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Cardiomyopathy refers to abnormalities of the structure or function of the heart muscle. There are 3 major types of cardiomyopathy: dilated congestive, hypertrophic and restrictive. The most commonly encountered form is dilated congestive cardiomyopathy (DCM). In this type of cardiomyopathy, the heart muscle is damaged, commonly as a result of coronary artery disease, and gradually loses its efficiency as a pump.
Causes & Development
DCM can be triggered by diabetes, alcohol abuse, infections, exposure to certain drugs and toxins, nutritional deficiencies, connective tissue diseases, hereditary disorders or pregnancy. Although rare in developed countries, protein-calorie malnutrition may cause cardiomyopathy.
Restrictive cardiomyopathy is usually due to a connective tissue disease, cancer, or an autoimmune condition. Both hypertrophic and restrictive cardiomyopathies are relatively uncommon.
Treatment & Prevention
Dan Shen (Salvia miltiorrhiza), a Chinese herb, has been traditionally used to treat angina and coronary artery disease. Several studies suggest that Dan Shen may improve the force of heart contractions and coronary circulation and may prevent damage to the heart muscle that could lead to cardiomyopathy. However, no clinical trials of Dan Shen for DCM have been reported. Doctors expert in Chinese herbal medicine typically recommend 1-6gm per day of dried root.
Veterinary studies have demonstrated benefits from supplementation with taurine 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. However, clinical studies in humans are lacking; thus, despite a good safety record, recommending taurine supplementation in people with any form of cardiomyopathy may be premature. When taurine supplements are used by doctors to treat people with other conditions, 2gm taken three times per day for a total of 6gm per day is often recommended.
Seek medical attention if
Cardiomyopathy is a serious health condition and requires expert medical care.
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Conditions that suggest Cardiomyopathy:
Risk factors for Cardiomyopathy: | | | | | Addictions |  Alcohol-related Problems | Cardiomyopathy occurs with greater frequency in people who drink too much alcohol. The risk of developing DCM is greater for female than for male alcoholics [JAMA 1995;274(2): pp.149-54]. Alcoholics can develop a form of thiamine deficiency called wet beri beri or Shoshin beri beri, which frequently includes cardiomyopathy. |
 Cigarette Smoke Damage| | The risk of being diagnosed with cardiomyopathy goes up with the number of cigarettes smoked per day. Although there is room for controversy, all doctors recommend that smokers with DCM quit smoking. |
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Circulation |
Hypertension| | Hypertrophic cardiomyopathy is usually a hereditary disorder, although incidence of this form of cardiomyopathy may also be higher in people with hypertension. [Hypertension 1994;24(5): pp.585-90] |
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Environment / Toxicity |
Mercury Toxicity (Amalgam Illness)| | Mercury levels in the heart tissue of individuals who died from Idiopathic Dilated Cardiomyopathy (IDCM) were found to be on average 22,000 times higher than in individuals who died of other forms of heart disease. [J Amer Coll Cardiology v33(6) pp.1578-1583,1999] |
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Organ Health |
Diabetes Type II| | People with diabetes have been reported to be at increased risk of being diagnosed with DCM. |
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Cardiomyopathy suggests the following may be present: | | | | | Environment / Toxicity |  Mercury Toxicity (Amalgam Illness)| | Mercury levels in the heart tissue of individuals who died from Idiopathic Dilated Cardiomyopathy (IDCM) were found to be on average 22,000 times higher than in individuals who died of other forms of heart disease. [J Amer Coll Cardiology v33(6) pp.1578-1583,1999] |
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Nutrients |
Magnesium Requirement| | Myocardial magnesium was measured in 8 young patients (mean age 32) with ventricular tachycardia of less than 30 seconds in duration who underwent endomyocardial biopsy. Histologically, 4 had myocarditis and 1 had right-ventricular dysplasia. The other 3 patients had a cardiomyopathy with electron microscopic findings consistent with intracellular calcium overload, possibly due to reduced intracellular magnesium. Myocardial magnesium content was lower in the 4 with cardiomyopathic and dysplastic lesions than in the 4 with inflammatory lesions (myocarditis) and 8 controls. 10gm magnesium over 24 hours caused a resolution of ventricular tachycardias and a greater than 80% reduction in ventricular extrasystoles. No response was seen in the 4 patients with inflammatory lesions. [Lancet: 1019, 1987] |
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Recommendations and treatments for Cardiomyopathy: | | | | | Amino Acid / Protein |  Acetyl-L-Carnitine| | There is some evidence that carnitine may be useful in cardiomyopathy [J Child Neurol (Canada) 10: pp.2S45-2S51, 1995]. A deficiency of carnitine is associated with the development of some forms of cardiomyopathy. Inherited forms of cardiomyopathy seen in children may be the most responsive to therapy with L-carnitine. The question of whether carnitine supplementation will help the average person with cardiomyopathy remains unanswered, but some doctors recommend up to 3gm of carnitine per day for the average adult. Carnitine is thought to work well with CoQ10, the two treatments being often combined. |
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Botanical |
 Arjun| | Arjun has been shown to improve the signs, symptoms and objective measurements of cardiomyopathy. A clinical trial using 500mg of an extract tid for DCM patients with severe heart failure showed improvement in heart function within 2 weeks and improvement which continued for the following 2 years. The arjun in this trial was concentrated, but not standardized, as are some commercial preparations (1% arjunolic acid). [Int J Cardiol 1995;49: pp.191-9] |
