Alcoholic cardiomyopathy: pathophysiologic insights

Cardiovasc Toxicol. 2014 Dec;14(4):291-308. doi: 10.1007/s12012-014-9252-4.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Alcohol Dehydrogenase / genetics
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / physiopathology
  • Aldehyde Dehydrogenase / genetics
  • Apoptosis / physiology
  • Autophagy / physiology
  • Binge Drinking / physiopathology
  • Cardiomyopathy, Alcoholic / drug therapy
  • Cardiomyopathy, Alcoholic / etiology*
  • Cardiomyopathy, Alcoholic / physiopathology
  • Cardiomyopathy, Alcoholic / therapy
  • Fatty Acids / metabolism
  • Humans
  • Micronutrients / deficiency
  • Mitochondria / physiology
  • Oxidative Stress / physiology
  • Proteins / metabolism


  • Fatty Acids
  • Micronutrients
  • Proteins
  • Alcohol Dehydrogenase
  • Aldehyde Dehydrogenase