Ischemic cardiomyopathy/alcohol

[Syed Abid]

I am not clear about two things
1- Caridiomyopathy is primary disease of myocardium, excluding HTN, IHD, Valvular heart disease. but I have read many times the term 'ISHEMIC CARDIOMYOPATHY' AND in one book most common cause of Dialted CMP is hypertension. what these contradictions mean?
2- Alcohol perhaps has been included in carcinogens by FDA but moderate quantity helps prevent IHD. What is the current recomnendations about alcohol by the doctors of FDA. can one take it in moderation or not at all?



thanks

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[bicycle]

1. Ischemic Cardiomyopathy is a misnomer. You are right, a cardiomyopathy is a primary disease of myocardium, and the term Ischemic Cardiomyopathy is a commonly used (but inaccurate) term refering to heart failure secondary to coronary artery disease (accumulation of hibernating and scarred myocardium). It is not a true cardiomyopathy.

2. Moderate alcohol consumption is defined as no more than 2 drinks per day where one drink = one beer, glass of wine, or 4 oz shot of alcohol. This is widely accepted as "cardioprotective" consumption as people in this range do better than heavy drinkers and also abstainers.

 

[ernie]

the heart only has 2 ways to compensate for decreased output - increase chamber size and/or increase wall thickness. In real life, these events happen together

1. ischemic cardiomyopathy is not necesarily a misnomer. The myocardium is damaged from lack of oxygen over time resulting in patchy ischemic damagae - Output decreases, heart adopts above response of dillation resulting in "cardiomyopathy."

2. alcohol is protective against atherosclerosis but is toxic to myocardium resulting in dilated cardiomyopathy.

 

[raptor5]

the heart only has 2 ways to compensate for decreased output - increase chamber size and/or increase wall thickness. In real life, these events happen together

1. ischemic cardiomyopathy is not necesarily a misnomer. The myocardium is damaged from lack of oxygen over time resulting in patchy ischemic damagae - Output decreases, heart adopts above response of dillation resulting in "cardiomyopathy."

2. alcohol is protective against atherosclerosis but is toxic to myocardium resulting in dilated cardiomyopathy.

Question. Are the toxic effects of EtOH such that they lead to myocyte cell death, inflammation, and subsequent remodeling and fibrosis with the end result being a dilated cardiomyopathy that is increasingly inefficient due to decreased muscle mass? Just too lazy to look it up. Thanks.

 

[Dr. J?]

Question. Are the toxic effects of EtOH such that they lead to myocyte cell death, inflammation, and subsequent remodeling and fibrosis with the end result being a dilated cardiomyopathy that is increasingly inefficient due to decreased muscle mass? Just too lazy to look it up. Thanks.

I thought it had more to do with the toxic effects of EtOH on the VSMC in the systemic arterioles. EtOH causes malfunctioning of the mitochondria, decrease in available ATP, consequent vasodilation of arterioles (primary determinant of SVR), increase in the amt of blood returning to the venous (capacitance) side, increase in CVP, as well as, blood return to the RV (and therefore LV), causing VOLUME OVERLOAD and thus a DILATED CARDIOMYOPATY