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瓶中的心痛:了解酒精性心肌病

Heartache in a Bottle: Understanding Alcoholic Cardiomyopathy.

作者信息

Ihekire Nkechinyere L, Okobi Okelue E, Adedoye Enoobong Aderonke, Akahara Patience F, Onyekwere Anita O, Afrifa-Yamoah Jeffrey, Akinyemi Falilatu B

机构信息

Internal Medicine, Windsor University School of Medicine, Cayon, KNA.

Family Medicine, Medficient Health Systems, Laurel, USA.

出版信息

Cureus. 2023 Aug 3;15(8):e42886. doi: 10.7759/cureus.42886. eCollection 2023 Aug.

Abstract

Alcoholic cardiomyopathy (ACM) is a cardiac ailment marked by impaired contraction and dilation of one or both ventricles of the heart. The extent of daily alcohol intake and duration of alcohol abuse are linked to the development of ACM, although the exact thresholds and timeline for alcohol misuse to induce heart dysfunction remain uncertain. Thus, the objective of this systematic review is to comprehensively evaluate the existing knowledge on the specific disease entity, particularly in light of the ongoing issue of alcohol misuse, with the intention of determining if recent advancements and discoveries have significantly altered the understanding of this condition compared to the past century. This systematic review involved a literature search that was conducted on PubMed to identify suitable and appropriate literature for the study. The inclusion criteria encompassed articles that focused on ACM or the relationship between alcohol abuse and cardiac dysfunction, involved human subjects or relevant animal models, were written in the English language, and were published within the last 10 years. The exclusion criteria included duplicates, case reports, letters, editorials, and reviews not specifically addressing ACM. As a result, a total of 18 articles were included in this systematic review. The risk of bias was assessed through the use of the Cochrane risk-of-bias tool for clinical trials. The findings of this systematic review indicated that the likelihood of ACM occurrence significantly rose when the consumption of over 80 g of alcohol per day occurred for at least five years. The systematic review further revealed that ACM is associated with various detrimental changes in the cellular, structural, and histological aspects of the heart muscles, even though the specific clinical and histological characteristics of ACM have yet to be established. In individuals with an extensive history of excessive alcohol abuse, the diagnosis of ACM was reached through the exclusion of other potential causes of the condition. The fundamental approach to treatment lies in abstaining from alcohol. It is crucial to manage symptoms in individuals with secondary heart failure and address any related complications.

摘要

酒精性心肌病(ACM)是一种心脏疾病,其特征是心脏一个或两个心室的收缩和舒张功能受损。每日酒精摄入量和酒精滥用持续时间与ACM的发生有关,尽管导致心脏功能障碍的酒精滥用的确切阈值和时间线仍不确定。因此,本系统评价的目的是全面评估关于这一特定疾病实体的现有知识,特别是鉴于持续存在的酒精滥用问题,旨在确定与过去一个世纪相比,近期的进展和发现是否显著改变了对这种疾病的认识。本系统评价涉及在PubMed上进行文献检索,以确定适合该研究的文献。纳入标准包括关注ACM或酒精滥用与心脏功能障碍之间关系的文章,涉及人类受试者或相关动物模型,用英语撰写,并在过去10年内发表。排除标准包括重复文章、病例报告、信件、社论以及未专门论述ACM的综述。结果,本系统评价共纳入18篇文章。通过使用Cochrane临床试验偏倚风险工具评估偏倚风险。本系统评价的结果表明,当每天饮酒超过80克至少持续五年时,发生ACM的可能性显著增加。该系统评价还进一步揭示,尽管ACM的具体临床和组织学特征尚未确定,但它与心肌细胞、结构和组织学方面的各种有害变化有关。在有大量过度饮酒史的个体中,通过排除该病症的其他潜在原因来诊断ACM。治疗的基本方法是戒酒。对继发性心力衰竭患者进行症状管理并处理任何相关并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b95/10474910/efb606fbd27b/cureus-0015-00000042886-i01.jpg

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