alcoholic cardiomyopathy stages

Individuals who completely quit alcohol generally have improved overall outcomes. They typically require fewer hospitalizations and show improved heart function on ECG readings. As a point of reference, consuming 80 grams of alcohol daily for at least 5 years can significantly increase the risk of ACM. Electrolyte abnormalities, including hypokalemia, hypomagnesemia, and hypophosphatemia, should be corrected promptly because of the risk of arrhythmia and sudden death. Richardson et al showed an elevation of creatine kinase, LDH, malic dehydrogenase, and alpha-hydroxybutyric dehydrogenase levels in endomyocardial biopsy specimens taken from 38 patients with DC. A standard drink contains 10 g of alcohol, equivalent to 100 mL of wine, 300 mL of beer, or 40 mL of spirits.

How is this condition treated, and can it be cured?

alcoholic cardiomyopathy stages

Symptoms of ACM are not specific and overlap with other forms of heart failure [30,41,58]. They appear when ventricle dilatation, hypertrophy, and dysfunction are established. Later and progressively in the course of the disease, around 20% of women and 25% of men with excessive alcohol consumption develop exertion dyspnea and orthopnea, leading to episodes of left-ventricle heart failure [39,46,59]. Depression https://ecosoberhouse.com/ of LV ejection fraction (EF) is the hallmark of this period that also occurs with a reduction in LV shortening fraction, increase in LV diameter, and mass indices that may be measured by echocardiography or cardiac MR spectroscopy [40,52]. Congestive symptoms, such as the expression of right ventricular failure, with peripheral edema or anasarca, are characteristic of advanced cases of ACM [42,56].

The Prognostic Factors of Alcoholic Cardiomyopathy

This forces the heart to work harder to pump blood to the rest of the body. Cardiac MRI may be helpful in the differential diagnosis to hypertrophic cardiomyopathy, storage diseases, and inflammatory cardiomyopathy. For a comprehensive overview see Table 1 (combined data from [6, 8, 24, 28]). In his 1972 review article, Bridgen was the first to introduce the term alcoholic cardiomyopathy [27].

alcoholic cardiomyopathy stages

Cardiac Effects of Alcohol

The acute ingestion of large amount of alcohol as well as chronic alcohol abuse induce toxic effects to all organs and tissues [7], particularly to central nervous system, liver and heart [8,9]. Measuring blood alcohol concentration in an acute intoxication gives baseline information but does not permit deductions to chronic misuse. Markers for chronic alcohol consumption rely on liver enzymes such as gamma-glutamyltransferase (GGT) [119], glutamic oxalacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT). Elevations of the transaminases (GOT, GPT), especially a ratio of GOT/GPT higher than 2 might be indicative of alcoholic liver disease instead of liver disease from other etiologies [120, 121]. An excellent marker is carbohydrate deficient transferrin (CDT), which best detects chronic alcohol consumption alone [122, 123] or in combination with the other markers such as GGT [8, 124].

The trillions of microbes in your colon and large and small intestines are critical to proper digestion. Cirrhosis, on the other hand, is irreversible and can lead to liver failure and liver cancer, even if you abstain from alcohol. Dr. Sengupta shares some of the not-so-obvious effects that alcohol has on your body. You probably already know that excessive drinking can affect you in more ways than one.

Differential Diagnosis

The key to diagnosis is a personal history of chronic heavy alcohol use and the absence of other etiologies. Enzymatic activity changes which are seen in the idiopathic cardiomyopathy including decreased activity of oxygen reduction mitochondrial enzymes, increased fatty acid uptake and alcoholic cardiomyopathy increased lysosomal/microsomal enzyme activity can be seen. Your doctor might prescribe ACE inhibitors and beta-blockers to help lower your blood pressure. If your heart is severely damaged, your doctor may recommend an implantable defibrillator or pacemaker to help your heart work.

alcoholic cardiomyopathy stages

ACM is a type of heart disease that develops due to chronic alcohol consumption. Chronic ethanol misuse clearly depresses protein synthesis and degradation, involving both structural and non-structural heart proteins [104,128]. At a pathological level, sarcomere Z-line distortion and disruption of the sarcomere pattern leads to myocytolysis [107,129]. Myocytolysis is evident through focal myofiber dissolution, cell vacuolization, and fiber disarray [19] (Figure 2). The sarcomere complex is early affected by ethanol, decreasing the titin content, a protein that is responsible for sarcomere relaxation and LV distensibility [130]. This damage first induces diastolic dysfunction, which is initially subclinical and later clinically apparent [57].

alcoholic cardiomyopathy stages

What Does Alcohol Do to Your Body? 9 Ways Alcohol Affects Your Health

Alcohol intake may also interfere with the drug and dietary treatment of hypertension. This altogether supports a causal relationship between alcohol consumption and a hypertensive state. Continued heavy alcohol use, on the other hand, will continue to make alcoholic cardiomyopathy worse.

