{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T11:51:21Z","timestamp":1765453881788,"version":"3.46.0"},"reference-count":69,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Methamphetamine (MA) abuse has emerged as a multisystem insult driving cardiovascular and neurovascular consequences. Methamphetamine-associated cardiomyopathy (MACM) remains an underrecognized cause of cardioembolic stroke through left ventricular thrombus (LVT) formation. MA-induced gut dysbiosis and enteric neural disruption exacerbate systemic inflammation and autonomic imbalance, resulting in broader dysregulation of the brain\u2013heart\u2013gut axis. This study aimed to synthesize contemporary evidence on chronic MA exposure and its role in LVT formation, stroke pathogenesis, diagnostic approaches, and anticoagulation management. We conducted a focused narrative review of PubMed- and Scopus-indexed literature (1990\u20132025) addressing cardiovascular, neurovascular, and gut-mediated consequences of chronic MA exposure. Observational cohorts and case reports were integrated to characterize pathophysiology, imaging approaches, and therapeutic considerations, supplemented by a representative clinical case. Chronic MA exposure mediates persistent catecholamine excess, myocardial fibrosis, ventricular dysfunction, and a prothrombotic milieu. Gut dysbiosis-related inflammation and autonomic dysregulation further promote intracardiac stasis. Affected individuals are typically young men with severe systolic dysfunction (left ventricular ejection fraction 20\u201330%), with a substantial proportion demonstrating apical or mural LVT on systematic imaging. Case-level evidence highlights a broader systemic embolic burden, involving the limbs, kidneys, and aorta. Echocardiography remains the first-line screening method, while cardiac CT and MRI offer greater sensitivity for thrombus detection. Anticoagulation is challenged by bleeding risk, inconsistent adherence, and the absence of standardized protocols. MACM represents a critical and underrecognized etiology of cardioembolic stroke in young adults. Early recognition of brain\u2013heart\u2013gut axis disruption, systematic cardiac imaging, and individualized anticoagulation are crucial for preventing emboli. Prospective registries and standardized imaging-guided treatment strategies are needed to improve outcomes in this high-risk population.<\/jats:p>","DOI":"10.3390\/ijms262411908","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T14:22:40Z","timestamp":1765376560000},"page":"11908","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methamphetamine-Associated Cardiomyopathy and Cardioembolic Stroke: Brain\u2013Heart\u2013Gut Axis Crosstalk, Diagnostic Strategies, and Anticoagulation Challenges"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4886-8815","authenticated-orcid":false,"given":"Pei-Jung","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neurology, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Hui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6541-6320","authenticated-orcid":false,"given":"Jen-Hung","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Taipei Heart Institute, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4542-3862","authenticated-orcid":false,"given":"Jakir Hossain Bhuiyan","family":"Masud","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science, The University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7448-1041","authenticated-orcid":false,"given":"Chien-Tai","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-4460","authenticated-orcid":false,"given":"Lung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-6667","authenticated-orcid":false,"given":"Chen-Chih","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University\u2014Shuang Ho Hospital, New Taipei 235, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1161\/ATVBAHA.119.312461","article-title":"Methamphetamine Use and Cardiovascular Disease","volume":"39","author":"Kevil","year":"2019","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e010273","DOI":"10.1161\/CIRCEP.121.010273","article-title":"Stimulant Drugs of Abuse and Cardiac Arrhythmias","volume":"15","author":"Dominic","year":"2022","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"173313","DOI":"10.1016\/j.scitotenv.2024.173313","article-title":"Evaluation of spatial and temporal changes in illicit drug use in the Taipei metropolitan area via wastewater-based epidemiology","volume":"934","author":"Lin","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jpsychires.2019.10.016","article-title":"Development of an addiction index and delineation 15-year trends of illicit drugs from the Taiwan national drug enhancement database","volume":"120","author":"Lin","year":"2020","journal-title":"J. Psychiatr. