Echocardiographic characteristics of new-onset methamphetamine-associated heart failure: a retrospective cohort study.

IF 4.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Echo Research and Practice Pub Date : 2026-08-24 DOI:10.1186/s44156-026-00133-3

Joey Chiang, Danelle Hidano, Heather Herren, Christopher T Longenecker, Mrinal Yadava, Cooper B Kersey

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引用次数: 0

Abstract

Background: Methamphetamine-associated heart failure (MAHF) is a growing cause of healthcare burden, yet the echocardiographic phenotype at the time of initial diagnosis is poorly characterized. We tested the hypothesis that new-onset MAHF exhibits a distinct echocardiographic phenotype that could aid in early disease identification.

Methods: We conducted a retrospective cohort study comparing echocardiographic parameters in patients with new-onset MAHF versus controls with non-ischemic cardiomyopathy unrelated to methamphetamine use. Patients with MAHF (n = 75) were identified by positive urine drug screen, ICD-10 codes for incident heart failure, and confirmed active methamphetamine use at index hospitalization. Controls were matched 1:1 by age, sex, and race. Pre-specified echocardiographic endpoints included left and right ventricular size and function, left ventricular thrombi, valvular dysfunction, and pulmonary artery systolic pressure.

Results: The two groups showed no significant differences in echocardiographic parameters. Left ventricular ejection fraction (28%, 20-36% vs. 25%, 19-35%), left ventricular indexed end-diastolic volume (103 ml/m2, 79-130 ml/m2 vs. 94 ml/m2, 73-118 ml/m2), left atrial size, right ventricular size and function, diastolic parameters, pulmonary artery pressures, and prevalence of ventricular thrombi were all similar between groups.

Conclusions: At the time of initial heart failure diagnosis, MAHF is indistinguishable by traditional echocardiographic parameters from other non-ischemic cardiomyopathies. The findings of this study differ from prior research into the echocardiographic phenotype of MAHF by focusing on the time of initial heart failure diagnosis, presumably when less adverse remodeling has occurred. These negative findings underscore that MAHF is a diagnosis of exclusion and a full work-up to assess for alternative etiologies of cardiomyopathy is paramount.

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新发甲基苯丙胺相关心力衰竭的超声心动图特征：一项回顾性队列研究

背景：甲基苯丙胺相关性心力衰竭（MAHF）是一个日益增长的医疗负担的原因，但超声心动图在初始诊断时的表型特征不佳。我们检验了新发MAHF表现出独特的超声心动图表型的假设，这有助于早期疾病识别。方法：我们进行了一项回顾性队列研究，比较新发MAHF患者与与甲基苯丙胺使用无关的非缺血性心肌病患者的超声心动图参数。75例MAHF患者通过尿药物筛查阳性、ICD-10心衰发生率代码以及在指数住院时确认活跃的甲基苯丙胺使用来确定。对照组按年龄、性别和种族按1:1匹配。预先指定的超声心动图终点包括左、右心室大小和功能、左心室血栓、瓣膜功能障碍和肺动脉收缩压。结果：两组超声心动图参数无明显差异。左室射血分数（28%,20-36% vs. 25%, 19-35%），左室舒张末期指数容积（103 ml/m2, 79-130 ml/m2 vs. 94 ml/m2, 73-118 ml/m2），左心房大小，右心室大小和功能，舒张参数，肺动脉压，心室血栓患病率在两组之间都相似。结论：在心衰初始诊断时，传统超声心动图参数无法将MAHF与其他非缺血性心肌病区分开来。本研究的结果不同于先前对MAHF超声心动图表型的研究，主要关注心力衰竭的初始诊断时间，可能是在不良重构发生较少的时候。这些阴性结果强调，MAHF是一种排除性诊断，对心肌病的其他病因进行全面检查是至关重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echo Research and Practice CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.70

自引率

12.70%

发文量

审稿时长

8 weeks

期刊介绍： Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.