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

Abstract

Aims: To evaluate the feasibility of assessing regional myocardial perfusion using real-time myocardial contrast echocardiography (MCE) at rest for detecting coronary microcirculation abnormalities in methamphetamine abusers.Material and methods: Twenty-two male methamphetamine abusers (11 without chest pain, 11 with chest pain), free of ascertained coronary artery disease, were enrolled in this study. A control group of 22 age-matched male healthy participants was studied for comparison. Standard 2D, flow and tissue Doppler echo with measurements of cardiac morphologic and functional indicators,MCE with measurements of regional myocardial perfusion were performed, respectively.Results: Compared to healthy participants, methamphetamine abusers had higher blood pressure, greater left ventricular mass index and more impaired diastolic function, with preserved cardiac sizes and systolic function. Methamphetamine abusers with chest pain had a faster heart rate than those without chest pain and healthy participants. MCE in methamphetamine abusers, especially with chest pain, had significant longer contrast agent arrival times, less functional capillary blood volumes, slower microvascular flow velocities and less myocardial perfusion than healthy participants (p<0.05). Moreover, along with the increases of dosage and duration of use (from group A to group C, group A: 1-2 g/day, <2 years; group B: 2-3 g/day, 2-5 years; group C: >3 g/day, >5 years) the reductions in the myocardial perfusion indices were more significant (p<0.01). The cutoff value with 5.1 dB2/s of the myocardial perfusion at the left ventricular apex had a sensitivity of 87.5%, specificity of 75.2% and accuracy of 81.9% for differentiating methamphetamine abusers from normal subjects.Conclusions: Real-time MCE can effectively detect coronary microcirculation abnormalities in methamphetamine abusers at rest and myocardial perfusion is significantly reduced in methamphetamine abusers. This finding may be involved in the occurrence and development of cardiac damage.

Contrast Echocardiography and vector velocity imaging in the early detection and monitoring of anthracycline and trastuzumab-induced cardiotoxicity in patients with breast cancer

“…If the time of myocardial contrast imaging is delayed, it indicates abnormal microcirculation perfusion [23] . The decrease of myocardial perfusion may be closely related to the occurrence and development of myocardial injury [24] . Abnormal microcirculation perfusion can not only early reflect chemotherapeutic myocardial microvascular disease, but also serve as an independent prognostic factor [25] .…”

Methamphetamine‐related cardiovascular diseases

“…Coronary artery disease is common in MA abusers. Early coronary microcirculation abnormalities and reduced myocardial perfusion can be detected by myocardial contrast echocardiography . In an Australian study of 894 MA‐associated deaths, autopsy showed a high prevalence of coronary artery disease (19%), LV‐dilatation (26.3%), LV‐hypertrophy (19%), myocardial scarring (19.8%) despite the young mean age of 37.9 years .…”

“…3D speckle tracing imaging markers are useful for early detection of ventricular dysfunction . Contrast echocardiography may be helpful in detecting early microvascular changes and myocardial ischaemia . Left heart catheterization should be performed to exclude coronary artery disease and, in the case of suspected myocarditis, to obtain myocardial biopsies.…”

Ultrasound study of right ventricular myocardial perfusion and functional changes in hypertrophic cardiomyopathy

“…Studies have shown that HCM patients with normal coronary angiography still have different degrees of myocardial ischemia, which is essentially coronary microvascular dysfunction [ 7 ]. Coronary microcirculation disorders and the effect of reperfusion therapy and clinical prognosis [ 8 , 9 ] can be accurately assessed by observing myocardial microcirculation perfusion [ 10 ] and assessing myocardial blood flow (MBF) with myocardial contrast echocardiography (MCE), which is of great importance to the clinical diagnosis and treatment of HCM.…”