Crystal methamphetamine-associated cardiomyopathy: Tip of the iceberg?
Crystal methamphetamine-associated cardiomyopathy: Tip of the iceberg?
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DOI：
10.1081/clt-120026521
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发表时间：
2003-01-01
期刊：
影响因子：
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通讯作者：
Schatz, I
中科院分区：
文献类型：
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作者：
Wijetunga, M;Seto, T;Schatz, I
背景冰毒已成为一种广泛使用的毒品。先前的报告描述了与甲基苯丙胺使用有关的心肌梗死、肺水肿和主动脉夹层。由于甲基苯丙胺暴露引起的心肌病很少被描述。方法.我们确定了1640例在4年内入院的原发性或继发性心肌病患者。我们排除了除药物滥用以外的已知心肌病病因的患者。我们发现120名患者被诊断为药物滥用，其中21名患者使用甲基苯丙胺。我们回顾性地回顾了这21名冰毒使用者的医疗记录。结果19例（84%）进行了超声心动图检查，结果一致，扩张型心肌病和整体心室功能障碍。五个人进行了核心肌灌注研究，没有缺血或梗死的证据。在6名接受心导管插入术的患者中，只有1人有冠状动脉狭窄的证据。结论甲基苯丙胺的使用似乎在一些使用者中产生心肌病。其发病机制可能与可卡因和儿茶酚胺引起的心肌病相似。细胞，动物和临床数据支持甲基苯丙胺暴露和心肌病理学之间的联系。
Background. Crystal methamphetamine has become a drug of widespread use. Previous reports describe myocardial infarction, pulmonary edema, and aortic dissection related to methamphetamine use. Cardiormyopathy due to methamphetamine exposure has been rarely described. Methods. We identified 1640 patients admitted in a 4-yr period with a primary or secondary diagnosis of cardiomyopathy. We excluded patients with known cause of cardiomyopathy other than substance abuse. We found 120 patients had a diagnosis of substance abuse, including 21 patients with methamphetamine use. We retrospectively reviewed the medical records of these 21 crystal methamphetamine users. Results. Nineteen (84%) underwent echocardiography with consistent findings of dilated cardiomyopathy and global ventricular dysfunction. Of five who had a nuclear myocardial perfusion study, none had evidence of ischemia or infarct. Of six who underwent cardiac catheterization, only one had evidence of coronary stenosis. Conclusion. Methamphetamine use appears to produce cardiomyopathy in some users. The pathogenesis is probably similar to that of cocaine and catecholamine-induced cardiomyopathy. Cellular, animal, and clinical data support the link between methamphetamine exposure and myocardial pathology.