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| Cardiomyopathy |
Last updated: Nov 05, 2009 |
Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations
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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.
DCM can be triggered by diabetes, alcohol abuse, infections, exposure to certain drugs and toxins, nutritional deficiencies, connective tissue diseases, hereditary disorders, and pregnancy. Although rare in developed countries, protein-calorie malnutrition may cause cardiomyopathy. Cardiomyopathy is a serious health condition and requires expert medical care.
Restrictive cardiomyopathy is usually due to a connective tissue disease, cancer, or an autoimmune condition. Both hypertrophic and restrictive cardiomyopathies are relatively uncommon.
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 Conditions that suggest Cardiomyopathy: | | | | | | Symptoms - Cardiovascular |  Enlarged heart
Counter-indicators:
 Absence of enlarged heart |
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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. |
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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 |
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. |
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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Infections |
Lyme Disease |
Nutrients |
Zinc Requirement| | Comparing 54 subjects with idiopathic dilated cardiomyopathy, with healthy matched controls, it was found that patients with dilated cardiomyopathy had higher levels of serum copper and lower levels of serum zinc than healthy controls, and no difference in magnesium levels. [Biol Trace Elem Res. 2003;95: pp.11-17] |
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Organ Health |
Diabetes Type II| | People with diabetes have been reported to be at increased risk for 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 |
Zinc Requirement| | Comparing 54 subjects with idiopathic dilated cardiomyopathy, with healthy matched controls, it was found that patients with dilated cardiomyopathy had higher levels of serum copper and lower levels of serum zinc than healthy controls, and no difference in magnesium levels. [Biol Trace Elem Res. 2003;95: pp.11-17] |
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]
Another study comparing patients with cardiomyopathy against controls found no difference in magnesium levels. [Biol Trace Elem Res. 2003;95: pp.11-17] How magnesium levels were measured is uncertain. |
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Recommendations for Cardiomyopathy: | | | | | | Amino Acid / Protein |  L-Carnitine| | There is a little 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. Will carnitine supplementation help the average person with cardiomyopathy? While it remains unknown, 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.
Carnitine deficiency may also be implicated in diabetic cardiomyopathy [ J Diabetes Complications 1999 Mar-Apr;13(2):86-90.] |
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Botanical |
 Arjun (Terminalia arjuna)| | 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 (Crataegus oxycantha)| | 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 > 2% vitexins). A study of cardiomyopathy and hawthorn has yet to be done. |
Coleus (Coleus forskohlii)| | 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 in people with cardiomyopathy. [Arzneim Forsch 1987;37: pp.364-7] It is unknown if oral coleus extracts would have the same effect, but some herbalists suggest 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 (Ubiquin-one/ol)| | 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 |
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