Severe ischaemic cardiomyopathy associated with khat chewing

Saha, Sagar; Dollery, C

doi:10.1258/jrsm.99.6.316

Cited by 30 publications

(10 citation statements)

References 8 publications

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“…By some reports, late gadolinium-enhancement cardiovascular MR has been helpful to identify the magnitude of fibrosis and likelihood of recovery in methamphetamineassociated cardiomyopathy cases. 104 Other cardiostimulant drugs, such as ecstasy (3,4-methylenedioxy-N-methylamphetamine, or MDMA), 105 "bath salts" that contain synthetic cathinones with amphetamine/cocaine-like properties such as mephedrone methylenedioxypyrovalerone, 106 and khat chewing, which contains cathinone, 107 have cardiotoxic effects and have been implicated in cases of MI, arrhythmias, cardiac arrest, and cardiomyopathy. Although rare, misuse or overdose of drugs used for attention deficit and hyperactivity disorder, such as methylphenidate, dextroamphetamine, and dextroamphetamine-amphetamine, has been associated with MI, cardiomyopathy, and sudden death.…”

Section: Cardiomyopathy Related To Methamphetamines and Other Stimulamentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Cardiomyopathy Related To Methamphetamines and Other Stimulamentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

View full text Add to dashboard Cite

show abstract

“…In confirmation of the hepatotoxicity of khat ingestion, a case report described an East African man with a regular khat chewing habit who developed jaundice as a result of acute hepatitis (Brostoff et al, 2006). Another report also described a patient with impaired liver function attributed to khat chewing (Saha and Dollery, 2006). More recently, severe acute liver injury has been attributed to khat chewing in the USA (Chapman et al, 2010).…”

Section: Effects Of Khat Chewing On the Gastrointestinal Tract And Livermentioning

confidence: 98%

“…Cathinone, having identical properties to amphetamine, may have the same effects on the heart muscle and may also produce dilated cardiomyopathy. Indeed, a case report describes an East African man who had chewed khat constantly for 2-3 days presenting with myocardial infarction and 27 months later echocardiography revealed severely impaired biventricular function consistent with ischaemic myopathy (Saha and Dollery, 2006). This article prompted a report by the BBC warning of the dangers of severe heart problems from khat chewing (BBC, 2006).…”

Section: Khat Chewing and Dilated Cardiomyopathymentioning

confidence: 99%

“…It was concluded that increased thrombogenecity among khat chewers is as key factor for cardiovascular complication (de Ridder et al, 2007a,b). Another male khat chewer admitted with MI showed stenosis in the left anterior descending coronary artery and filling defects consistent with thrombus formation (Saha and Dollery, 2006). Further studies are therefore urgently required to examine whether the blood from khat chewers shows greater thrombogenecity and the likely mechanisms involved.…”

Section: Khat Chewing Thrombosis and Aspirin Intakementioning

confidence: 99%

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Khat chewing, cardiovascular diseases and other internal medical problems: The current situation and directions for future research

Al‐Motarreb

Al‐Habori

Broadley

2010

Journal of Ethnopharmacology

174

150

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The leaves of khat (Catha edulis Forsk.) are chewed as a social habit for the central stimulant action of their cathinone content. This review summarizes the prevalence of the habit worldwide, the actions, uses, constituents and adverse health effects of khat chewing. There is growing concern about the health hazards of chronic khat chewing and this review concentrates on the adverse effects on health in the peripheral systems of the body, including the cardiovascular system and gastrointestinal tract. Comparisons are made with amphetamine and ecstasy in particular on the detrimental effects on the cardiovascular system. The underlying mechanisms of action of khat and its main constituent, cathinone, on the cardiovascular system are discussed. Links have been proposed between khat chewing and the incidence of myocardial infarction, dilated cardiomyopathy, vascular disease such as hypertension, cerebrovascular ischaemia and thromboembolism, diabetes, sexual dysfunction, duodenal ulcer and hepatitis. The evidence, however, is often based on limited numbers of case reports and only few prospective controlled studies have been undertaken. There is therefore an urgent need for more thorough case-control studies to be performed. This review outlines the current knowledge on the adverse health effects of khat chewing on the cardiovascular system and other internal medical problems, it assesses the evidence and the limitations of the studies and identifies the questions that future studies should address.

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“…This finding is congruent with a report of increased serum levels of CK, AST and lactate dehydrogenase with intravenous khat alone or in combination with adrenaline in experimental animals (Alkadi et al, 2002). The vasoconstriction effects of khat on the coronary arteries have been reported in a number of clinical and experimental studies (Al-Motarreb and Broadley, 2003;Al-Motarreb et al, 2005;Saha and Dollery, 2006). Thus, chronic and frequent khat consumption may lead to transient but repetitive coronary vasoconstriction causing a reduction in blood flow and myocardial damage.…”

Section: Effect On Cardiac Biomarkersmentioning

confidence: 97%

Subchronic administration of Catha edulis F. (khat) extract is marked by elevation of cardiac biomarkers and subendocardial necrosis besides blood pressure alteration in rats

Admassie

Engidawork

2011

Journal of Ethnopharmacology

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Severe ischaemic cardiomyopathy associated with khat chewing

Cited by 30 publications

References 8 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Khat chewing, cardiovascular diseases and other internal medical problems: The current situation and directions for future research

Subchronic administration of Catha edulis F. (khat) extract is marked by elevation of cardiac biomarkers and subendocardial necrosis besides blood pressure alteration in rats

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