Abstract 15859: Cardiopulmonary Exercise Function in Methamphetamine-Associated Heart Failure

Abstract

Introduction: The role of methamphetamine (meth) cessation in the functional recovery of methamphetamine-associated HF (meth-HF) is unknown. Objective To evaluate the role of active meth use on cardiopulmonary function in participants with meth-HF. Methods: We recruited participants from a longitudinal cohort study of meth-HF and used cardiopulmonary exercise testing (CPET) with maximal effort upright cycle ergometer to assess exercise cardiorespiratory function. Descriptive analysis was used to study associations between cardiopulmonary function and 1) active use and 2) ejection fraction (EF) recovery. Results: Of those assessed for eligibility (n = 55), 11 were deceased and 30 could not be contacted/declined participation. Ten studies were completed of the 14 scheduled, with three no-shows and one termination due to pre-test PVCs. Of those who completed studies, 90% were male, median age was 52 years [40, 54] and duration of HF was 33 months [16, 58]. Five were active users, and five had a recovered EF. All were on quad-guideline-directed medical therapy (GDMT) for a median duration of 15 months [9.1, 29]. Baseline EF was 28% [21, 42], and EF closest to CPET date was 50% [42, 59]. Peak VO 2 (% predicted) in prior vs. active use was 73 [66, 75] and 60 [48, 66]; in persistently low vs. recovered EF, it was 75 [66, 75] and 63 [60, 66] ( Figure 1A ). Adjusted heart rate reserve (aHRR, %) in prior vs. active use was 42 [37, 43] and 46 [44, 58]; in persistently low vs. recovered EF, it was 58 [44, 62] and 37 [35, 43] ( Figure 1B ). In prior vs. active use, VO 2 pulse (VO 2 /HR, mL/beat) was 16 [15, 17] and 13 [12, 15]. One participant died of sudden cardiac death between CPET and time of analysis. Conclusions: To our knowledge, this is the first study looking at cardiorespiratory fitness in the setting of meth use and HF. Our preliminary findings suggest that peak VO 2 and aHRR remain low, which suggests the presence of persistent cardiac effects of meth use despite cessation of use and/or recovery of EF.