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American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

 

 

 

 

 

 

 

ABSTRACT 

Effects of alcohol metabolites, mainly acetaldehyde, on the heart. Disturbances in metabolism and electrolyte 

imbalance lead to arrhythmias and disturbances in the functional activity of the heart. Acetaldehyde disrupts the 

synthesis of several compounds and increases the synthesis of inflammatory cytokines and leads to the development 

of an autoimmune process. The weight of the heart is 500-550 gr. and it is observed that it is filled with fat. When the 

heart is placed on the operating table, it is diffuse, similar to infectious myocarditis, and the heart is red or purple in 

color. 

KEYWORDS 

Alcohol, cardiomyocyte, heart, ventricle, compartment, dystrophy. 

INTRODUCTION

In recent years, according to WHO data and 

epidemiological studies, diseases of the cardiovascular 

system remain dominant in economically developed 

countries. Cardiomyopathies are an important part of 

cardiovascular diseases with their severe course and 

numerous life-threatening complications [3,5]. There 

are several types of cardiomyopathies, one of which is 

alcoholic cardiomyopathy. The relevance of alcoholic 

CMP is determined by its relatively frequent 

occurrence, development along with other heart 

diseases, and in most cases it leads to sudden death. It 

has been confirmed that 15% of patients with chronic 

alcoholism suffer from alcoholic CMP and 18% of them 

die accidentally [1,4]. 

  Research Article 

 

CHARACTERISTICS OF PATHOMORPHOLOGICAL CHANGES OF 

ALCOHOLIC CARDIOMYOPATHY 
 

Submission Date: June 20, 2024, Accepted Date:  June 25, 2024,  

Published Date: June 30, 2024  

Crossref doi: https://doi.org/10.37547/ajbspi/Volume04Issue06-11 

 

 

Oripova Ozoda Olimovna 
Samarkand State Medical University, Samarkand, Uzbekistan 

 

 

 

Journal Website: 

https://theusajournals.

com/index.php/ajbspi 

Copyright: Original 

content from this work 

may be used under the 

terms of the creative 

commons attributes 

4.0 licence. 

 

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Volume 04 Issue 06-2024 80 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

This type of CMP develops from the specific effects of 

alcohol on the heart. The main reason is chronic alcohol 

consumption, drinking 100 ml every day for 10-20 years. 

Histological examination reveals that the muscle fibers 

are thickened and there are many connective tissue 

fibers between the muscles, the typical characteristic 

of this KMP is that the interstitial tissue is wide, the 

muscle fibers are stiffened, and there are large thrombi 

attached to the inner wall of the left ventricle [2,6]. 

The purpose of the research: to clarify the specific 

macro- and microscopic changes of the heart in 

alcoholic cardiomyopathy; 

METHODS 

We reviewed 5,642 reports from the RPAM autopsy 

department during 2011-2020, and a total of 64 CMPs 

were identified during this period, accounting for 1.13% 

of all autopsies and 4.7% of cardiovascular diseases. 11 

of the 64 identified cases were alcoholic 

cardiomyopathy. After macroscopic examination of 

the heart, 1.5x1.5x0.5 cm pieces taken from the walls of 

both ventricles and both compartments were frozen in 

a 10% solution of formalin in phosphate buffer for 48 

hours, then washed in running water for 3-4 hours and 

placed in a series of alcohol batteries of increasing 

concentration (80˚ , 90˚, 96˚, 96˚, 100˚) and dehydrated 

in chloroform, paraffin with added wax was poured, 

and bricks were prepared. Histological sections 5-6 μm 

thick were taken from paraffin blocks and stained with 

hematoxylin-eosin and van Gieson stain to identify 

connective tissue fibers. Histological preparations 

were studied in 10, 20, 40 lenses of a light microscope, 

and pictures were taken from the necessary areas. 

RESULTS 

Due to the chronic intoxication of the body under the 

influence of alcoholic KMP ethanol, in most cases, due 

to the lack of proteins and thiamine in the heart tissue, 

all parts of the organ become enlarged almost to the 

same extent, their cavities expand, often the right 

ventricle becomes enlarged and dilated. In our 

material, 14 cases of alcoholic KMP were detected, all 

of which had a dramatically enlarged heart, with an 

average weight of 582.7 g. it was observed that the 

heart was filled with fat in some of them. It was 

observed that the heart was macroscopically enlarged, 

reddish in color, softened in consistency, and spread 

out like dough when placed on the table. From the 

cavities of the heart, it was often found that the right 

ventricle was suddenly enlarged, and its wall was 

dilated. 

