[Alcoholic cardiomyopathy - a risk factor in sudden death].

Alcoholic cardiomyopathy (ACMP) is characterised on the basis of light and ultrastructural analysis as a separate unity which in 30% is a cause of sudden cardiac death (SCD) of persons of the most active age. Specific features of SCD in the presence of ACMP as compared to SCD from coronary heart disease is a younger age, a lesser degree of coronary stenosis, differences in the microcirculation as well as histological and ultrastructural myocardial alterations. Ultrastructural alterations indicate serious disturbances of electrolyte metabolism in cardiomyocytes including calcium metabolism which may result in the discordance between excitation and contraction and sudden death. ACMP develops not frequently even in persons with long-lasting alcoholic abuse. This implies that specific metabolic background, particularly concerning the activity of enzymes involved in the ethanol metabolism, appears to be necessary for the development of ACMP.