
  25. Circulation. 1996;93:1043–1065[Free Full Text]
  26. Malpas SC, Whiteside EA, Maling TJ. Heart rate variability and cardiac autonomic function in men with chronic alcohol dependence. Br Heart J. 1991;65:84–88[Abstract/Free Full Text]
  27. Yokoyama A, Takagi T, Ishii H. Impaired autonomic nervous system in alcoholics assessed by heart rate variation. Alcohol Clin Exp Res. 1991;15:761–765[CrossRef][Web of Science][Medline]
  28. Weise F, Muller D, Krell D, Kielstein V, Koch RD. Heart rate variability in chronic alcoholics: a follow-up. Drug Alcohol Depend. 1986;17:365–368[CrossRef][Web of Science][Medline]
  29. Pearson TA. Alcohol and heart disease. Circulation. 1996;94:3023–3025[Free Full Text]
  30. Klatsky AL, Armstrong MA, Friedman GD. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. Am J Cardiol. 1990;66:1237–1242[CrossRef][Web of Science][Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J Heart FailHome page
I. Laonigro, M. Correale, M. Di Biase, and E. Altomare
Alcohol abuse and heart failure
Eur J Heart Fail, May 1, 2009; 11(5): 453 - 462.
[Abstract] [Full Text] [PDF]

Home page
 ESC Textbook of Cardiovascular MedicineHome page
O. M. Hess, W. McKenna, and H.-P. Schultheiss
CHAPTER 18 Myocardial Disease
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Pathol.Home page
D. M. Yoerger, C. A. Best, B. M. McQuillan, G. E. Supple, J. L. Guererro, J. E. Cluette-Brown, A. Hasaba, M. H. Picard, J. R. Stone, and M. Laposata
Rapid Fatty Acid Ethyl Ester Synthesis by Porcine Myocardium Upon Ethanol Infusion into the Left Anterior Descending Coronary Artery
Am. J. Pathol., May 1, 2006; 168(5): 1435 - 1442.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Pathol.Home page
L. Wang, Z. Zhou, J. T. Saari, and Y. J. Kang
Alcohol-Induced Myocardial Fibrosis in Metallothionein-Null Mice: Prevention by Zinc Supplementation
Am. J. Pathol., August 1, 2005; 167(2): 337 - 344.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. Aguilar, H. Skali, L. A. Moye, E. F. Lewis, J. M. Gaziano, J. D. Rutherford, L. H. Hartley, O. S. Randall, E. M. Geltman, G. A. Lamas, et al.
Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction
J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2015 - 2021.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
L. Fauchier
Alcoholic Cardiomyopathy and Ventricular Arrhythmias
Chest, April 1, 2003; 123(4): 1320 - 1320.
[Full Text] [PDF]

Home page
 ChestHome page
M. R. Piano
Alcoholic Cardiomyopathy* : Incidence, Clinical Characteristics, and Pathophysiology
Chest, May 1, 2002; 121(5): 1638 - 1650.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A.H.M.M. Balk
Dilated cardiomyopathy, are a few drinks allowed?
Eur. Heart J., February 2, 2000; 21(4): 267 - 269.
[PDF]

This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (22)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Fauchier, L.
Right arrow Articles by Fauchier, J.P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fauchier, L.
Right arrow Articles by Fauchier, J.P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?