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e016704","DOI":"10.1161\/JAHA.120.016704","article-title":"Clinical Characteristics and Management of Methamphetamine-Associated Cardiomyopathy: State-of-the-Art Review","volume":"9","author":"Reddy","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"113795","DOI":"10.1016\/j.expneurol.2021.113795","article-title":"Neurotoxicity of methamphetamine: Main effects and mechanisms","volume":"344","author":"Jayanthi","year":"2021","journal-title":"Exp. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jchf.2017.02.017","article-title":"Clinical Characteristics, Histopathological Features, and Clinical Outcome of Methamphetamine-Associated Cardiomyopathy","volume":"5","author":"Klingel","year":"2017","journal-title":"JACC Heart Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1161\/STROKEAHA.119.024156","article-title":"Risk Factors for Ischemic Stroke in Younger Adults","volume":"51","author":"George","year":"2020","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hemphill, K., Tierney, S., Tirschwell, D., and Davis, A.P. (2024). A review of methamphetamine use and stroke in the young. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1397677"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e033667","DOI":"10.1161\/JAHA.123.033667","article-title":"Cardiomyopathy in Patients With Acute Ischemic Stroke and Methamphetamine Use: Relevance for Cardioembolic Stroke and Outcome","volume":"13","author":"Lee","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Benito, Y., Martinez-Legazpi, P., Rossini, L., P\u00e9rez del Villar, C., Yotti, R., Mart\u00edn Peinador, Y., Rodr\u00edguez-P\u00e9rez, D., Desco, M.M., Medrano, C., and Antoranz, J.C. (2019). Age-Dependence of Flow Homeostasis in the Left Ventricle. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00485"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e205","DOI":"10.1161\/CIR.0000000000001092","article-title":"Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association","volume":"146","author":"Levine","year":"2022","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1161\/CIRCULATIONAHA.112.111591","article-title":"High Levels of Circulating Epinephrine Trigger Apical Cardiodepression in a \u03b22-Adrenergic Receptor\/Gi\u2013Dependent Manner","volume":"126","author":"Paur","year":"2012","journal-title":"Circulation"},{"key":"ref_14","first-page":"e39917","article-title":"Duet of Death: Biventricular Thrombus in a Methamphetamine User","volume":"15","author":"Dhaliwal","year":"2023","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1093\/eurheartj\/ehp598","article-title":"Amphetamines induce tissue factor and impair tissue factor pathway inhibitor: Role of dopamine receptor type 4","volume":"31","author":"Gebhard","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S62","DOI":"10.1016\/j.cardfail.2019.07.178","article-title":"Clinical Differences between Methamphetamine and Non-Methamphetamine Associated Non-Ischemic Dilated Cardiomyopathy","volume":"25","author":"Reddy","year":"2019","journal-title":"J. Card. Fail."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"482","DOI":"10.7150\/ijms.99159","article-title":"A Mechanistic Review on Toxicity Effects of Methamphetamine","volume":"22","author":"Ramli","year":"2025","journal-title":"Int. J. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ferrucci, M., Limanaqi, F., Ryskalin, L., Biagioni, F., Busceti, C.L., and Fornai, F. (2019). The Effects of Amphetamine and Methamphetamine on the Release of Norepinephrine, Dopamine and Acetylcholine from the Brainstem Reticular Formation. Front. Neuroanat., 13.","DOI":"10.3389\/fnana.2019.00048"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/j.1369-1600.2010.00270.x","article-title":"Effect of methamphetamine dependence on heart rate variability","volume":"17","author":"Henry","year":"2012","journal-title":"Addict. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"van Weperen, V.Y.H., and Vaseghi, M. (2023). Cardiac vagal afferent neurotransmission in health and disease: Review and knowledge gaps. Front. Neurosci., 17.","DOI":"10.3389\/fnins.2023.1192188"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Borrego-Ruiz, A., and Borrego, J.J. (2025). The Bidirectional Interplay Between Substances of Abuse and Gut Microbiome Homeostasis. Life, 15.","DOI":"10.3390\/life15060834"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"18178","DOI":"10.1038\/s41598-021-97548-1","article-title":"Altered fecal microbiota composition in individuals who abuse methamphetamine","volume":"11","author":"Yang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1186\/s40001-025-02446-1","article-title":"Intestinal barrier damage caused by addictive substance use disorder","volume":"30","author":"Gao","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11481-021-10022-7","article-title":"Drugs and Bugs: