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Cardiomyopathy is a condition that affects the muscle of the heart. The muscle becomes thin, which is called dilated cardiomyopathy, due to various factors. It can also thicken, which is called hypertrophic cardiomyopathy.

 Many patients start Ornish Lifestyle Medicine while they are waiting for a donor heart.

This month we received questions about both conditions. To start, I’ll point to my previous article on hypertrophic cardiomyopathy,  Is There Research to Indicate Your Program Can Reverse Hypertrophy Heart Disease and Hypertension?

In this article, I’ll focus on dilated cardiomyopathy.

The Effects of Dilated Cardiomyopathy

The muscle of the heart gets sicks and weak as a result of a toxin, a heart attack, decreased blood supply, inflammation or a virus. It can stretch due to the intense pressures. When the heart stretches just a little, it is not a problem if it is able to recover quickly. Some people who experience this may never know they had an issue. When the heart muscle is injured repeatedly, the heart may stretch out to such an extent that it does not pump blood very well. This can happen with alcoholic cardiomyopathy, ischemic cardiomyopathy, or severe viral cardiomyopathy.

Ejection Fraction

Ejection fraction, which is written as a percentage, is the amount of blood the heart pumps out with each contraction. A normal ejection fraction is roughly between fifty and seventy percent. A borderline case is when someone has an ejection fraction between forty-one and forty-nine percent. Once a person’s ejection drops between thirty-five and forty percent, they are experiencing moderate to mild heart failure. An ejection fraction of less than thirty-five percent is considered severe. If it does not reverse, and physicians are not able to find a cause, then patients are often offered a heart transplant as a potential life saving measure.

Since it often takes a while to get a donor heart, many of these patients start the Ornish Lifestyle Medicine program while they are waiting. This is a great way for them to learn how to live in a heart healthy way. The program helps to decrease existing plaques in other arteries, and decrease systemic inflammation. It also helps with the emotional challenge of being told they need a heart transplant.

We didn’t develop Ornish Lifestyle Medicine to reverse dilated cardiomyopathy (and it is a problem that has many causes), but we have seen more than a dozen of these cases reverse to such an extent that the patient no longer needs a heart transplant.

You can read about a few of them here.

Many heart patients have also joined the Ornish Lifestyle Program to help their recovery after a heart transplant. You can read another story here.

Why Does the Program Create Such a Dramatic Change?

It’s important to understand that Ornish Lifestyle Medicine is not just a diet. That is only one-fourth of the program. The other three parts are stress management, exercise and group support. The stress management and group support elements of the program help to decrease systemic inflammation. Several studies have shown that Yoga and Stress Management are helpful for CHF. Studies have also shown that exercise is helpful.


The fitness element helps to increased oxygenation of tissues, collateral blood vessel development, and decrease plaques due to remodeling and then regression.

Plant-Based Diet

The low-fat, low- cholesterol plant-based diet, which is high in antioxidants, makes the entire system less ‘sticky.’  Cutting out meat and fat also means less toxins and food that create oxidative stress.

More than 80% of people who make these changes see a reversal of plaques and a 300%-400% increase in blood flow to the heart over 5 years. The more people change the better they feel, and that gives them the motivation to stick with the changes. (85-90% of people are still on the program one year later.)

Recommendations for Dilated Cardiomyopathy

In addition to the medical therapy recommended by a good cardiologist, we recommend:

  • Get your thyroid checked and ask your cardiologist if he or she thinks, you are are a good candidate for empiric therapy.
  • Get a test to rule out celiac disease as the incidence is much higher in patients with cardiomyopathy.
  • Some doctors may also recommend certain supplements that have been shown to add benefit including TaurineCoQ10 and Magnesium.
Contributed by

Ben Brown, MD
Medical Director, Ornish Lifestyle Medicine

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