Home inotrope therapy in chronic stimulant-induced cardiomyopathy: a case series.

Autor:	Joseph M; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Batra S; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Kamran W; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Barrett K; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Ebert B; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Nassar A; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Misselbeck T; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA., Hawwa N; Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd #300, Allentown, PA 18103, USA.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2024 Aug 12; Vol. 8 (8), pp. ytae406. Date of Electronic Publication: 2024 Aug 12 (Print Publication: 2024).
DOI:	10.1093/ehjcr/ytae406
Abstrakt:	Background: Patients with chronic stimulant-induced cardiomyopathy presenting with cardiogenic shock can be stabilized with conventional measures. However, their management post-stabilization has not been well described and poses unique challenges: (i) less chance of myocardial recovery compared to acute stimulant-induced cardiomyopathy, (ii) psychosocial barriers to left ventricular assist device (LVAD) and heart transplantation, and (iii) concern for use of peripherally inserted central catheter for home inotrope in those with a history of substance abuse. Case Summary: Three patients with chronic stimulant-induced cardiomyopathy were admitted with cardiogenic shock progressing to Society for Cardiovascular Angiography & Interventions stage D or E. They were stabilized with inotrope and/or biventricular mechanical circulatory support. Long-term home inotrope was used as either a bridge to LVAD, reverse remodelling, or stabilization. Discussion: Home inotrope should be viewed as an option in chronic stimulant-induced cardiomyopathy on a case-by-case basis. It can buy time to allow for myocardial stabilization or recovery through goal-directed medical therapy and stimulant cessation. It can also serve as a 'psychosocial stress test' for future consideration of advanced heart failure therapies. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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