Meth-associated HF with reduced ejection fraction reversible

Patients with methamphetamine-associated heart failure (HF) with reduced left ventricular (LV) ejection fraction (HFrEF) have a more severe disease compared with other HF patients, a study has found. But more importantly, quitting meth leads to an improvement in LV function with fewer hospital admissions, suggesting that meth-associated HFrEF may be reversed.

The retrospective analysis involved 51 HFrEF patients (28 methamphetamine users and 23 controls) and 60 HF patients with preserved EF (HFpEF; 28 methamphetamine users and 32 controls). Among meth users, 14 of those with reduced EF and 13 of those with preserved EF had quit the drug at the 1-year follow-up.

In the meth-HFrEF group (mean age, 51 years; 82.1 percent male), cessation of drug use resulted in an improvement in EF (10.6 percent; p=0.009) and fewer HF admissions per year compared with continued use (median, 0.0 vs 2.0; p=0.039).

On the other hand, meth-HFpEF patients (mean age, 50 years; 60.7 percent male) vs controls had higher baseline right ventricular systolic pressure (median, 53.44 vs 36.64; p=0.011) and lower lateral E/E’ ratio (8.1 vs 11.2; p<0.01). There were no significant improvements in echocardiographic parameters and clinical outcomes seen following discontinuation of drug use in this group.

The findings highlight the importance of initiating efforts focused on methamphetamine cessation to improve outcomes for users with HFrEF. Meanwhile, further investigation is warranted to shed light on occult abnormalities in LV function among meth users with HFpEF.