PMID- 8903537
OWN - NLM
STAT- MEDLINE
DCOM- 19970228
LR  - 20190512
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 19
IP  - 1
DP  - 1996 Jan
TI  - Prediction of recovery after abstinence in alcoholic cardiomyopathy: role of 
      hemodynamic and morphometric parameters.
PG  - 45-50
AB  - The aim of the study is to describe the hemodynamic and morphometric 
      characteristics of patients with alcoholic cardiomyopathy (ACM) and to evaluate 
      whether these parameters can identify the subgroup of patients in whom recovery 
      of cardiac function after abstinence will occur. Nineteen male patients (mean age 
      52.4 years, range 39-64 years) with symptomatic left ventricular dysfunction 
      (LVD) [ejection fraction (EF) <50%] and a history of chronic heavy alcohol intake 
      were submitted to a full invasive work-up including right ventricular 
      endomyocardial biopsy (EMB). Counseling aimed at obtaining abstention and 
      clinical follow-up were regularly performed in all patients. The two requisites 
      necessary to define recovery were (1) an increase in left ventricular EF, and (2) 
      improvement of symptoms. The former was defined as a gain in left ventricular EF 
      > 15% from baseline; the latter, as a gain of at least one New York Heart 
      Association (NYHA) functional class. Using these criteria, 9 alcoholic patients 
      (48%) (Group A) improved significantly, while 10 (52%) (Group B) either 
      stabilized or deteriorated at 2 years' follow-up. Group A patients had 
      significantly lower pulmonary artery mean pressure (27.8 mmHg +/- 13.3 vs. 40.3 
      mmHg +/- 12.4; p < 0.05) and pulmonary capillary wedge pressure (18.4 mmHg +/- 
      8.9 vs. 26.5 mmHg +/- 7.7; p < 0.05) compared with Group B. All other hemodynamic 
      data did not show statistically significant differences in the two groups. 
      Quantitative evaluation of myocardial hypertrophy and interstitial fibrosis 
      performed on EMB tissue samples using the morphometric approach was not 
      predictive of recovery. Improvement in cardiac performance and functional class 
      was detected in about one-half of patients with ACM who abstained from alcohol, 
      and occurred even in cases presenting with severe LVD. Recovery is associated 
      with significantly lower pulmonary artery and pulmonary wedge pressures. The 
      morphometric evaluation of EMB does not provide adjunctive prognostic information 
      in these patients.
FAU - La Vecchia, L L
AU  - La Vecchia LL
AD  - Division of Clinical Cardiology, University of Verona, Vicenza, Italy.
FAU - Bedogni, F
AU  - Bedogni F
FAU - Bozzola, L
AU  - Bozzola L
FAU - Bevilacqua, P
AU  - Bevilacqua P
FAU - Ometto, R
AU  - Ometto R
FAU - Vincenzi, M
AU  - Vincenzi M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Adult
MH  - Alcoholism/*rehabilitation
MH  - Biopsy
MH  - Cardiac Catheterization
MH  - Cardiomyopathy, Alcoholic/diagnosis/*physiopathology
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Prognosis
MH  - Ventricular Dysfunction, Left/diagnosis/*physiopathology
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - 10.1002/clc.4960190109 [doi]
PST - ppublish
SO  - Clin Cardiol. 1996 Jan;19(1):45-50. doi: 10.1002/clc.4960190109.