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Alcoholic Cardiomyopathy: Pathophysiologic Insights

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Abstract

Alcoholic cardiomyopathy (ACM) is a specific heart muscle disease found in individuals with a history of long-term heavy alcohol consumption. ACM is associated with a number of adverse histological, cellular, and structural changes within the myocardium. Several mechanisms are implicated in mediating the adverse effects of ethanol, including the generation of oxidative stress, apoptotic cell death, impaired mitochondrial bioenergetics/stress, derangements in fatty acid metabolism and transport, and accelerated protein catabolism. In this review, we discuss the evidence for such mechanisms and present the potential importance of drinking patterns, genetic susceptibility, nutritional factors, race, and sex. The purpose of this review is to provide a mechanistic paradigm for future research in the area of ACM.

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References

  1. Maron, B. J., Towbin, J. A., Thiene, G., Antzelevitch, C., Corrado, D., Arnett, D., et al. (2006). Contemporary definitions and classification of the cardiomyopathies: An American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation, 113, 1807–1816.

    Article  PubMed  Google Scholar 

  2. Fernandez-Sola, J., Preedy, V. R., Lang, C. H., Gonzalez-Reimers, E., Arno, M., Lin, J. C., et al. (2007). Molecular and cellular events in alcohol-induced muscle disease. Alcoholism, Clinical and Experimental Research, 31, 1953–1962.

    Article  PubMed  CAS  Google Scholar 

  3. Piano, M. R. (2002). Alcoholic cardiomyopathy: Incidence, clinical characteristics, and pathophysiology. Chest, 121, 1638–1650.

    Article  PubMed  Google Scholar 

  4. Fauchier, L., Babuty, D., Poret, P., Casset-Senon, D., Autret, M. L., Cosnay, P., et al. (2000). Comparison of long-term outcome of alcoholic and idiopathic dilated cardiomyopathy. European Heart Journal, 21, 306–314.

    Article  PubMed  CAS  Google Scholar 

  5. McKenna, C. J., Codd, M. B., McCann, H. A., & Sugrue, D. D. (1998). Alcohol consumption and idiopathic dilated cardiomyopathy: A case control study. American Heart Journal, 135, 833–837.

    Article  PubMed  CAS  Google Scholar 

  6. Kupari, M., Koskinen, P., Suokas, A., & Ventilä, M. (1990). Left ventricular filling impairment in asymptomatic chronic alcoholics. American Journal of Cardiology, 66(20), 1473–1477.

    Article  PubMed  CAS  Google Scholar 

  7. Askanas, A., Udoshi, M., & Sadjadi, S. A. (1980). The heart in chronic alcoholism: A noninvasive study. American Heart Journal, 99(1), 9–16.

    Article  PubMed  CAS  Google Scholar 

  8. Silberbauer, K., Juhasz, M., Ohrenberger, G., & Hess, C. (1988). Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in young alcoholics. Cardiology, 75(6), 431–439.

    Article  PubMed  CAS  Google Scholar 

  9. Lazarevic, A. M., Nakatani, S., Neskovic, A. N., Marinkovic, J., Yasumura, Y., Stojicic, D., et al. (2000). Early changes in left ventricular function in chronic asymptomatic alcoholics: Relation to the duration of heavy drinking. Journal of the American College of Cardiology, 35, 1599–1606.

    Article  PubMed  CAS  Google Scholar 

  10. Mathews, E. C, Jr, Gardin, J. M., Henry, W. L., Del Negro, A. A., Fletcher, R. D., Snow, J. A., et al. (1981). Echocardiographic abnormalities in chronic alcoholics with and without overt congestive heart failure. The American Journal of Cardiology, 47, 570–578.

    Article  PubMed  Google Scholar 

  11. Urbano-Marquez, A., Estruch, R., Navarro-Lopez, F., Grau, J. M., Mont, L., & Rubin, E. (1989). The effects of alcoholism on skeletal and cardiac muscle. The New England Journal of Medicine, 320, 409–415.

    Article  PubMed  CAS  Google Scholar 

  12. Graves, E. J. (1995). Detailed diagnoses and procedures, National Hospital Discharge Survey, 1993. Vital and Health Statistics. Series 13, Data from the National Health Survey (pp. 1–288).

