The good, the bad, and the ugly with alcohol use and abuse on the heart

Alcohol Clin Exp Res. 2013 Aug;37(8):1253-60. doi: 10.1111/acer.12109. Epub 2013 Mar 25.

Abstract

Since its advent, alcohol has been utilized throughout history socially, for rituals, worship, and for its therapeutic, antibacterial, and analgesic properties. In moderation, alcohol consumption and its use are generally viewed as clinically beneficial. Excessive alcohol consumption on the other hand has been recognized as having several adverse implications. Excessive use increases the risk of liver and heart disease, metabolic disturbances, nutritional deficiencies, certain cancers, brain damage, dementia, neuropathy, as well as other facets of morbidity and mortality. This review targets the sequelae of alcohol consumption on the heart, specifically on myocardial contractility, calcium channel signaling, and intracellular signaling pathways. With the incidence of alcohol-induced cardiac abnormalities being higher than previously thought, it is of increasing importance to elucidate the mechanisms behind them. Here, the cardiac effects of alcohol were not discussed in isolation but in conjunction with other important factors, such as high- and low-density lipoprotein levels and vascular dilatory influences. We explore these mechanisms, in particular, the oxidative stress as the major contributor, as well as pathways that may prove to be cardioprotective. As such, we demonstrate the involvement of nuclear factor (erythroid-derived 2)-like 2 (NFE2L2/NRF2) as well as AKT that act as regulators of oxidative balance during oxidative stress responses. Thus, alcohol consumption may confer a cardioprotective effect when used in moderation through an AKT/NRF2-dependent mechanism.

Keywords: AKT; Alcohol; Cardiomyopathy; Heart; Oxidative Stress.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Alcoholic Beverages / statistics & numerical data
  • Apoptosis
  • Calcium Signaling
  • Cardiomyopathy, Alcoholic / etiology*
  • Central Nervous System Depressants / metabolism
  • Central Nervous System Depressants / pharmacology*
  • Ethanol / metabolism
  • Ethanol / pharmacology*
  • Heart / drug effects*
  • Homeostasis
  • Humans
  • Ischemic Preconditioning
  • Myocardial Contraction
  • Oxidative Stress
  • Sex Characteristics

Substances

  • Central Nervous System Depressants
  • Ethanol