ABSTRACT
The ingestion of alcohol in excessive quantities causes both metabolic and functional abnormalities in the heart, including diastolic dysfunction, atrial fibrillation, myofibrillary disarray and raised cardiac enzyme activities [1-5]. Left ventricular hypertrophy or cardiomegaly may be present. As an approximation, alcoholic cardiomyopathy (ACM) may be associated with an alcohol consumption of 80 g ethanol/day, with a duration of continuous exposure in excess of 10 years or more, or a cumulative ethanol ingestion of 250 kg. Cumulative alcohol intake correlates inversely with cardiac ejection fraction and directly with left ventricular mass [4]. In the latter study of some 52 alcoholic subjects, regression analysis of the author’s data showed that ejection fractions of 55% or less were obtained when the total cumulative ethanol intake was approximately 1400 kg of ethanol (assuming that average body weight was 70 kg [4]). The proposition that cumulative (as opposed to immediate) intake of alcohol is important in the genesis of alcoholic cardiomyopathy is supported by observations showing that this disease entity is uncommon in subjects under 40 years of age [6,7]. However, a pre-clinical form of alcoholic cardiomyopathy may be apparent only after stress or additional pathophysiological stimuli in some subjects [6,7].