  13. Gavazzi, A., De Maria, R., Parolini, M., & Porcu, M. (2000). Alcohol abuse and dilated cardiomyopathy in men. The American Journal of Cardiology, 85, 1114–1118.

    Article  PubMed  CAS  Google Scholar 

  14. McKenna, C. J., Codd, M. B., McCann, H. A., & Sugrue, D. D. (1998). Alcohol consumption and idiopathic dilated cardiomyopathy: A case control study. American Heart Journal, 135, 833–837.

    Article  PubMed  CAS  Google Scholar 

  15. Hookana, E., Junttila, M. J., Kaikkonen, K. S., Ukkola, O., Kesaniemi, Y. A., Kortelainen, M. L., et al. (2012). Comparison of family history of sudden cardiac death in nonischemic and ischemic heart disease. Circulation. Arrhythmia and Electrophysiology, 5, 757–761.

    Article  PubMed  Google Scholar 

  16. Ho, E., Karimi Galougahi, K., Liu, C. C., Bhindi, R., & Figtree, G. A. (2013). Biological markers of oxidative stress: Applications to cardiovascular research and practice. Redox Biology, 1(1), 483–491.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Fernandez-Checa, J. C., Kaplowitz, N., Garcia-Ruiz, C., & Colell, A. (1998). Mitochondrial glutathione: Importance and transport. Seminars in Liver Disease, 18, 389–401.

    Article  PubMed  CAS  Google Scholar 

  18. Capasso, J. M., Li, P., Guideri, G., Malhotra, A., Cortese, R., & Anversa, P. (1992). Myocardial mechanical, biochemical, and structural alterations induced by chronic ethanol ingestion in rats. Circulation Research, 71, 346–356.

    Article  PubMed  CAS  Google Scholar 

  19. Segel, L. D., Rendig, S. V., & Mason, D. T. (1981). Alcohol-induced cardiac hemodynamic and Ca2+ flux dysfunctions are reversible. Journal of Molecular and Cellular Cardiology, 13, 443–455.

    Article  PubMed  CAS  Google Scholar 

  20. Sarma, J. S., Ikeda, S., Fischer, R., Maruyama, Y., Weishaar, R., & Bing, R. J. (1976). Biochemical and contractile properties of heart muscle after prolonged alcohol administration. Journal of Molecular and Cellular Cardiology, 8, 951–972.

    Article  PubMed  CAS  Google Scholar 

  21. Bing, R. J., Tillmanns, H., Fauvel, J. M., Seeler, K., & Mao, J. C. (1974). Effect of prolonged alcohol administration on calcium transport in heart muscle of the dog. Circulation Research, 35, 33–38.

    Article  PubMed  CAS  Google Scholar 

  22. Zhang, R. H., Gao, J. Y., Guo, H. T., Scott, G. I., Eason, A. R., Wang, X. M., et al. (2013). Inhibition of CYP2E1 attenuates chronic alcohol intake-induced myocardial contractile dysfunction and apoptosis. Biochimica et Biophysica Acta, 1832(1), 128–141.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Weishaar, R., Sarma, J. S., Maruyama, Y., Fischer, R., Bertuglia, S., & Bing, R. J. (1977). Reversibility of mitochondrial and contractile changes in the myocardium after cessation of prolonged ethanol intake. The American Journal of Cardiology, 40, 556–562.

    Article  PubMed  CAS  Google Scholar 

  24. Pachinger, O. M., Tillmanns, H., Mao, J. C., Fauvel, J. M., & Bing, R. J. (1973). The effect of prolonged administration of ethanol on cardiac metabolism and performance in the dog. Journal of Clinical Investigation, 52, 2690–2696.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Segel, L. D., Rendig, S. V., Choquet, Y., Chacko, K., Amsterdam, E. A., & Mason, D. T. (1975). Effects of chronic graded ethanol consumption on the metabolism, ultrastructure, and mechanical function of the rat heart. Cardiovascular Research, 9, 649–663.

    Article  PubMed  CAS  Google Scholar 

  26. Cederbaum, A. I., & Rubin, E. (1975). Molecular injury to mitochondria produced by ethanol and acetaldehyde. Federation Proceedings, 34, 2045–2051.

