Takehana H, Izumi T
Department of Internal Medicine, Kitasato University School of Medicine.
Nihon Rinsho. 2000 Jan;58(1):151-6.
Alcoholic heart disease is caused by a lifestyle in which alcoholics are continue to consume an excessive amount of alcohol over a long period of time. Total abstinence is a very effective way to treat them to prevent the development of the final stage of this disease. In contrast, repetitive drinking of massive amount of alcohol is very harmful and causes exacerbation of this disease. From our clinical studies, six candidates were nominated as symptoms of alcoholic heart disease, namely(1) tachyarrhythmias (incidence: 33%), (2) left ventricular hypokinesis(17%), (3) QT interval prolongation(17%), (4) hyperthickened LV wall(13%), (5) LV dilatation with pump failure: alcoholic cardiomyopathy(0.1%), and (6) sudden cardiac death (unknown %). In the beginning of alcoholic heart disease, the patient usually complains of no symptoms, and physical signs are quite poor. Ordinarily, either transient atrial fibrillation and/or left ventricular hypertrophy which is initially documented by electrocardiography or echocardiography is one of the first signals in the diagnosis. Without such early signals, an early diagnosis is impossible. To make a definite diagnosis of alcoholic heart disease, a clinical follow-up is by all means necessary. Improvement of cardiac function after total abstinence, it's worsening after drinking again, and again improvement after abstinence a second time is a diagnostic clue. In this follow-up study, electrocardiography and echocardiography were employed as important ways to gather date. In treatment, total abstinence is essential. To achieve this therapeutic goal, education of the patient is necessary, because approximately 70 per cent of patients with alcoholic heart disease fail to continue abstinence within two years even if they have good training.
酒精性心脏病是由一种生活方式引起的，即酗酒者长期持续过量饮酒。完全戒酒是治疗他们以预防该疾病发展到终末期的一种非常有效的方法。相比之下，反复大量饮酒非常有害，会导致该疾病恶化。根据我们的临床研究，有六种情况被认定为酒精性心脏病的症状，即：（1）快速性心律失常（发生率：33%），（2）左心室运动减弱（17%），（3）QT间期延长（17%），（4）左心室壁增厚（13%），（5）左心室扩张伴泵衰竭：酒精性心肌病（0.1%），以及（6）心源性猝死（未知百分比）。在酒精性心脏病初期，患者通常没有症状主诉，体征也很不明显。通常，最初通过心电图或超声心动图记录到的短暂性心房颤动和/或左心室肥厚是诊断的首批信号之一。没有这些早期信号，就不可能早期诊断。要明确诊断酒精性心脏病，临床随访是绝对必要的。完全戒酒之后心脏功能改善，再次饮酒后病情恶化，再次戒酒又改善，这是一个诊断线索。在这项随访研究中，心电图和超声心动图被用作收集数据的重要手段。在治疗方面，完全戒酒至关重要。为实现这一治疗目标，对患者进行教育是必要的，因为即使接受了良好的培训，约70%的酒精性心脏病患者在两年内仍无法持续戒酒。
