Estruch R, Fernández-Solá J, Mont L, Grau J M, Paré C, Navarro F, Urbano-Márquez A
Med Clin (Barc). 1989 Jan 21;92(2):69-71.
The sustained alcohol intake results in the development of a dilated cardiomyopathy; its pathogenesis and prognostic and evolutive factors have not yet been completely defined. It is classically considered that alcoholic cardiomyopathy has a poor prognosis, as two thirds of patients die within three years. However, in recent years some isolated cases of clinical reversibility after short abstinence periods have been reported without identification of the involved factors. Two chronic alcoholic patients are reported with congestive heart failure at admission; a diagnosis of alcoholic cardiomyopathy was made after cardiac catheterization and endomyocardial biopsy. The morphometric study of endomyocardial biopsy showed a preservation of the myofibrillary fraction with mild fibrosis. The clinical outcome was favorable: after three months of alcoholic abstinence, a complete clinical recovery with definite improvement of echocardiographic parameters and left ventricular ejection fraction in the radionuclide ventriculography were observed. Finally, the factors that appear to be involved in the presence or absence of reversibility of this type of cardiomyopathy are discussed.
持续饮酒会导致扩张型心肌病的发生；其发病机制、预后及演变因素尚未完全明确。传统观点认为酒精性心肌病预后较差，因为三分之二的患者会在三年内死亡。然而，近年来有报道称，少数患者在短期戒酒之后出现了临床可逆的孤立病例，但尚未明确其中涉及的因素。本文报告了两名慢性酒精中毒患者，入院时均患有充血性心力衰竭；经心导管检查和心内膜心肌活检后诊断为酒精性心肌病。心内膜心肌活检的形态学研究显示，肌原纤维部分保存，伴有轻度纤维化。临床结果良好：戒酒三个月后，观察到临床完全恢复，超声心动图参数和放射性核素心室造影中的左心室射血分数有明显改善。最后，本文讨论了与这类心肌病可逆性存在或不存在相关的因素。