    PubMed  CAS  Google Scholar 

  27. Hastillo, A. H., Poland, J., & Hess, M. L. (1980). Mechanical and subcellular function of rat myocardium during chronic ethanol consumption. Proceedings of the Society for Experimental Biology and Medicine, 164, 415–420.

    Article  PubMed  CAS  Google Scholar 

  28. Piano, M. R., Rosenblum, C., Solaro, R. J., & Schwertz, D. (1999). Calcium sensitivity and the effect of the calcium sensitizing drug pimobendan in the alcoholic isolated rat atrium. Journal of Cardiovascular Pharmacology, 33, 237–242.

    Article  PubMed  CAS  Google Scholar 

  29. Tsiplenkova, V. G., Vikhert, A. M., & Cherpachenko, N. M. (1986). Ultrastructural and histochemical observations in human and experimental alcoholic cardiomyopathy. Journal of the American College of Cardiology, 8, 22A–32A.

    Article  PubMed  CAS  Google Scholar 

  30. Jing, L., Jin, C. M., Li, S. S., Zhang, F. M., Yuan, L., Li, W. M., et al. (2012). Chronic alcohol intake-induced oxidative stress and apoptosis: Role of CYP2E1 and calpain-1 in alcoholic cardiomyopathy. Molecular and Cellular Biochemistry, 359(1–2), 283–292.

    Article  PubMed  CAS  Google Scholar 

  31. Hibbs, R. G., Ferrans, V. J., Black, W. C., Weilbaecher, D. G., & Burch, G. E. (1965). Alcoholic cardiomyopathy: An electron microscopic study. American Heart Journal, 69, 766–779.

    Article  PubMed  CAS  Google Scholar 

  32. Beckemeier, M. E., & Bora, P. S. (1998). Fatty acid ethyl esters: Potentially toxic products of myocardial ethanol metabolism. Journal of Molecular and Cellular Cardiology, 30, 2487–2494.

    Article  PubMed  CAS  Google Scholar 

  33. Hu, C., Ge, F., Hyodo, E., Arai, K., Iwata, S., Lobdell, H. T., et al. (2013). Chronic ethanol consumption increases cardiomyocyte fatty acid uptake and decreases ventricular contractile function in C57BL/6 J mice. Journal of Molecular and Cellular Cardiology, 59, 30–40.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  34. Dalle-Donne, I., Rossi, R., Colombo, R., Giustarni, D., & Milzani, A. (2006). Biomarkers of oxidative damage in human disease. Clinical Chemistry, 52(4), 601–623.

    Article  PubMed  CAS  Google Scholar 

  35. Vikhert, A. M., Tsiplenkova, V. G., & Cherpachenko, N. M. (1986). Alcoholic cardiomyopathy and sudden cardiac death. Journal of the American College of Cardiology, 8, 3A–11A.

    Article  PubMed  CAS  Google Scholar 

  36. Fahimi, H. D., Kino, M., Hicks, L., Thorp, K. A., & Abelman, W. H. (1979). Increased myocardial catalase in rats fed ethanol. American Journal of Pathology, 96, 373–390.

    PubMed  CAS  PubMed Central  Google Scholar 

  37. Kino, M. (1981). Chronic effects of ethanol under partial inhibition of catalase activity in the rat heart: Light and electron microscopic observations. Journal of Molecular and Cellular Cardiology, 13, 5–21.

    Article  PubMed  CAS  Google Scholar 

  38. Ribiere, C., Hininger, I., Rouach, H., & Nordmann, R. (1992). Effects of chronic ethanol administration on free radical defense in rat myocardium. Biochemical Pharmacology, 44, 1495–1500.

    Article  PubMed  CAS  Google Scholar 

  39. Vendemiale, G., Grattagliano, I., Altomare, E., Serviddio, G., Portincasa, P., Prigigallo, F., et al. (2001). Mitochondrial oxidative damage and myocardial fibrosis in rats chronically intoxicated with moderate doses of ethanol. Toxicology Letters, 123, 209–216.

    Article  PubMed  CAS  Google Scholar 

  40. Edes, I., Toszegi, A., Csanady, M., & Bozoky, B. (1986). Myocardial lipid peroxidation in rats after chronic alcohol ingestion and the effects of different antioxidants. Cardiovascular Research, 20, 542–548.

