Methamphetamines can also induce direct toxicity to myocardial cells. These combined factors lead to myocardial contractile dysfunction, chronic inflammation and, ultimately, myocyte loss due to replacement fibrosis resulting in dilated cardiomyopathy. Methamphetamine-related cardiomyopathy is associated with severe systolic dysfunction, left ventricular chamber dilation, 55.59 Clinical and autopsy reports obtained from long-term methamphetamine users showed indicators of cardiomyopathy, such as necrosis, fibrosis, hypertrophy and enlargement of the heart, 60 The degree of fibrosis predicts functional recovery after cessation of methamphetamine use, while heart function did not improve in any of the patients who continued to use methamphetamine, 55 The use of methamphetamine generally promotes dilated cardiomyopathy with an enlarged and dilated heart and decline severe contractile function, 61 In animal models, methamphetamine administration induces cardiomyopathies with cardiomyocyte disorder, intracellular and extracellular edema, abnormally shaped mitochondria and nuclei, dilated T tubules, myocyte degeneration, contractile band degeneration and myofilament loss (Figure 2D). Methamphetamine is known to cause cardiomyopathy that can be reversible with appropriate medical treatment and cessation of use.
Cardiovascular magnetic resonance imaging (CMR) with a delayed increase in gadolinium has been shown to identify fibrosis in ischemic and non-ischemic cardiomyopathies. We report a case of severe cardiomyopathy associated with methamphetamine in which heart function recovered after 6 months. The CMR evaluation with a delayed increase in gadolinium was notable for the lack of improvement, suggesting an absence of irreversible myocyte injury and a good prognosis. CMR may be useful in predicting recovery in non-ischemic cardiomyopathies associated with toxins.
A: Methamphetamine use is associated with acute vascular constriction and vasospasm, while chronic methamphetamine use causes endothelial damage and pulmonary hypertension in some patients. Previous research also suggests that the risk of cardiovascular problems among methamphetamine users increases when the drug is combined with alcohol, cocaine, or opiates. Long-term methamphetamine use has been associated with a severe form of dilated cardiomyopathy, a condition in which the weakened heart muscle enlarges and cannot pump adequate blood. Factors that influence the cardiovascular effects of methamphetamine The dose necessary and sufficient to cause serious cardiovascular complications or death, i.e., the “toxic dose”, is unclear, since the response to a specific dose varies due to individual differences in responsiveness and variations in The degree of tolerance.
While there are few reports of chronic systemic hypertension among methamphetamine users, long-term methamphetamine abuse can cause a marked increase in pulmonary hypertension. In addition to vasospasm, methamphetamine users show a significant worsening of atherosclerotic cardiovascular disease, despite the reduction of several typical atherosclerotic risk factors. Expression of c-Fos, Fos-b, c-jun and dusp-1 in the mouse heart after single and repeated administration of methamphetamine. The development of methamphetamine-associated cardiomyopathy (MACM) represents a serious complication of chronic methamphetamine abuse.
The use of methamphetamine induces powerful vasoconstriction that can cause severe vasospasm of the coronary arteries and microvasculature, resulting in myocardial ischemia. However, additional studies are needed to better define the pro-survival and pro-apoptotic functions of inducing autophagy during methamphetamine-induced toxicity. Because of the individual variation in sensitivity to the cardiotoxic properties of methamphetamine, treatment for methamphetamine toxicity should be based on the presentation of symptoms and not on the reported dose administered. Methamphetamine has good lipid solubility compared to its parent compound, amphetamine, and can more easily cross the blood-brain barrier.
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