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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.

Background 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. Methods We performed a single institution retrospective review of medical records and analyses of echocardiographic findings in patients ≤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. Results 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). Conclusions 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.