Coronary sinus flow is reduced in methamphetamine abusers: a transthoracic echocardiographic study

Abstract

To compare the coronary sinus flow among healthy participants, methamphetamine abusers without chest pain and those with chest pain. One hundred and eight methamphetamine abusers: 53 ones without chest pain, 55 ones with chest pain, free of ascertained coronary artery disease, were enrolled in this study. A control group of 50 age-matched male healthy participants was studied for comparison. Standard 2D, flow and tissue Doppler echo with measurements of cardiac morphologic and functional indicators, coronary sinus flow, and inferior vena cava (IVC) ultrasound with measurements of the IVC dimensions and their collapsibility index were performed, respectively. Compared to healthy participants, methamphetamine abusers had higher blood pressure, greater left ventricular mass index and more impaired diastolic function, with preserved cardiac sizes, systolic function and right atrial pressure. Methamphetamine abusers with chest pain had faster heart rate than those without chest pain and healthy participants. Coronary sinus flow was significantly less in methamphetamine abusers than in healthy participants (P < 0.05), and was extremely lower in those with chest pain than in healthy participants (about one-fourth) (P < 0.01). The area under the curve (AUC) of coronary sinus flow was 0.913 (0.864-0.962), and the cutoff value with 221.65 mL/min had sensitivity of 83.4%, specificity of 87.2% and accuracy of 85.2% for differentiating methamphetamine abusers from healthy participants. While the AUC of coronary sinus flow was 0.996 (0.989-1.003), and the cutoff value with 172.59 mL/min had sensitivity of 100%, specificity of 93.3% and accuracy of 96.5% for predicting methamphetamine abusers with chest pain. Coronary sinus flow is significant reduced in methamphetamine abusers, which is maybe a good indicator for indentifying methamphetamine abusers from normal population, and for predicting methamphetamine abusers with chest pain.

Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography

“…distal coronary microvessels and capillary networks. These findings provided direct evidence for our previous studies in which methamphetamine has been shown to decrease coronary sinus flow and myocardial function [13,14].…”

2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

“…Like cocaine, methamphetamine also may reduce coronary sinus blood flow. 7 It has been reported that up to 70% of methamphetamine users have an abnormal ECG, with the most common finding being tachycardia. 8 Additional abnormalities on the ECG have been attributed to presence of hypertension, pulmonary artery hypertension, and cardiomyopathy, all of which have been associated with methamphetamine use.…”

Quality of Life in Patients With Methamphetamine Use Disorder: Relationship to Impulsivity and Drug Use Characteristics

“…Furthermore, impulsivity was the strongest predictor of PHYSQOL which refers to the patients' physical pain, fatigue, sleep, mobility, daily life, dependence on medical treatment, and ability to work (65). Previous studies have found that patients with SUDs tend to report physical discomfort, such as pain (66,67) and poor quality of sleep (68,69), which may interfere with their treatment. Our findings may provide advice to clinicians that reducing impulsivity may improve their perception of PHYSQOL, thereby promoting treatment.…”