Hawthorn Berry Extract| | Hawthorn can be an effective therapy for congestive heart failure, which is the main complication of cardiomyopathy. The clinical trials with heart failure patients have demonstrated efficacy using 80-300mg per day of standardized extract of hawthorn per day (containing more than 2% vitexins). A study of cardiomyopathy and hawthorn has yet to be done. |
Coleus| | Forskolin, found in coleus, may help dilate blood vessels and improve the forcefulness with which the heart pumps blood. A preliminary trial found that intravenous forskolin reduced blood pressure and improved heart function amongst people with cardiomyopathy [Arzneim Forsch 1987;37: pp.364-7]. It is unknown whether oral coleus extracts would have the same effect, but some herbalists recommend taking 200-600mg orally per day of a 10% forskolin extract. |
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Diet |
Alcohol Avoidance| | Many doctors suggest that individuals with cardiomyopathy abstain from alcohol consumption. People with alcohol-induced cardiomyopathy who avoid alcohol may regain their health. |
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Habits |
Not recommended:
 Aerobic Exercise| | Heavy physical activity can be life-threatening for cardiomyopathy patients. However, appropriate physician supervised exercise often benefits individuals with cardiomyopathy. |
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Mineral |
Boron |
Nutrient |
 CoQ10 (Ubiquinone)| | Pioneering trials of CoQ10 in cases of heart failure involved primarily patients with dilated weak heart muscle of unknown cause (idiopathic dilated cardiomyopathy). CoQ10 was added to standard treatments for heart failure such as fluid pills (diuretics), digitalis preparations, and ACE inhibitors. Several trials involved the comparison between supplemental CoQ10 and placebo on heart function as measured by echocardiography. CoQ10 was given orally in divided doses as a dry tablet chewed with a fat-containing food or an oil-based gel cap swallowed at mealtime.
Heart function, as indicated by the fraction of blood pumped out of the heart with each beat (the ejection fraction), showed a gradual and sustained improvement in tempo with a gradual and sustained improvement in patients' symptoms of fatigue, shortness of breath, chest pain and palpitations. The degree of improvement was occasionally dramatic with some patients developing a normal heart size and function on CoQ10 alone. Most of these dramatic cases were patients who began CoQ10 shortly after the onset of congestive heart failure. Patients with more established disease frequently showed clear improvement but not a return to normal heart size and function.
A few studies, however, have found no benefit from CoQ10 supplementation in treating people with cardiomyopathy. Despite a partial lack of consistency in the outcomes of published research, most holistic doctors recommend 100-150mg per day taken with meals.
Coenzyme Q10 has also been shown to improve cardiac function in people with hypertrophic cardiomyopathy - a less common form of cardiomyopathy. [Am Heart J 1996;132(Pt 1): pp.61-70] |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link |  | | Strongly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended | | | May have adverse consequences |
GLOSSARY
Angina
Angina Pectoris: Severe, restricting chest pain with sensations of suffocation caused by temporary reduction of oxygen to the heart muscle through narrowed diseased coronary arteries. Often triggered by exertion. Angina Vasomotoria: Like the previous, but less dangerous and more frequently caused by purely neurologic stimulus. The pain is more spasmodic and there is usually little actual blood vessel blockage.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Cardiac
Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.
Carnitine
A compound found in skeletal and cardiac muscle and certain other tissues that functions as a carrier of fatty acids across the membranes of the mitochondria. Carnitine has been used therapeutically in treating angina and certain deficiency diseases.
Coenzyme
A heat stable molecule that must be associated with another enzyme for the enzyme to perform its function in the body. It is necessary in the utilization of vitamins and minerals.
Congestive
Pertaining to accumulation of blood or fluid within a vessel or organ.
DCM
Dilated Congestive Cardiomyopathy, the most common type of cardiomyopathy.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Diuretic (Diuretics)
An agent increasing urine flow, causing the kidneys to excrete more than the usual amount of sodium, potassium and water.
Dysplasia
Abnormal development of tissue.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Idiopathic
Arising spontaneously or from an obscure or unknown cause.
Lesion (Lesions)
Any damage to tissue structure or function; an abnormal change in body tissue caused by disease or injury. A scar is a lesion, as is cancer, a stomach ulcer or a pimple.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Myocarditis
Inflammation of heart muscle. It can be mild, with virtually no noticeable symptoms, or more serious, leading to weakening of the heart muscle. It can then cause heart failure (with symptoms of shortness of breath, fatigue, fluid accumulation in the lungs, etc.) as well as heart rhythm irregularities from inflammation and/or scarring of the electrical system of the heart.
Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Taurine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. May be needed for the proper development and maintenance of the central nervous system. Taurine's role in bile formation is important for fat metabolism and blood cholesterol control.
Thiamine (B1, B-1, Thiamin, Vitamin B1)
A B-complex vitamin that acts as a coenzyme necessary for the conversion of carbohydrates into glucose, which is burned in the body for energy. It is essential for the functioning of the nervous system.
TID
Three times a day.
Ventricular Tachycardia
Excessively rapid heart beat due to uncontrolled ectopic focus in the ventricle.
Last updated: Apr 13, 2008
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