The Natural Course of Alcoholic Cardiomyopathy

Fifty-seven patients with cardiomyopathy associated with alcoholism were followed for an average of 40.5 months (range, 4 months to 8 years). None of the patients were treated with prolonged bed rest. During the follow-up period, the clinical status improved in 15 patients (group A), was stable in 12 patients (group B), and had deteriorated in 30 patients (group C). Seventy-three percent of the group A patients abstained from alcohol, whereas in groups B and C only 25% and 13% of patients, respectively, abstained. These differences were significant—P < 0.03 (group A versus B) and P < 0.001 (group A versus C). The average duration of symptoms in the group A patients was 4.2 months and was significantly (P < 0.05) shorter than that of patients in groups B and C (17 and 11.1 months, respectively). Only 10 patients (17%), all in group A, had a return of heart size to normal. Twenty-four patients (42%), all in group C, died in an average time of 36 months; thus, a short duration of symptoms before initiation of therapy and abstention from alcohol were associated with a more favorable course.