Dry Cargo Container.

20′ Steel Dry Cargo Container

Exterior
Length
Width
Height

20′-0″

8′-0″

8′-6″

6.058 m

2.438 m

2.591 m

Interior
Length
Width
Height

19′-4 13/16″

7′-8 19/32″

7′-9 57/64″

5.898 m

2.352 m

2.385 m

Weight
Door Opening
MGW
TARE
NET
Width
Height

52,910 lb

5,140 lb

47,770 lb

7′-8 1/8″

7′-5 3/4″

67,200 lb

5,290 lb

61,910 lb

2.343 m

2.280 m

24,000 kg

2,330 kg

21,670 kg

CU.M

CU.FT

30,480 kg

2,400 kg

28,080 kg

33.1

1,169

Purpose

Captioned units(MGW 30,480 KG) can be coordinated from EMCU 3204073 and EISU 3568118. Used for all kinds of general cargo.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Dry Cargo Container.

40′ Steel Dry Cargo Container

Exterior
Length
Width
Height

40′-0″

8′-0″

8′-6″

12.192 m

2.438 m

2.591 m

Interior
Length
Width
Height

39′-5 45/64″

7′-8 19/32″

7′-9 57/64″

12.032 m

2.352 m

2.385 m

Weight
Door Opening
MGW
TARE
NET
Width
Height

67,200 lb

8,820 lb

58,380 lb

 

7′-8 1/8″

7′-5 3/4″

30,480 kg

4,000 kg

26,480 kg

67.5

2,385

Purpose

Used for all kinds of general cargo.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Dry Cargo Container.

40′ Hi-Cube Steel Dry Cargo Container

Exterior
Length
Width
Height

40′-0″

8′-0″

9′-6″

12.192 m

2.438 m

2.896 m

Interior
Length
Width
Height

39′-5 45/64″

7′-8 19/32″

8′-9 15/16″

12.032 m

2.352 m

 

2.69 m

Weight
Door Opening
MGW
TARE
NET
Width
Height

67,200 lb

9,260 lb

57,940 lb

7′-8 1/8″

8′-5 49/64″

30,480 kg

4,200 kg

26,280 kg

2.343 m

CU.M

76.2

2.585 m

CU.FT

2,690

Purpose

Used for all kinds of general cargo.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Dry Cargo Container.

45′ Hi-Cube Steel Dry Cargo Container

Exterior
Length
Width
Height

45′-0″

8′-0″

9′-6″

13.716 m

2.438 m

2.896 m

Interior
Length
Width
Height

44′-5 7/10”

7′-8 19/32”

8′-10 17/64”

13.556 m

2.352 m

2.698 m

Weight
Door Opening
MGW
TARE
NET
Width
Height

67,200 lb

10,580 lb

56,620 lb

7′-8 1/8″

8′-5 3/4″

30,480 kg

4,800 kg

25,680 kg

2.340 m

CU.M

86.1

2.585 m

CU.FT

3,040

Purpose

Used for all kinds of general cargo.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Refrigerated Container

20′ M.G.S.S. Refrigerated Container

Exterior
Length
Width
Height

20′-0″

8′-0″

8′-6″

6.058 m

2.438 m

2.591 m

Interior
Length
Width
Height

18′- 17/32″

7′-6 15/32″

7′-5 39/54″

5.5 m

2.298 m

2.276 m

Nominal
Door Opening
Cubic Capacity
MGW
TARE

1006 cu.ft.

67,180 lb

2.340 m

6,700 lb

2.585 m

28.5 cu.m.

CU.M

28.8

CU.FT

1,016

Cooling capacity

Air exchange rate

Type

Temp.
control precision

w(kcal)/C(F)

CFM

cu.m/hr

2.340 m

2.585 m

11,000(9,460)/1.7(35)
6,280(5,400)/-18(0)

0-106

0-180

MHI
CPE14-2BAIIIEU

+-0.25C

10,550(9,073)/2(35)
6,150(5,289)/-18(0)

0-142

0-240

CARRIER
69NT40-551-501

+-0.25C

Purpose

Used for all kinds of general cargo.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Refrigerated Container

20′ Aluminum Refrigerated Container

Exterior
Length
Width
Height

20′-0″

8′-0″

8′-6″

6.058 m

2.438 m

2.591 m

Interior
Length
Width
Height

17′-9 15/16″

7′-6″

7′-3.63/64″

5.543 m

2.286 m

2.235 m

Nominal
Door Opening
Cubic Capacity
MGW
TARE

978.46 cu.ft.

