RELATIONSHIP BETWEEN CARDIOMYOPATHY AND LIVER-DISEASE IN CHRONIC-ALCOHOLISM

Based on anecdotal impressions, there is a common clinical perception that alcoholics with liver disease do not develop cardiomyopathy and t hat those with alcohol-induced cardiac disease are spared cirrhosis. T o determine the relationship between alcoholic cardiomyopathy and cirr hosis, we carried out a prospective cross-sectional study that include d: (1) 30 alcoholic men with cardiomyopathy; (2) 30 alcoholic men with out cardiomyopathy (left ventricular ejection fraction > 55%); (3) 20 actively drinking alcoholics with cirrhosis; (4) 15 abstaining alcohol ics with cirrhosis; and (5) 15 nonalcoholics with cirrhosis of other e tiologies, Cirrhosis was observed in 13 of 30 patients with alcoholic cardiomyopathy (43%), compared with 2 of 30 alcoholics without cardiom yopathy (6%) (P < .001). Ten of the 20 active alcoholics with cirrhosi s (50%) showed evidence of dilated cardiomyopathy. Actively drinking a lcoholics with cirrhosis had a significantly lower mean ejection fract ion and shortening fraction, as well as a greater mean end-diastolic d iameter and left ventricular mass than abstaining alcoholics with cirr hosis, Cardiac studies of patients with nonalcoholic cirrhosis were no rmal. We conclude that a positive correlation exists between alcoholic cardiomyopathy and cirrhosis, Alcoholics admitted solely for cardiomy opathy have a higher prevalence of cirrhosis than unselected alcoholic s without heart disease. Actively drinking alcoholics admitted only fo r cirrhosis show impaired cardiac performance, whereas abstaining alco holics with liver disease tend to manifest normal cardiac function.