Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA. hiroki
Clin Cardiol. 2009 Jun;32(6):E18-22. doi: 10.1002/clc.20367.
Methamphetamine is currently the most widespread illegal stimulant abused in the United States. No previous reports comparing echocardiographic findings of cardiomyopathy with and without a history of methamphetamine abuse are available.
We performed a single institution retrospective review of medical records and analyses of echocardiographic findings in patients < or = 45 years of age hospitalized between 2001 and 2004 who were discharged with a diagnosis of cardiomyopathy or heart failure. After exclusion of patients with coronary artery disease or severe cardiac valvular disease, the remaining patients were divided into 2 groups based on their abuse or non abuse of methamphetamine, as determined by the documented history in the medical records or urine toxicology testing.
Among a total of 59 patients, 28 (47%) had a history of methamphetamine abuse or positive urine toxicology. Both methamphetamine abusers and non-abusers were predominately male (64.3% vs 64.5%, P = .99), and had a high prevalence of obesity (55.6% vs 73.3%, P = .16). Bivariate analysis revealed significant differences between the methamphetamine abusers and non-abusers in left atrium volume (119.7 +/- 55.4 ml vs 85.8 +/- 33.5 ml, P = .008), left ventricular end-diastolic volume (201.9 +/- 71.4 ml vs 156.6 +/- 63.1 ml, P = .01), left ventricular end-systolic volume (136.0 +/- 53.7 ml vs 92.3 +/- 55.8 ml, P = .004), right ventricular dimension (26.3 +/- 6.0 mm vs 21.3 +/- 6.0 mm, P = .007), and quantified left ventricular ejection fraction (32.9% +/- 11.3% vs 44.6% +/- 17.8%, P = .004).
We found a high prevalence of methamphetamine abuse in our study population. Methamphetamine abusers had echocardiographic findings of more severe dilated cardiomyopathy compared with non-abusers.
冰毒是目前美国滥用最广泛的非法兴奋剂。目前尚无比较有或无冰毒滥用史的心肌病患者超声心动图检查结果的报道。
我们对 2001 年至 2004 年间因心肌病或心力衰竭住院且病历中有诊断记录的年龄≤45 岁的患者进行了单中心回顾性病历分析和超声心动图检查。排除冠状动脉疾病或严重心脏瓣膜病患者后,根据病历记录或尿液毒理学检测,将其余患者分为有或无冰毒滥用史两组。
共 59 例患者,28 例(47%)有冰毒滥用史或尿液毒理学阳性。冰毒滥用者和非滥用者均以男性为主(64.3%比 64.5%,P=.99),且肥胖率较高(55.6%比 73.3%,P=.16)。两组间比较,冰毒滥用者的左心房容积(119.7+/-55.4ml 比 85.8+/-33.5ml,P=.008)、左心室舒张末期容积(201.9+/-71.4ml 比 156.6+/-63.1ml,P=.01)、左心室收缩末期容积(136.0+/-53.7ml 比 92.3+/-55.8ml,P=.004)、右心室内径(26.3+/-6.0mm 比 21.3+/-6.0mm,P=.007)和左心室射血分数(32.9%+/-11.3%比 44.6%+/-17.8%,P=.004)均显著增大。
我们的研究人群中冰毒滥用率较高。与非滥用者相比,冰毒滥用者的超声心动图检查结果表明其扩张型心肌病更严重。