Methamphetamine abusers regain heart function after quitting

Methamphetamine abuse significantly increases one’s morbidity leading to complications such as arrhythmias, hypertension and methamphetamine-associated cardiomyopathy (MACM).

Researchers, led by Norman Mangner, MD, in the department of internal medicine/cardiology at the University of Leipzig in Germany, examined 30 patients to see if complications related to MACM could be reversed if an individual quit using methamphetamines.

Patients were 93.3 percent male with a median age of 30.3 years old. All of the participants had a history of methamphetamine abuse (the mean being 5.7 years) with a left ventricular ejection fraction of less than 40 percent.

The researchers followed up with patients at a mean of 35 months. At that time, five patients continued using methamphetamines, 22 had quit and three had died.

“Discontinuation of methamphetamine abuse together with guideline-based medical therapy for heart failure partially improved cardiac function and symptoms, whereas patients with continues methamphetamine abuse did not show improvement,” wrote Mangner et al. “The improvement of cardiac function seemed to depend on the extent of fibrosis as a marker of irreversible myocardial damage.”

The study included a number of other prominent conclusions:

• Methamphetamine abuse was associated with severe heart failure with severely depressed LVEF and dilatation of the cardiac chambers.
• MACM was associated with the development of intracardiac thrombi in one-third of the study subjects.
• Discontinuation of methamphetamine abuse at follow-up was associated with an improvement of symptoms and cardiac function, whereas continued abuse was related to a persistently impaired functional status and cardiac function leading to an increased risk of death, nonfatal stroke, and rehospitalization for heart failure.
• Fibrosis was closely related to a longer exposure of methamphetamine and was more pronounced in patients with continued methamphetamine abuse at follow-up.
• Fibrosis, assessed in the endomyocardial biopsy, seemed to be an independent predictor of the development of LVEF at follow-up.