title: Comparison of long-term outcome of alcoholic and idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  The outcome of alcoholic cardiomyopathy is thought to be better than idiopathic dilated cardiomyopathy if patients abstain from alcohol. The aim of this study was to compare the long-term clinical outcome of alcoholic and idiopathic dilated cardiomyopathy.
  
  
  RESULTS
  Of 134 patients with dilated cardiomyopathy and normal coronary angiography, 50 had alcoholic cardiomyopathy; they were compared serially to 84 patients with idiopathic dilated cardiomyopathy. Left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiac index, severity of ventricular arrhythmias, measurement of heart rate variability and results of signal-averaged ECG were similar in both groups. Although alcohol withdrawal was strongly recommended but observed in only 70% of patients with alcoholic cardiomyopathy, both groups had similar outcome in terms of cardiac death after follow-up treatment of 47+/-40 months. Multivariate analysis in the entire cohort demonstrated that increased pulmonary capillary wedge pressure (P=0. 003), alcoholism and lack of abstinence during follow-up (P=0.006) and decreased standard deviation of all normal-to-normal RR intervals (P=0.02) were independent predictors of cardiac death.
  
  
  CONCLUSIONS
  In contrast with previous studies, patients with alcoholic cardiomyopathy did not have a better outcome than patients with idiopathic dilated cardiomyopathy. Alcoholism without abstinence was a strong predictor of cardiac death. This suggests that a more aggressive approach to alcohol cessation is needed in these patients.
authors.affiliation: Service de Cardiologie B et Laboratoire d'électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Fauchier
authors.forename: D
authors.initials: D
authors.lastname: Babuty
authors.forename: P
authors.initials: P
authors.lastname: Poret
authors.forename: D
authors.initials: D
authors.lastname: Casset-Senon
authors.forename: M L
authors.initials: ML
authors.lastname: Autret
authors.forename: P
authors.initials: P
authors.lastname: Cosnay
authors.forename: J P
authors.initials: JP
authors.lastname: Fauchier
mesh_terms: D000328:Adult; D002310:Cardiomyopathy, Alcoholic / Q000401:mortality* / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D016277:Ventricular Function, Left