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Cardiomyopathy Information
refers to abnormalities in the structure or function of the heart muscle.
There are three major types of cardiomyopathy: dilated congestive, hypertrophic, and
restrictive.
The most prevalent form is dilated congestive cardiomyopathy (DCM). In people with DCM, the
heart muscle is damaged, most commonly by coronary artery disease (atherosclerosis).1 People with diabetes have been reported to be at increased risk of
DCM.2 DCM can also be triggered by alcohol abuse, infections, exposure to certain drugs and toxins,
nutritional deficiencies, connective tissue diseases, hereditary disorders, and pregnancy.
In DCM, the heart gradually loses its efficiency as a pump. is a serious
health condition and requires expert medical care rather than self-treatment. However, because
of the associations between cardiomyopathy and diseases such as atherosclerosis, diabetes, hypertension, and congestive heart failure, lifestyle recommendations
for the prevention of these conditions may also help prevent DCM.
Hypertrophic cardiomyopathy is usually a hereditary disorder, although the incidence of
this form of cardiomyopathy may also be higher in people with hypertension.3
Restrictive cardiomyopathy is usually due to a connective tissue disease, cancer, or an autoimmune condition. Both hypertrophic
and restrictive cardiomyopathies are relatively uncommon.
What are the symptoms of cardiomyopathy?
People with cardiomyopathy may have difficulty breathing during light exertion, and they
may become fatigued easily. Other chronic symptoms are swelling around the ankles and an
enlarged abdomen.
Dietary changes that may be helpful for cardiomyopathy
Protein-calorie malnutrition (PCM) may cause cardiomyopathy, though PCM is rare in U.S.
society.
Lifestyle changes that may be helpful for cardiomyopathy
occurs with greater frequency in people who drink to excess.4
Alcoholics are at significantly greater risk of developing a deficiency of thiamine (vitamin B1).5 6 They
also may develop a form of thiamine deficiency called wet beri beri or Shoshin beri beri,
which frequently includes cardiomyopathy.7 8 See “Nutritional
supplements that may be helpful,” below, for more information.
Among alcoholics, the risk of developing DCM is greater for women than for men.9
Many doctors suggest that people with cardiomyopathy abstain from alcohol consumption. People
with alcohol-induced cardiomyopathy who avoid
alcohol may regain their health.
Moderate to heavy physical activity can be life-threatening for people with
cardiomyopathy;10 however, appropriate exercise often improves the
condition.11 12 13 14 How much is “too
much” varies from person to person. Any exercise program undertaken by someone with
cardiomyopathy requires professional supervision.
The risk of being diagnosed with cardiomyopathy goes up with the number of cigarettes
smoked per day.15 16 However, a few studies have reported a paradoxical
decrease in the death rate among smokers with DCM compared with nonsmokers who have
this disease.17 18 While the meaning of this association remains
unclear, virtually all doctors recommend that smokers with DCM quit smoking for a wide variety
of health-related reasons.
Nutritional supplements that may be helpful for cardiomyopathy
People with DCM have been shown to be deficient in coenzyme Q10.19 Most studies using coenzyme
Q10 in the treatment of cardiomyopathy have demonstrated positive results, including improved
quality of life, heart function tests, and survival rates.20 21
22 Coenzyme Q10 also has been shown to improve cardiac function in people with
hypertrophic cardiomyopathy—a less common form of cardiomyopathy.23 A few
studies, however, have found no benefit from CoQ10 supplementation in treating people with
cardiomyopathy.24 25 Despite a lack of consistency in the outcomes of
published research, many doctors recommend that 100 to 150 mg be taken each day, with
meals.
Deficiency of L-carnitine, an amino acid, is associated with the development of some
forms of cardiomyopathy.26 Inherited forms of cardiomyopathy seen in children may
be the most responsive to therapy with L-carnitine.27 28 Whether
carnitine supplementation helps the average person with cardiomyopathy remains unknown.
Nonetheless, some doctors recommend 1 to 3 grams of carnitine per day for adults of average
weight.
