There is a discrepancy between the incidence of cardiac abnormality seen at autopsy (up to 90%), the incidence of contractility abnormality at cardiac catheterisation (about 30%) and the low clinical incidence of cardiac abnormality (some 2%) seen in chronic alcoholics. This suggests that sub-clinical cardiomyopathy may be frequent. Support for this suggestion is provided by the high incidence of contractility abnormality (approximately 30%) observed using the non-invasive technique of systolic time interval measurement and by studies which have demonstrated release of cardiac mitochondrial enzymes into coronary sinus blood in chronic alcoholics following acute alcohol exposure. Histopathological abnormalities in the hearts of chronic alcoholics serve to explain the haemodynamic abnormalities observed, and the structural abnormalities may be interpreted on the basis of possible biochemical alteration.
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