Alcoholic Cardiomyopathy in Patients With Advanced Alcoholic Liver Disease: Single-Center Experience and Review of Literature.

Abstract

The impact of excessive alcohol on human health is associated with a lifetime cumulative use of alcohol and is further affected by various factors such as age, gender, nutritional status, concurrent cigarette smoking or drug use, diabetes, obesity, other cardiovascular diseases, and socio-economic status. Alcohol cardiomyopathy (ACM) is a type of acquired dilated cardiomyopathy, which is associated with long-term heavy alcohol consumption with historical rates varying from 3.8% to 47 % among patients with heart failure. Data regarding the prevalence of concurrent ACM in patients with alcoholic liver disease is limited. Among 483 patients with advanced liver disease who underwent liver transplant evaluation at a single transplant center during 2016-2021, based on screening transthoracic echocardiogram and a clear definition, none (0%) of the patients had alcoholic cardiomyopathy (range ejection fraction: 55-80%), 7% had left ventricular dilation (mild dilation: 82%), and 12.4% had diastolic dysfunction. We also review data regarding known risk factors, natural progression, and treatment of ACM, and further explore the evidence regarding the concurrence of alcohol-associated disease in liver with other organs such as heart and pancreas. In persons with excessive alcohol consumption, abstinence from alcohol or moderating its use has been shown to help decrease the progression of heart failure, arrythmias, and hypertension as well as liver dysfunction. Focus on the identification of both genetic markers and modifiable risk factors associated with various organ injuries in conjunction with public health policies for the safe use of alcohol is needed to mitigate the risk of alcohol use disorder.