Alcoholic cardiomyopathy can improve without complete abstinence

NEW YORK (Reuters Health) – In men with alcoholic cardiomyopathy, cardiac function improves with moderated drinking as well as with abstinence, researchers report in the February 5th issue of the Annals of Internal Medicine.

Dr. Emanuel Rubin from Jefferson Medical College, Philadelphia, and colleagues studied 55 men, 31 to 59 years of age, with alcoholic cardiomyopathy who had been consuming at least 100 g of ethanol per day for a minimum of 10 years. The investigators note that "abstinence is thought to be essential to halt further deterioration of cardiac contractility in such patients."

During the first year of the study 17 patients stopped drinking, 15 limited their alcohol consumption to 20 to 60 g of ethanol per day and 16 patients continued drinking more than 80 g of ethanol per day.

Men who had stopped drinking by the first year of evaluation, showed a significant improvement in left ventricular function, with a mean increase in left ventricular ejection fraction of 0.131. A similar improvement was also seen among men who limited their drinking (mean increase in left ventricular fraction 0.125), the researchers report.

However, patients who continued to consume high quanties of alcohol had further deterioration of left ventricular ejection fraction, Dr. Rubin's group found.

Among men who abstained or who controlled their alcohol intake, injection fraction continued to improve during the 4-year study. However, of the patients who continued to abuse alcohol, 10 died during the study period, the team notes.

Despite these findings, Dr. Rubin and colleagues stress that "abstinence remains the cornerstone of any alcohol treatment program and continues to be recommended to all alcoholic patients with dilated cardiomyopathy."

"What to do with this kind of information is, of course, problematic," Dr. Joshua Wayne from Harper Hospital in Detroit writes in a journal editorial. "Are we really to encourage the use of moderate alcohol consumption, even though we are aware of its multiple (potential) deleterious effects? I think not."

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