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.
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.
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.
Cardiomyopathy is a serious health condition and requires expert medical care.
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.
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.
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]
People with diabetes have been reported to be at increased risk of being diagnosed with DCM.
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.1578-83,1999]
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]
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.
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 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.
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.
Many doctors suggest that individuals with cardiomyopathy abstain from alcohol consumption. People with alcohol-induced cardiomyopathy who avoid alcohol may regain their health.
There have been several studies of CoQ10 use in cardiomyopathy. One double-blind controlled trial followed 80 people with various forms of cardiomyopathy over a period of 3 years. Of those treated with CoQ10, 89% improved significantly, but when the treatment was stopped, their heart function deteriorated. [Langsjoen PH, et al. Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10. Proc Natl Acad Sci 82: 4240, 1985.]
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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