1. Overview of Methamphetamine-Associated Pulmonary Arterial Hypertension.
- Author
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Charoenpong P, Hall NM, Keller CM, Ram AK, Murnane KS, Goeders NE, Dhillon NK, and Walter RE
- Subjects
- Humans, Amphetamine-Related Disorders complications, Amphetamine-Related Disorders physiopathology, Central Nervous System Stimulants adverse effects, Hypertension, Pulmonary physiopathology, Hypertension, Pulmonary chemically induced, Hypertension, Pulmonary diagnosis, Methamphetamine adverse effects, Pulmonary Arterial Hypertension physiopathology, Pulmonary Arterial Hypertension drug therapy, Pulmonary Arterial Hypertension chemically induced
- 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., Competing Interests: Financial/Nonfinancial Disclosures None declared., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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