    Article  PubMed  CAS  Google Scholar 

  41. Edes, I., Piros, G., Forster, T., & Csanady, M. (1987). Alcohol-induced congestive cardiomyopathy in adult turkeys: Effects on myocardial antioxidant defence systems. Basic Research in Cardiology, 82, 551–556.

    Article  PubMed  CAS  Google Scholar 

  42. Khanna, D., Kan, H., Fang, Q., Xie, Z., Underwood, B. L., Jain, A. C., et al. (2007). Inducible nitric oxide synthase attenuates adrenergic signaling in alcohol fed rats. Journal of Cardiovascular Pharmacology, 50, 692–696.

    Article  PubMed  CAS  Google Scholar 

  43. Tan, Y., Li, X., Prabhu, S. D., Brittian, K. R., Chen, Q., Yin, X., et al. (2012). Angiotensin II plays a critical role in alcohol-induced cardiac nitrative damage, cell death, remodeling, and cardiomyopathy in a protein kinase C/nicotinamide adenine dinucleotide phosphate oxidase-dependent manner. Journal of the American College of Cardiology, 59(16), 1477–1486.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  44. Zhang, B., Turdi, S., Li, Q., Lopez, F. L., Eason, A. R., Anversa, P., et al. (2010). Cardiac overexpression of insulin-like growth factor 1 attenuates chronic alcohol intake-induced myocardial contractile dysfunction but not hypertrophy: Roles of Akt, mTOR, GSK3beta, and PTEN. Free Radical Biology & Medicine, 49, 1238–1253.

    Article  CAS  Google Scholar 

  45. Fogle, R. L., Lynch, C. J., Palopoli, M., Deiter, G., Stanley, B. A., & Vary, T. C. (2010). Impact of chronic alcohol ingestion on cardiac muscle protein expression. Alcoholism, Clinical and Experimental Research, 34, 1226–1234.

    PubMed  CAS  PubMed Central  Google Scholar 

  46. Cheng, H. J., Grant, K. A., Han, Q. H., Daunais, J. B., Friedman, D. P., Masutani, S., et al. (2010). Up-regulation and functional effect of cardiac beta3-adrenoreceptors in alcoholic monkeys. Alcoholism, Clinical and Experimental Research, 34, 1171–1181.

    PubMed  CAS  PubMed Central  Google Scholar 

  47. Cheng, C. P., Cheng, H. J., Cunningham, C., Shihabi, Z. K., Sane, D. C., Wannenburg, T., et al. (2006). Angiotensin II type 1 receptor blockade prevents alcoholic cardiomyopathy. Circulation, 114, 226–236.

    Article  PubMed  CAS  Google Scholar 

  48. Li, S. Y., Gilbert, S. A., Li, Q., & Ren, J. (2009). Aldehyde dehydrogenase-2 (ALDH2) ameliorates chronic alcohol ingestion-induced myocardial insulin resistance and endoplasmic reticulum stress. Journal of Molecular and Cellular Cardiology, 47(2), 247–255.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  49. Li, S. Y., & Ren, J. (2008). Cardiac overexpression of alcohol dehydrogenase exacerbates chronic ethanol ingestion-induced myocardial dysfunction and hypertrophy: Role of insulin signaling and ER stress. Journal of Molecular and Cellular Cardiology, 44, 992–1001.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  50. Nadal-Ginard, B., Kajstura, J., Anversa, P., & Leri, A. (2003). A matter of life and death: Cardiac myocyte apoptosis and regeneration. J Clin Investig, 111, 1457–1459.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  51. Farber, N. B., & Olney, J. W. (2003). Drugs of abuse that cause developing neurons to commit suicide. Brain Research. Developmental Brain Research, 147, 37–45.

    Article  PubMed  CAS  Google Scholar 

  52. Zambo, V., Simon-Szabo, L., Szelenyi, P., Kereszturi, E., Banhegyi, G., & Csala, M. (2013). Lipotoxicity in the liver. World Journal of Hepatology, 5, 550–557.

    PubMed  PubMed Central  Google Scholar 

  53. Fernandez-Sola, J., Fatjo, F., Sacanella, E., Estruch, R., Bosch, X., Urbano-Marquez, A., et al. (2006). Evidence of apoptosis in alcoholic cardiomyopathy. Human Pathology, 37, 1100–1110.