Several veterinary studies have demonstrated benefits from supplementation with taurine, another amino acid, in animals with
cardiomyopathy. Most of these studies showed taurine deficiency to be a cause of
cardiomyopathy. Taurine supplementation in animals with DCM has resulted in improvement of
symptoms and survival rates.29 30 However, clinical studies in humans
are lacking; thus, despite a good safety record, the benefits of taurine supplementation in
people with any form of cardiomyopathy remain speculative. When taurine supplements are used
by doctors to treat people with other conditions, 2 grams taken three times per day for a
total of 6 grams per day is often recommended.
Selenium deficiency has occasionally been
reported as a cause of cardiomyopathy.31 32 Selenium deficiency is the
probable cause of Keshan’s disease, a form of cardiomyopathy found in China33
34 but only rarely reported in the United States.35 Studies comparing
populations in parts of the world other than mainland China have not supported a link between
selenium deficiency and DCM,36 37 except in Taiwan.38
Moreover, no clinical trials outside of China have explored the effects of supplementation
with selenium for people with DCM, nor is there reason to believe that selenium
supplementation would help most people outside of China and Taiwan suffering from
cardiomyopathy.
The small proportion of people with cardiomyopathy whose disease is due to severe vitamin B1 (thiamine) deficiency (known as wet beri
beri) generally require intravenous vitamin B1, followed by oral supplementation. Vitamin B1
does not appear to be helpful for other types of cardiomyopathy. People requiring vitamin B1
for cardiomyopathy must first be diagnosed as having wet beri beri, and treatment must be
supervised by a healthcare professional.
Are there any side effects or interactions with Cardiomyopathy?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful for cardiomyopathy
Many doctors expert in herbal medicine consider hawthorn to be an effective and low-risk therapy for
congestive heart failure, the main
complication of cardiomyopathy. Rigorous clinical trials have now confirmed the effectiveness
of hawthorn for the signs and symptoms of early-stage congestive heart failure,39
40 41 though hawthorn studies with cardiomyopathy patients have yet to
be conducted. The clinical trials with heart-failure patients have demonstrated efficacy using
80 to 300 mg of standardized extract of hawthorn leaves and flowers two to three times per
day.
Two herbs used in the traditional medicine of India (Ayurveda) to treat people with cardiomyopathy and
congestive heart failure have recently been supported by a small amount of clinical research.
Arjun (Terminalia arjuna) has been shown to significantly improve the signs and
symptoms of cardiomyopathy, as well as the objective measurements of heart
function.42 In a clinical trial, people with DCM and severe heart failure took 500
mg of arjun extract three times daily. After two weeks, significant improvement in heart
function was observed, an effect that continued over the course of approximately two
years.43 The arjun used in this study was concentrated, but not standardized for
any particular constituent. Commercial preparations are sometimes standardized to contain 1%
arjunolic acid.
Another Ayurvedic herb, coleus, contains
forskolin, a substance that may help dilate blood vessels and improve the forcefulness with
which the heart pumps blood.44 Recent clinical studies indicate that forskolin
improves heart function in people with cardiomyopathy and congestive heart
failure.45 46 A preliminary trial found that forskolin reduced blood
pressure and improved heart function in people with cardiomyopathy. These trials used
intravenous injections of isolated forskolin. It is unknown whether oral coleus extracts would
have the same effect. While many doctors and practitioners of herbal medicine would recommend
200 to 600 mg per day of a coleus extract containing 10% forskolin, these amounts are
extrapolations and have yet to be confirmed by direct clinical research.
Dan shen (Salvia miltiorrhiza), a Chinese herb, has been traditionally used to
treat angina and coronary artery disease. Some studies suggest that dan
shen may improve the force of heart contractions and coronary circulation, and may prevent
damage to the heart muscle that might lead to cardiomyopathy.47 48
49 However, no clinical trials of dan shen for DCM have been reported. Doctors expert in
Chinese herbal medicine typically recommend 1 to 6 grams per day of dried root.
Are there any side effects or interactions with Cardiomyopathy?
Refer to the individual herb for information about any side effects or interactions.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
pharmacist for any health problem and before using any supplements or before
making any changes in prescribed medications.
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