Heavy Burden of Toxic Dilated Cardiomyopathy Among Young Adults: A Retrospective Study and Review of the Literature
| Autor: | Steve Radermaker, Christine Bourgault, Kim O'Connor, Eric Charbonneau, Marie-Ève Komlosy, Marie-Hélène Leblanc, Joëlle Morin, Sacha-Michelle Dubois-Sénéchal, Jonathan Beaudoin, Alexandre Cinq-Mars, Claudine Laliberté, Mario Sénéchal, Montse Massot, Mathieu Bernier, David Belzile, Sébastien Bergeron, Pierre Yves Turgeon, Maxime Laflamme |
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| Rok vydání: | 2022 |
| Předmět: |
Cardiomyopathy
Dilated medicine.medical_specialty Substance-Related Disorders medicine.medical_treatment Cardiomyopathy Ventricular Function Left Young Adult Internal medicine medicine Humans cardiovascular diseases Ventricular remodeling Retrospective Studies Ejection fraction Ventricular Remodeling business.industry Dilated cardiomyopathy Retrospective cohort study medicine.disease Transplantation Ventricular assist device Heart failure cardiovascular system Cardiology Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Canadian Journal of Cardiology. 38:49-58 |
| ISSN: | 0828-282X |
| DOI: | 10.1016/j.cjca.2021.11.002 |
| Popis: | Background Dilated cardiomyopathy (DCM) is a well-described entity for heart failure (HF) with reduced left ventricular ejection fraction (LVEF). Recently, drugs and other substance of abuse have been recognized as potential triggers for DCM. The aim of this study was to assess the survival in patients under 65 years old with toxic cardiomyopathy (TCM). Left ventricular remodeling and the potential usefulness of left ventricular assist device (LVAD) was also assessed. Methods Single center retrospective study from January 2003 to August 2019 at a tertiary care cardiology center identified 553 patients younger than 65 years old with LVEF Results Two hundred and one patients (36%) had a diagnosis of idiopathic DCM. Further analysis identified 38 patients (19%) for which a TCM was the most likely etiology (amphetamine [50%], cocaine [37%], anabolic steroids [8%], and energy drinks [5%]). Despite a mean LVEF of 17±8% at presentation, most patients (n=27, 71%) had an event-free survival with guideline-directed medical therapy, and 61% (n=23) recovered a LVEF ≥40% after a median follow-up of 21±23 months. Seven patients (18%) required a LVAD and 1 (3%) patient a transplantation. All LVAD were explanted or decommissioned after a median support time of 11±4 months following partial or complete LVEF recovery. Conclusion TCM induced by substance abuse is a frequent cause of HF accounting for almost 20% of all patients with DCM of unknown etiology under 65 years of age. Treatment must be tailored on an individual basis. Mechanical circulatory support demonstrated its usefulness in carefully selected patients. |
| Databáze: | OpenAIRE |
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