    Article  PubMed  CAS  Google Scholar 

  54. Fernandez-Sola, J., Lluis, M., Sacanella, E., Estruch, R., Antunez, E., & Urbano-Marquez, A. (2011). Increased myostatin activity and decreased myocyte proliferation in chronic alcoholic cardiomyopathy. Alcoholism, Clinical and Experimental Research, 35, 1220–1229.

    Article  PubMed  CAS  Google Scholar 

  55. Marzetti, E., Csiszar, A., Dutta, D., Balagopal, G., Calvani, R., & Leeuwenburgh, C. (2013). Role of mitochondrial dysfunction and altered autophagy in cardiovascular aging and disease: From mechanisms to therapeutics. American Journal Physiology Heart and Circulatory Physiology, 305(4), H459–H476.

    Article  CAS  Google Scholar 

  56. Miro, O., Robert, J., Casademont, J., Alonso, J. R., Nicolas, J. M., Fernandez-Sola, J., et al. (2000). Heart mitochondrial respiratory chain complexes are functionally unaffected in heavy ethanol drinkers without cardiomyopathy. Alcoholism, Clinical and Experimental Research, 24, 859–864.

    Article  PubMed  CAS  Google Scholar 

  57. Williams, E. S., & Li, T. K. (1977). The effect of chronic alcohol administration on fatty acid metabolism and pyruvate oxidation of heart mitochondria. Journal of Molecular and Cellular Cardiology, 9, 1003–1011.

    Article  PubMed  CAS  Google Scholar 

  58. Cunningham, C. C., & Spach, P. I. (1994). Alcoholism and myocardial energy metabolism. Alcoholism, Clinical and Experimental Research, 18, 132–137.

    Article  PubMed  CAS  Google Scholar 

  59. Lange, L. G., & Sobel, B. E. (1983). Myocardial metabolites of ethanol. Circulation Research, 72, 724–731.

    CAS  Google Scholar 

  60. Kaphalia, B. S., Cai, P., Khan, M. F., Okorodudu, A. O., & Ansari, G. A. (2004). Fatty acid ethyl esters: Markers of alcohol abuse and alcoholism. Alcohol, 34, 151–158.

    Article  PubMed  CAS  Google Scholar 

  61. Yoerger, D. M., Best, C. A., McQuillan, B. M., Supple, G. E., Guererro, J. L., Cluette-Brown, J. E., et al. (2006). Rapid fatty acid ethyl ester synthesis by porcine myocardium upon ethanol infusion into the left anterior descending coronary artery. American Journal of Pathology, 168, 1435–1442.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  62. Lang, C. H., Frost, R. A., Summer, A. D., & Vary, T. C. (2005). Molecular mechanisms responsible for alcohol-induced myopathy in skeletal muscle and heart. The International Journal of Biochemistry & Cell Biology, 37, 2180–2195.

    Article  CAS  Google Scholar 

  63. Vary, T. C., & Deiter, G. (2005). Long-term alcohol administration inhibits synthesis of both myofibrillar and sarcoplasmic proteins in heart. Metabolism, Clinical and Experimental, 54, 212–219.

    Article  CAS  Google Scholar 

  64. Vary, T. C., Deiter, G., & Lantry, R. (2008). Chronic alcohol feeding impairs mTOR(Ser 2448) phosphorylation in rat hearts. Alcoholism, Clinical and Experimental Research, 32, 43–51.

    Article  PubMed  CAS  Google Scholar 

  65. Lang, C. H., & Korzick, D. H. (2013). Chronic alcohol consumption disrupts myocardial protein balance and function in aged, but not adult, female F344 rats. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 306(1), R23–R33.

    PubMed  Google Scholar 

  66. Donohue, T. M, Jr. (2009). Autophagy and ethanol-induced liver injury. World Journal of Gastroenterology: WJG, 15, 1178–1185.

    Article  PubMed  CAS  Google Scholar 

  67. Lang, C. H., Huber, D., & Frost, R. A. (2007). Burn-induced increase in atrogin-1 and MuRF-1 in skeletal muscle is glucocorticoid independent but downregulated by IGF-I. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 292, R328–R336.

