Myocardial perfusion and left ventricular function indices assessed by gated myocardial perfusion SPECT in methamphetamine abusers Bita Dadpour a , Vahid R. Dabbagh Kakhki b , Reza Afshari a , Masoumeh Dorri-giv c , Seyed A.R. Mohajeri b and Somayeh Ghahremani b Objectives Methamphetamine (MA) is associated with alterations of cardiac structure and function, although it is less known. In this study, we assessed possible abnormality in myocardial perfusion and left ventricular function using gated myocardial perfusion SPECT. Methods Fifteen patients with MA abuse, on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) MA dependency determined by Structured Clinical Interview for DSM-IV, underwent 2-day dipyridamole stress/rest 99m Tc-sestamibi gated myocardial perfusion SPECT. Results An average daily dose of MA use was 0.91 ± 1.1 (0.2–4) g. The duration of MA use was 3.4 ± 2.1 (1–7) years. In visual and semiquantitative analyses, all patients had normal gated myocardial perfusion SPECT, with no perfusion defects. In all gated SPECT images, there was no abnormality in left ventricular wall motion and thickening. All summed stress scores and summed rest scores were below 3. Calculated left ventricular functional indices including the end-diastolic volume, end-systolic volume, and left ventricular ejection fraction were normal. Conclusion Many cardiac findings because of MA mentioned in previous reports are less likely because of significant epicardial coronary artery stenosis. Nucl Med Commun 37:1302–1305 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Nuclear Medicine Communications 2016, 37:1302–1305 Keywords: amphetamine, cardiomyopathy, coronary artery disease, gated SPECT, methamphetamine, myocardial perfusion SPECT a Department of Medical Toxicology, Imam Reza Hospital, b Nuclear Medicine Research Center, Department of Nuclear Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad and c Department of Radiology, Paramedical School, Shahid Behshti of Medical Sciences, Tehran, Iran Correspondence to Vahid R. Dabbagh Kakhki, MD, Nuclear Medicine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad 917669199, Iran Tel: + 98 51 38012794; fax: + 98 51 38424630; e-mail: dabbaghvr@mums.ac.ir Received 9 April 2016 Revised 16 July 2016 Accepted 20 July 2016 Introduction Methamphetamine (MA) abuse has increased sig- nificantly worldwide and has become a major cause for concern in terms of public health. MA is a potent sti- mulant synthetic amine that is abused widely in many countries. It is commonly referred to as speed, crystal, crank, go, glass, and ice [1,2]. A combination that mainly consists of MA (MA ± amphetamine) is consumed as a commonly used amphetamine compound with the street name ‘Shisheh’ (glass) in Iran. The route of consumption is inhalation to a large extent and as an intravenous injection in a few cases. MA induces a false feeling of well-being, and an over- estimation of mental and physical capacities. However, MA is associated with alterations of cardiac structure and function, although it is less known [3]. Stimulation of sympathetic nervous system activity results in tachy- cardia, hypertension, and cardiac dysrhythmia. Different effects of MA on the cardiovascular system have been reported: palpitations, tachycardia, cardiac arrhythmias, hypertension, chest pain, acute coronary syndrome, sudden cardiac death, aortic dissection, chronic cardiovascular pathology, heart failure, and cardiomyo- pathy [1–3]. Previous cellular, animal, and autopsy stu- dies, as well as case reports and case series suggest that MA consumption is associated with structural and func- tional changes in myocytes [1–3]. The aim of this study was to assess the association between MA abuse and the possibility of abnormal myocardial perfusion and left ventricular function using gated myocardial perfusion SPECT. Methods Patients Fifteen patients admitted at the Medical Toxicology Centre with a diagnosis of MA abuse were recruited. All patients were interviewed by an expert psychiatrist according to semistructured clinical criteria. Inclusion criteria in the current study were as follows: (i) age 19–49 years and (ii) Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) MA dependency determined by Structured Clinical Interview for DSM-IV (SCID-IV), which was administered by expert psychia- trists. Exclusion criteria were as follows: (i) use of any Original article 0143-3636 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MNM.0000000000000585 Copyright r 2016 Wolters Kluwer Health, Inc. All rights reserved.