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Cardiomyopathy
Breathe easier and return your heart to better health
by dealing with the damage caused by cardiomyopathy. According to research or
other evidence, the following self-care steps may be helpful:

- See a specialist
- Consult a cardiologist for advice on treating your
type of cardiomyopathy and its underlying causes
- Count on coenzyme Q10
- At mealtime, take 100 to 150 mg a day of this
powerful antioxidant to improve quality of life, heart function, and survival
rates
- Get help from hawthorn
- Relieve heart failure symptoms associated with
cardiomyopathy by taking 160 to 900 mg a day of a standardized extract of this
heart-healthy herb
- Kick the habits
- Prevent cardiomyopathy and its complications by
limiting or giving up alcohol and ending your addiction to cigarettes
- Discover arjun
- Improve heart function by taking 500 mg of a
concentrated extract of this herb three times a day
These recommendations are not comprehensive and are not
intended to replace the advice of your doctor or pharmacist. Continue reading
the full cardiomyopathy article for more in-depth, fully-referenced information
on medicines, vitamins, herbs, and dietary and lifestyle changes that may be
helpful.
About cardiomyopathy
Cardiomyopathy 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. Cardiomyopathy 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.
Product ratings
for 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.
Medical options
Prescription drug therapy is directed toward treating any underlying cause.
Medications used include cholesterol-lowering drugs, such as atorvastatin
(Lipitor) and rosuvastatin
(Crestor); ACE
inhibitors, such as captopril
(Capoten), enalapril
(Vasotec), and lisinopril
(Zestril, Prinivil); beta-blockers,
such as atenolol
(Tenormin), carvedilol
(Coreg), and metoprolol
(Lopressor, Toprol XL); the combination of hydralazine
(Apresoline) and isosorbide
dinitrate (Isordil); digoxin
(Lanoxin); and diuretics,
such as hydrochlorothiazide
(HydroDIURIL) and furosemide
(Lasix).
Severe cases might require heart transplantation surgery.
Dietary changes that may be helpful
Protein-calorie malnutrition (PCM) may cause cardiomyopathy, though PCM is
rare in U.S. society.
Lifestyle changes that may be helpful
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.
Vitamins that may be helpful
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 cardiomyopathya 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 Keshans 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? Refer to the individual supplement for information about
any side effects or interactions.
Herbs that may be helpful
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? Refer to the individual herb for information about any
side effects or interactions.
References
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Copyright © 2006 Healthnotes, Inc. All rights reserved.
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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. Information expires August
2007.
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