Clinical characteristics and outcomes of patients with amphetamine-associated cardiomyopathy in South Auckland, New Zealand

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Authors:

Kueh SA et al.

January 7, 2017

Summary:

This paper describes the characteristics and outcomes of 30 patients admitted to Middlemore Hospital with heart failure and echocardiographic evidence of cardiomyopathy between 2005 and 2014 and who had a documented history of amphetamine abuse. Mean age at presentation was 40 years. The majority (n=25; 83%) were male and of Indigenous Māori ethnicity. Four patients presented with cardiogenic shock. Five patients were admitted to the intensive care unit for inotropic support and mechanical ventilation. Fifteen had severe left ventricular (LV) dilation (mean LV end-diastolic dimension 6.8 cm) and all patients had severe LV dysfunction (mean LV ejection fraction 22%). Severe LV dilation and significant LV dysfunction persisted with minimal improvement despite optimal heart failure therapy. During a median 18-month follow-up, 5 patients died from end-stage heart failure and 17 had at least one readmission with decompensated heart failure.

Comment:

I recently attended a health conference in Hawaii and Professor Mau presented similar findings from a Hawaiian heart failure study. We often think of the acute and chronic mental and social health issues of methamphetamine – this research highlights the health effects of it on our young Indigenous men and women.

Reference: Heart Lung Circ. 2016;25(11):1087-93

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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