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Review
. 2024 Jun;165(6):1518-1533.
doi: 10.1016/j.chest.2024.01.014. Epub 2024 Jan 9.

Overview of Methamphetamine-Associated Pulmonary Arterial Hypertension

Prangthip Charoenpong  1 , Nicole M Hall  2 , Courtney M Keller  3 , Anil Kumar Ram  4 , Kevin S Murnane  5 , Nicholas E Goeders  5 , Navneet Kaur Dhillon  4 , Robert E Walter  6
Affiliations
Review

Overview of Methamphetamine-Associated Pulmonary Arterial Hypertension

Prangthip Charoenpong et al. Chest. 2024 Jun.

Abstract

Topic importance: The global surge in methamphetamine use is a critical public health concern, particularly due to its robust correlation with methamphetamine-associated pulmonary arterial hypertension (MA-PAH). This association raises urgent alarms about the potential escalation of MA-PAH incidence, posing a significant and imminent challenge to global public health.

Review findings: This comprehensive review meticulously explores MA-PAH, offering insights into its epidemiology, pathophysiology, clinical presentation, diagnostic intricacies, and management strategies. The pathogenesis, yet to be fully described, involves complex molecular interactions, including alterations in serotonin signaling, reduced activity of carboxylesterase 1, oxidative stress, and dysregulation of pulmonary vasoconstrictors and vasodilators. These processes culminate in the structural remodeling of the pulmonary vasculature, resulting in pulmonary arterial hypertension. MA-PAH exhibits a more severe clinical profile in functional class and hemodynamics compared with idiopathic pulmonary arterial hypertension. Management involves a multifaceted approach, integrating pulmonary vasodilators, cessation of methamphetamine use, and implementing social and rehabilitation programs. These measures aim to enhance patient outcomes and detect potential relapses for timely intervention.

Summary: This review consolidates our understanding of MA-PAH, pinpointing knowledge gaps for future studies. Addressing these gaps is crucial for advancing diagnostic accuracy, unraveling mechanisms, and optimizing treatment for MA-PAH, thereby addressing the evolving landscape of this complex health concern.

Keywords: estrogen paradox; methamphetamine; methamphetamine-associated pulmonary arterial hypertension; pulmonary arterial hypertension; pulmonary hypertension.

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Conflict of interest statement

Financial/Nonfinancial Disclosures None declared.

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References

    1. Chin K.M., Channick R.N., Rubin L.J. Is methamphetamine use associated with idiopathic pulmonary arterial hypertension? Chest. 2006;130(6):1657–1663. - PubMed
    1. Zamanian R.T., Hedlin H., Greuenwald P., et al. Features and outcomes of methamphetamine associated pulmonary arterial hypertension. Am J Respir Crit Care Med. 2018;197(6):788–800. - PMC - PubMed
    1. Kolaitis N.A., Zamanian R.T., de Jesus Perez V.A., et al. Pulmonary Hypertension Association Registry Investigators. Clinical differences and outcomes between methamphetamine-associated and idiopathic pulmonary arterial hypertension in the Pulmonary Hypertension Association Registry. Ann Am Thorac Soc. 2021;18(4):613–622. - PMC - PubMed
    1. Zhao S.X., Kwong C., Swaminathan A., Gohil A., Crawford M.H. Clinical characteristics and outcome of methamphetamine-associated pulmonary arterial hypertension and dilated cardiomyopathy. JACC Heart Fail. 2018;6(3):209–218. - PubMed
    1. Simonneau G., Montani D., Celermajer D.S., et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019;53(1) - PMC - PubMed

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