With the rapid development of the social economy in China, the incidence of diseases caused by excessive drinking is gradually increasing as well. Alcoholic cardiomyopathy refers to long-term high intake of ethanol, and has typical dilated cardiomyopathy characteristics, such as, hemodynamic changes, symptoms, signs, and morphological features. It is a kind of cardiomyopathy that excludes other causes of dilated cardiomyopathy. Due to the lack of specific pathological changes, the forensic pathological identification of alcoholic cardiomyopathy can only be based on the patient's medical history and by ruling out other causes of cardiomyopathy. This paper reviews the pathogenesis and forensic identification of alcoholic cardiomyopathy in order to provide reference for forensic pathologists and clinicians.
Cardiomyopathy, Alcoholic/pathology* ; China ; Ethanol ; Forensic Pathology/trends* ; Humans

OBJECTIVETo investigate the protective effect of puerarin on the myocardium of rats with acute and chronic alcoholism.

METHODSIn acute alcoholism experiment, normal male SD rats were randomly divided into the control group, alcoholism group and puerarin group (n=8), and high- and low-dose puerarin was administered. In chronic alcoholism experiment, increasing puerarin doses were given. Serum and myocardial levels of spartate aminotransferase (AST) and creatine phosphokinase (CPK) were determined using enzymatic methed, and superoxide dismutase (SOD), malondialdehyde (MDA), Ca(2+)-Mg(2+)-ATPase, and Na(+)-K(+)-ATPase in the myocardium were assayed with colorimetric method. HE staining was used to observe the microscopic changes of the myocardium.

RESULTSCompared with alcoholism group, puerarin-treated groups showed significantly lowered myocardial contents of MDA, CPK and AST and serum levels of AST and CPK (P<0.05, P<0.01) and increased myocardial SOD (P<0.05, P<0.01), Na(+)-K(+)-ATPase and Ca(2+)-Mg(2+)-ATPase activity (P<0.05, P<0.01), but Na(+)-K(+)-ATPase was similar between the two groups (P>0.05). HE staining of the myocardium showed cell swelling and obscure cell boundaries in alcoholism group, especially in chronic alcoholism group. The myocardial structure in puerarin group remained clear and regular.

CONCLUSIONPuerarin can protect from myocardial injuries induced by acute and chronic alcoholism in rats.

Alcoholism ; drug therapy ; Animals ; Cardiomyopathy, Alcoholic ; metabolism ; pathology ; prevention & control ; Ethanol ; toxicity ; Isoflavones ; pharmacology ; therapeutic use ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the pathologic features of dilated heart in cardiac transplant recipients, with clinicoradiologic correlation.

METHODSSixty recipient hearts from cardiac transplantation performed in Fuwai Hospital were analyzed by gross examination, histologic observation and electron microscopy. Clinicoradiologic correlation was available in 40 cases.

RESULTSAmongst the 40 cases of dilated heart, 52.5% (21/40) were due to dilated cardiomyopathy, 22.5% (9/40) due to arrhythmogenic right ventricular cardiomyopathy, 15.0% (6/40) due to ischemic cardiomyopathy, and the remaining 10.0% (4/40) due to miscellaneous causes, including local noncompaction of ventricular myocardium, giant cell myocarditis, alcoholic cardiomyopathy and hypertensive cardiomyopathy. The discrepancy rate between clinical and pathologic diagnosis was 37.5% (15/40). The erroneous categories included arrhythmogenic right ventricular cardiomyopathy (7 cases), ischemic cardiomyopathy (5 cases), and giant cell myocarditis (1 case), which were all mistaken clinically as dilated cardiomyopathy. While ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, noncompaction of ventricular myocardium and giant cell myocarditis have distinctive pathologic features, the diagnosis of alcoholic and hypertensive cardiomyopathies required clinicopathologic correlation. Dilated cardiomyopathy due to viral myocarditis was not identified in the cases studied.

CONCLUSIONPathologic examination is essential in analysis of transplant recipient heart and helps to rectify clinical diagnostic discrepancy.

Adolescent ; Adult ; Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; pathology ; Cardiomyopathy, Alcoholic ; diagnosis ; pathology ; Cardiomyopathy, Dilated ; diagnosis ; pathology ; Diagnostic Errors ; Dilatation, Pathologic ; diagnosis ; pathology ; Female ; Giant Cells ; pathology ; Heart Transplantation ; pathology ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Myocardial Ischemia ; diagnosis ; pathology ; Myocardium ; pathology