    Article  PubMed  CAS  Google Scholar 

  68. Lang, S. M., Kazi, A. A., Hong-Brown, L., & Lang, C. H. (2012). Delayed recovery of skeletal muscle mass following hindlimb immobilization in mTOR heterozygous mice. PLoS ONE, 7(6), e38910.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  69. Gustafsson, A. B., & Gottlieb, R. A. (2009). Autophagy in ischemic heart disease. Circulation Research, 104, 150–158.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  70. Sukhanov, S., Semprun-Prieto, L., Yoshida, T., Michael Tabony, A., Higashi, Y., Galvez, S., et al. (2011). Angiotensin II, oxidative stress and skeletal muscle wasting. The American Journal of the Medical Sciences, 342, 143–147.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Guo, R., Hu, N., Kandadi, M. R., & Ren, J. (2012). Facilitated ethanol metabolism promotes cardiomyocyte contractile dysfunction through autophagy in murine hearts. Autophagy, 8, 593–608.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  72. Roerecke, M., & Rehm, J. (2010). Irregular heavy drinking occasions and risk of ischemic heart disease: A systematic review and meta-analysis. American Journal of Epidemiology, 171, 633–644.

    Article  PubMed  Google Scholar 

  73. Gu, L., Fink, A. M., Chowdhury, S. A., Geenen, D. L., & Piano, M. R. (2013). Cardiovascular responses and differential changes in mitogen-activated protein kinases following repeated episodes of binge drinking. Alcohol and Alcoholism, 48, 131–137.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  74. Thombs, D. L., Olds, R. S., & Snyder, B. M. (2003). Field assessment of BAC data to study late-night college drinking. Journal of Studies on Alcohol, 64, 322–330.

    PubMed  Google Scholar 

  75. Kajander, O. A., Kupari, M., Perola, M., Pajarinen, J., Savolainen, V., Penttila, A., et al. (2001). Testing genetic susceptibility loci for alcoholic heart muscle disease. Alcoholism, Clinical and Experimental Research, 25, 1409–1413.

    Article  PubMed  CAS  Google Scholar 

  76. Husemoen, L. L., Fenger, M., Friedrich, N., Tolstrup, J. S., Beenfeldt Fredriksen, S., & Linneberg, A. (2008). The association of ADH and ALDH gene variants with alcohol drinking habits and cardiovascular disease risk factors. Alcoholism, Clinical and Experimental Research, 32, 1984–1991.

    PubMed  CAS  Google Scholar 

  77. Djousse, L., Levy, D., Herbert, A. G., Wilson, P. W., D’Agostino, R. B., Cupples, L. A., et al. (2005). Influence of alcohol dehydrogenase 1C polymorphism on the alcohol-cardiovascular disease association (from the Framingham Offspring Study). The American Journal of Cardiology, 96, 227–232.

    Article  PubMed  CAS  Google Scholar 

  78. Hines, L. M., Stampfer, M. J., Ma, J., Gaziano, J. M., Ridker, P. M., Hankinson, S. E., et al. (2001). Genetic variation in alcohol dehydrogenase and the beneficial effect of moderate alcohol consumption on myocardial infarction. The New England Journal of Medicine, 344, 549–555.

    Article  PubMed  CAS  Google Scholar 

  79. Reinke, L. A., Lai, E. K., DuBose, C. M., & McCay, P. B. (1987). Reactive free radical generation in vivo in heart and liver of ethanol-fed rats: Correlation with radical formation in vitro. Proceedings of the National Academy of Sciences of the United States of America, 84, 9223–9227.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  80. Wang, L., Zhou, Z., Saari, J. T., & Kang, Y. J. (2005). Alcohol-induced myocardial fibrosis in metallothionein-null mice: Prevention by zinc supplementation. American Journal of Pathology, 167, 337–344.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  81. Fuchs, F. D., Chambless, L. E., Folsom, A. R., Eigenbrodt, M. L., Duncan, B. B., Gilbert, A., et al. (2004). Association between alcoholic beverage consumption and incidence of coronary heart disease in whites and blacks: The Atherosclerosis Risk in Communities Study. American Journal of Epidemiology, 160, 466–474.

    Article  PubMed  Google Scholar 

  82. Sempos, C. T., Rehm, J., Wu, T., Crespo, C. J., & Trevisan, M. (2003). Average volume of alcohol consumption and all-cause mortality in African Americans: The NHEFS cohort. Alcoholism, Clinical and Experimental Research, 27, 88–92.

