The effects of alcohol on the heart.

We have discussed in this review many features and possible mechanisms responsible for the development of alcoholic cardiomyopathy. The evidence suggests that defects in myofibrillar protein turnover occur in both acute and chronic alcohol studies. Possible mechanisms to explain poor contractile function include alterations in cellular calcium, magnesium or phosphate homeostasis. The toxic effects of acetaldehyde or the formation of fatty acid ethyl esters may cause impairment of mitochondrial oxidative phosphorylation. Alternatively, reduced amounts of heat shock proteins may result in poor assembly and protection of proteins. In acute ethanol toxicity ischaemia may occur, possibly due to increased xanthine oxidase activity or beta-adrenergic stimulation. Chronic alcohol consumption can also lead to the development of hypertension via magnesium loss and consequent alterations in peripheral vascular calcium regulation. However, these are only a few facets of a complex relationship between alcohol and the cardiovascular system.