52,800 lb

24,000 kg

6,314 lb

2,870 kg

27.72 cu.m.

CU.M

27.72

CU.FT

978.46

Cooling capacity

Air exchange rate

Type

Temp.
control precision

w(kcal)/C(F)

CFM

cu.m/hr

2.340 m

2.585 m

11,000(9,460)/1.7(35)
6,280(5,400)/-18(0)

0-106

0-180

MHI
CPE14-2BAIIIEU

+-0.25C

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Refrigerated Container

40′ M.G.S.S. Hi-Cube Refrigerated Container

Exterior
Length
Width
Height

40′-0″

8′-0″

9′-6″

12.192 m

2.438 m

2.896 m

Interior
Length
Width
Height

37′-11 55/64″

7′-6 15/32″

8′-4 5/32″

11.579 m

2.298 m

2.544 m

Nominal
Door Opening
Cubic Capacity
MGW
TARE

2,390 cu.ft.

74,960 lb

34,000 kg

9,150 lb

4,150 kg

67.70 cu.m.

CU.M

67.7

CU.FT

2,390

Cooling capacity

Air exchange rate

Type

Temp.
control precision

w(kcal)/C(F)

CFM

cu.m/hr

MHI
CPE16-2BAIIIEV

+-0.25C

11,000(9,460)/1.7(35)
6,280(5,400)/-18(0)

0-106

0-180

CARRIER
69NT40-551-501

+-0.25C

10,550(9,073)/2(35)
6,150(5,289)/-18(0)

0-142

0-240

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Refrigerated Container

40′ Hi-Cube Aluminum Refrigerated Container

Exterior
Length
Width
Height

40′-0″

8′-0″

9′-6″

12.192 m

2.438 m

2.896 m

Interior
Length
Width
Height

37′-11 55/64″

7′-6 15/32″

8′-4 5/32″

11.579 m

2.298 m

2.544 m

Nominal
Door Opening
Cubic Capacity
MGW
TARE

2,390 cu.ft.

74,960 lb

34,000 kg

9,150 lb

4,150 kg

67.70 cu.m.

CU.M

67.7

CU.FT

2,390

Cooling capacity

Air exchange rate

Type

Temp.
control precision

w(kcal)/C(F)

CFM

cu.m/hr

MHI
CPE16-2BAIIIEV

+-0.25C

11,000(9,460)/1.7(35)
6,280(5,400)/-18(0)

0-106

0-180

CARRIER
69NT40-551-501

+-0.25C

10,550(9,073)/2(35)
6,150(5,289)/-18(0)

0-142

0-240

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Special Container

20′ Full Height Open Top Container

Exterior
Length
Width
Height

19′-10 1/2″

8′-0″

8′-6″

6.058 m

2.438 m

2.591 m

Interior
Length
Width
Height

19′-4 13/64″

7′-8 19/32″

7′-7 11/16″

5.898 m

2.352 m

2.329 m

Weight
Door Opening
MGW
TARE
NET
Width
Height

52,910 lb

5,310 lb

47,600 lb

7′-8 1/4″

7′-4 31/32″

24,000 kg

2,410 kg

21,590 kg

2.343 m

2.260 m

CU.M

CU.FT

32.5

1,148

Purpose

Captioned units can be coordinated from UGMU 490001~UGMU 490150
and EMCU 460161~EMCU 460520.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Special Container

20′ Flat Rack Container with Collapsible End

Exterior
Length
Width
Height

20′-0″

8′-0″

8′-6″

6.058 m

2.438 m

2.591 m

Interior
Length
Width
Height

18′-5 31/32″

7′-3 23/32″

7′-3 59/64″

5.638 m

2.228 m

2.233 m

Weight
MGW
TARE
NET

74,950 lb

6,370 lb

68,580 lb

34,000 kg

2,890 kg

31,110 kg

Purpose

Captioned units can be coordinated from EISU 750000 to EISU 750300.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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Special Container

40′ Flat Rack Container with Collapsible End

Exterior
Length
Width
Height

40′-0″

8′-0″

8′-6″

12.192 m

2.438 m

2.591 m

Interior
Length
Width
Height

38′-7 39/64″

7′-3 23/32″

6′-4 61/64″

11.752 m

2.374 m

1.955 m

Weight
MGW
TARE
NET

99,210 lb

10,800 lb

89,410 lb

45,000 kg

4,900 kg

40,100 kg

Purpose

Captioned units can be coordinated from EISU 710000~EISU 710500.

Pl. note: These are approximate measurements and may vary slightly from line to line.

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