    Article  PubMed  Google Scholar 

  83. National Institute on Alcohol Abuse and Alcoholism. (2008). Alcohol: A women’s health issue. NIH Publication No. 03 4956. Washington, DC: U.S. Department of Health and Human Services.

  84. Fernandez-Sola, J., Estruch, R., Nicolas, J. M., Pare, J. C., Sacanella, E., Antunez, E., et al. (1997). Comparison of alcoholic cardiomyopathy in women versus men. The American Journal of Cardiology, 80, 481–485.

    Article  PubMed  CAS  Google Scholar 

  85. Kennedy, R. H., Stewart, C., Light, K. E., & Wyeth, R. P. (2002). Effects of gender on the cardiac toxicity elicited by chronic ethanol intake in rats. Toxicology Applied Pharmacology, 179, 111–118.

    Article  PubMed  CAS  Google Scholar 

  86. Lochner, A., Cowley, R., & Brink, A. J. (1969). Effect of ethanol on metabolism and function of perfused rat heart. American Heart Journal, 78, 770–780.

    Article  PubMed  CAS  Google Scholar 

  87. Piano, M. R., Geenen, D. L., Schwertz, D. W., Chowdhury, S. A., & Yuzhakova, M. (2007). Long-term effects of alcohol consumption in male and female rats. Cardiovascular Toxicology, 7, 247–254.

    Article  PubMed  CAS  Google Scholar 

  88. Vary, T. C., Kimball, S. R., & Sumner, A. (2007). Sex-dependent differences in the regulation of myocardial protein synthesis following long-term ethanol consumption. American Journal Physiology-Regulatory Integrative and Comparative Physiology, 292, R778–R787.

    Article  CAS  Google Scholar 

  89. Fogle, R. L., Hollenbeak, C. S., Stanley, B. A., Vary, T. C., Kimball, S. R., & Lynch, C. J. (2011). Functional proteomic analysis reveals sex-dependent differences in structural and energy-producing myocardial proteins in rat model of alcoholic cardiomyopathy. Physiological Genomics, 43, 346–356.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  90. Mackie, A. R., Krishnamurthy, P., Verma, S. K., Thorne, T., Ramirez, V., Qin, G., et al. (2013). Alcohol consumption negates estrogen-mediated myocardial repair in ovariectomized mice by inhibiting endothelial progenitor cell mobilization and function. Journal of Biological Chemistry, 288, 18022–18034.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  91. Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2013). ACCF/AHA guideline for the management of heart failure. Journal of the American Association of Cardiology, 62(16), e148–e239.

    Google Scholar 

  92. Iacovoni, A., De Maria, R., & Gavazzi, A. (2010). Alcoholic cardiomyopathy. Journal of Cardiovascular Medicine, 11, 884–892.

    Article  PubMed  Google Scholar 

  93. Piano, M. R. (2002). Alcohol and heart failure. Journal of Cardiac Failure, 8(4), 239–246.

    Article  PubMed  CAS  Google Scholar 

  94. Balady, G. J., Williams, M. A., Ades, P. A., et al. (2007). Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. Circulation, 115, 2675–2682.

    Article  PubMed  Google Scholar 

  95. Substance Abuse and Mental Health Services Administration. (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of national findings. NSDUH series H-41. HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  96. Small, E. M., Frost, R. J., & Olson, E. N. (2010). MicroRNAs add a new dimension to cardiovascular disease. Circulation, 121, 1022–1032.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Miranda, R. C., Pietrzykowski, A. Z., Tang, Y., Sathyan, P., Mayfield, D., Keshavarzian, A., et al. (2010). MicroRNAs: Master regulators of ethanol abuse and toxicity? Alcoholism, Clinical and Experimental Research, 34, 575–587.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

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Acknowledgments

Due to page limitations, we recognize that we have not included all the excellent scientific work completed in the area of alcohol and the cardiovascular system. This study was supported by National Institutes of Health grants AA015578 (MRP), HL85614 (SAP), HL095701 (SAP), and HL095701-02S1 (SAP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Correspondence to Mariann R. Piano.

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Piano, M.R., Phillips, S.A. Alcoholic Cardiomyopathy: Pathophysiologic Insights. Cardiovasc Toxicol 14, 291–308 (2014). https://doi.org/10.1007/s12012-014-9252-4

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