Microscopic examination of this condition revealed 

that this type of KMP is a characteristic change, that is, 

the myocardial interstitial tissue is strongly swollen, as 

a result of which each of the muscle fibers is shriveled 

and located separately (Fig. 1). Separated muscle fibers 

are crooked, some of them are cracked, the transverse 

extension lines are not well visible, they are sparse. 

Cardiomyocyte nuclei are few and those that are 

present are hypertrophied and enlarged. It is 

determined that the connective fibers in the interstitial 

tissue are shortened and turned into a sparse network, 

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Volume 04 Issue 06-2024 81 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

and the cells are suspended. It is observed that the 

swelling of the interstitium is even stronger in the areas 

where the blood vessels are located, as a result of 

which the structural units of the connective tissue are 

disintegrated, blood is poured around the vessels in a 

diapedesis manner. It is determined that the wall of the 

arterial blood vessels is narrowed due to sclerosis, the 

tissue structures in the wall are dense with each other 

and form a whole layer. It is observed that the blood 

vessels of the vein are sharply expanded, the wall is 

thinned, the cavity is filled with blood, blood is poured 

around it in a diapedesis method (Fig. 2). It is 

determined that the murash fibers located in this area 

are shriveled and fragmented, some of them undergo 

myolysis, and others undergo vacuolization. 

In most cases of alcoholic KMP, it is determined that 

the interstitial swelling spread in the myocardial tissue 

simultaneously spreads to the interstitial tissue and the 

cytoplasm of parenchymatous cells, that is, 

cardiomyocytes. This condition is called myocardosis, 

the reason for which is a metabolic disorder in 

alcoholism, that is, due to a violation of the protein 

synthesizing function of the liver, there is less protein 

in the myocardium, instead of it, thiamine substance 

increases, and the swelling process develops in both 

interstitial tissue and cardiomyocytes. Microscopically, 

small vacuoles appeared in the sarcoplasm of some 

cardiomyocytes, while in others, a tumor center 

appeared under the outer cytolemma (Fig. 3), around 

myofibrils. In this case, it is determined that the nucleus 

and myofibrils of cardiomyocytes are pushed to the 

edge of the cell. 

 

Figure 1. Alcoholic KMP. Myocardial interstitial tissue is severely swollen and muscle fibers are separated from 

each other. Paint: G-E. Floor: 10x40. 

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Volume 04 Issue 06-2024 82 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

 

Figure 2. Alcoholic KMP. Myocardial artery wall is narrowed due to thickening, veins are widened and full. Paint: G-

E. Floor: 10x40. 

 

 

Figure 3. Alcoholic KMP. Intracellular and extracellular edema in the myocardium. Paint: G-E. Floor: 10x40. 

 

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Volume 04 Issue 06-2024 83 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

 

Figure 4. Alcoholic KMP. Interstitial tissue tumor, sclerosis in and around the artery wall, development of 

destruction in the wall. Paint: G-E. Floor: 10x10. 

As characteristic changes of alcoholic KMP, a strong 

swelling of the interstitial tissue and the wall of blood 

vessels and around it, as well as the growth of 

connective tissue, were noted. In this 

photomicrograph, it is clearly seen that due to the 

development of a very strong swelling in the interstitial 

tissue of the myocardium, muscle fibers are separated 

and torn. If we pay attention to the wall of the artery, 

it is determined that the connective tissue has a 

different thickness due to growth and destruction. In 

one part of the arterial wall, it is determined that the 

tissue structures have hardened, fatty substances have 

accumulated between them, and even spread to the 

endothelium layer, bulging it (Fig. 4). 

Another reason for myocardium swelling and dilatation 

in alcoholic KMP is that the process of extracellular and 

intracellular swelling in some areas of the myocardium 

eventually destroys the sarcoplasm and myofibrils of 

cardiomyocytes and leads to myolysis (Fig. 5). In this 

area, accumulation of lymphohistiocytic cells in the 

interstitial tissue and around blood vessels, their 

activation and hypertrophy and hyperchromasia are 

determined. As another pathological change in the 

composition of cardiomyocyte cells, foci of 

lipofuscinosis and calcinosis are observed. 

