[Course and prognosis of apparently primary congestive cardiomyopathies in chronic alcoholic patients].
The authors analyse a series of 36 chronic alcoholic patients with primary congestive cardiomyopathy. The clinical course of these cases was analysed in order to define the prognostic factors. All of the patients were male with a mean age of 47 years. 55 per cent of cases presented a functional deterioration. The 5 year mortality was 50 per cent. The high incidence of sudden death (38 per cent of deaths) was probably related to ventricular arrhythmias. The other deaths were due to end-stage heart failure. The survival did not differ significantly from that of primary congestive cardiomyopathy in non-alcoholic patients. It depends, above all, on the left ventricular function and is influenced by the initial value for the ejection fraction. Alcoholic withdrawal was found to be a beneficial prognostic factor when it was early, but it became ineffective in cases with major alteration in the left ventricular function. Ultrasound and radioisotope studies demonstrated the development of segmental kinetic disorders and intracavitary thrombi in the left ventricle. These lesions have a pejorative prognostic significance. The initial systolic diameter of the left auricle seems to have a prognostic value as it reflects the degree of activity of the disease.
D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology; D002310:Cardiomyopathy, Alcoholic / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000276:immunology / Q000503:physiopathology*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors; D014463:Ultrasonography
Evolution et pronostic des cardiomyopathies congestives d'apparence primitive chez les sujets éthyliques chroniques.