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Volume 04 Issue 06-2024 84 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

 

Figure 5. Alcoholic KMP. Due to extracellular and intracellular swelling, sarcoplasm and myofibrils of 

cardiomyocytes were shriveled and subjected to myolysis. Paint: G-E. Floor: 10x40. 

 

 

Figure 6. Alcoholic KMP. The appearance and proliferation of fat cells and histiocytic cells in the interstitial tissue 

of the myocardium. Paint: G-E. Floor: 10x40. 

 

Microscopic examination of myocardial tissue in 

alcoholic KMP revealed another specific 

pathomorphological change. Since these data are not 

found in the scientific literature, we will describe the 

comprehensive histological picture. In some areas of 

the interstitial tissue of the myocardium, the 

proliferation of connective tissue cells, i.e. histiocytic 

cells, among them, metaplasia of histiocytic cells into 

fat cells was found (Fig. 6). It can be distinguished that 

in fact it has been confirmed that fat cells grow into the 

interstitium of the myocardium from the adipose tissue 

under the epicardium. In our material, it was found that 

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Volume 04 Issue 06-2024 85 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

fat cells, i.e., lipocytes, arise by metaplasia from 

interstitial tissue histiocytes. Proliferation and increase 

of histiocytic cells is observed in the composition and 

space of muscle fibers around this area. In cases of 

alcoholic KMP, foci of histiocytic proliferation and 

lipomatous metaplasia in the interstitial tissue of the 

myocardium are enlarged due to the increase of 

adipocytes, fat cells are scattered around. Around such 

foci, it is determined that there is an increase in fat 

cells, different morphofunctional conditions, that is, 

there are cells rich in granules and cells with reduced 

granules (Fig. 7). In the places where fat cells are 

located, it is determined that both interstitial tissue 

and muscle tissues are dystrophied and destroyed. 

 

Figure 7. Alcoholic KMP. The appearance of fat cells in the lipomatous area of the intermediate tissue. Paint: G-E. 

Floor: 10x40. 

 

Figure 8. Alcoholic KMP. Metaplasia of histiocytic cells to lipocytes in the interstitial tissue of the myocardium. 

Paint: G-E. Floor: 10x40. 

Pathomorphological changes that develop in the 

myocardium in alcoholic CMP have been confirmed to 

have a specific morphogenesis, as a result of joint 

initiation and escalation of alcohol intoxication, 

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Volume 04 Issue 06-2024 86 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 04 ISSUE 06 PAGES: 79-86 

OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

metabolic disorders, organization and dysregeneration 

processes. First of all, if there is a strong swelling and 

destruction of structural structures in the interstitial 

tissue, in addition, due to dysregeneration of 

histiocytic cells, their metaplasia into fat cells is 

determined. In this case, the histiocytic cells have a 

different structure, the cytoplasm of some of them is 

strongly eosinophilic, while the cytoplasm of others is 

swollen due to the appearance of lipids (Fig. 8). The 

cytoplasm of some of them is completely filled with 

lipids, so the cytoplasm is wide and the lipid-filled 

adiposide is determined. 

CONCLUSION 

As characteristic changes of alcoholic KMP, a strong 

swelling of interstitial tissue and the wall of blood 

vessels and around them, as well as growth of 

connective tissue are observed. It is determined that 

the arterial wall has a different thickness due to the 

growth and destruction of the connective tissue. In 

some areas of the interstitial tissue of the myocardium, 

proliferation and increase of connective tissue cells, 

that is, histiocytic cells, among them, metaplasia of 

histiocytic cells into fat cells was found. The cytoplasm 

of some of them is completely filled with lipids, so it is 

determined that they have completely metaplasticized 

into the adiposide cells, which have a large cytoplasm 

and are full of lipids. 

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V.N.  Cirrhotic cardiomyopathy: the liver affects the 

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2. Elleuch N., Mrabet S., Ben Slama A., Jaziri H., 

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3. Karafiatova L., Pika T. Amyloid cardiomyopathy. // 

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6. Zardi E.M., Abbate A, Zardi D.M., Dobrina A., 

Margiotta D., Van Tassell B.W., Afeltra A., Sanyal 

A.J. Cirrhotic cardiomyopathy. // J. Am. Coll. 

Cardiol.- 2010. - Aug 10. -№56 (7). – Р.539-49.  

 

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