The Gut-Brain Axis and Substance Use Disorders","volume":"17","author":"Simpson","year":"2022","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.cell.2016.02.011","article-title":"Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk","volume":"165","author":"Zhu","year":"2016","journal-title":"Cell"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e006347","DOI":"10.1161\/JAHA.117.006347","article-title":"Trimethylamine-N-Oxide Induces Vascular Inflammation by Activating the NLRP3 Inflammasome Through the SIRT3-SOD2-mtROS Signaling Pathway","volume":"6","author":"Chen","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4249","DOI":"10.1038\/s41598-019-40638-y","article-title":"Trimethylamine N-Oxide, Circulating Endothelial Progenitor Cells, and Endothelial Function in Patients with Stable Angina","volume":"9","author":"Chou","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1038\/s42003-020-01408-z","article-title":"Methamphetamine induces cardiomyopathy by Sigmar1 inhibition-dependent impairment of mitochondrial dynamics and function","volume":"3","author":"Abdullah","year":"2020","journal-title":"Commun. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.jcmg.2009.03.017","article-title":"Contrast-enhanced anatomic imaging as compared to contrast-enhanced tissue characterization for detection of left ventricular thrombus","volume":"2","author":"Weinsaft","year":"2009","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"180","DOI":"10.3390\/tomography7020016","article-title":"Left Ventricular Thrombi: Insights from Cardiac Magnetic Resonance Imaging","volume":"7","author":"Chaosuwannakit","year":"2021","journal-title":"Tomography"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/MCA.0000000000001223","article-title":"Predictors of left ventricular thrombus after acute myocardial infarction: A systematic review and meta-analysis","volume":"34","author":"Kwok","year":"2023","journal-title":"Coron. Artery Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e209771","DOI":"10.1212\/WNL.0000000000209771","article-title":"Cardiac CT vs Echocardiography for Intracardiac Thrombus Detection in Ischemic Stroke","volume":"103","author":"Ghozy","year":"2024","journal-title":"Neurology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"598","DOI":"10.24976\/Discov.Med.202436182.56","article-title":"The Value of Combined Detection of Serum BNP, Cardiac Troponin-I and Dynamic Electrocardiogram in Early Clinical Diagnosis and Prognosis of Patients with Acute Myocardial Infarction","volume":"36","author":"Yu","year":"2024","journal-title":"Discov. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Marinescu, M.C., Oprea, V.D., Munteanu, S.N., Nechita, A., Tutunaru, D., Nechita, L.C., and Romila, A. (2024). Carbohydrate Antigen 125 (CA 125): A Novel Biomarker in Acute Heart Failure. Diagnostics, 14.","DOI":"10.20944\/preprints202403.0391.v1"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1002\/ejhf.2295","article-title":"Antigen carbohydrate 125 as a biomarker in heart failure: A narrative review","volume":"23","author":"Santas","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104907","DOI":"10.1016\/j.neubiorev.2022.104907","article-title":"Heart rate variability in the prediction of mortality: A systematic review and meta-analysis of healthy and patient populations","volume":"143","author":"Jarczok","year":"2022","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1249\/MSS.0000000000000201","article-title":"Exercise training improves heart rate variability after methamphetamine dependency","volume":"46","author":"Dolezal","year":"2014","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"7614828","DOI":"10.1155\/2019\/7614828","article-title":"The Effect of Stroke Subtypes on Baroreceptor Sensitivity, a Predict for Acute Stroke Outcome","volume":"2019","author":"Tsai","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lin, C.H., Yen, C.C., Hsu, Y.T., Chen, H.H., Cheng, P.W., Tseng, C.J., Lo, Y.K., and Chan, J.Y.H. (2019). Baroreceptor Sensitivity Predicts Functional Outcome and Complications after Acute Ischemic Stroke. J. Clin. Med., 8.","DOI":"10.3390\/jcm8030300"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/0379-0738(95)01765-B","article-title":"Cardiac lesions and their reversibility after long term administration of methamphetamine","volume":"75","author":"Islam","year":"1995","journal-title":"Forensic Sci. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106782","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106782","article-title":"Embolic infarct topology differs between atrial fibrillation subtypes and embolic stroke of undetermined source","volume":"31","author":"Wolfe","year":"2022","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s40256-022-00523-y","article-title":"A Comprehensive Approach to Managing Methamphetamine-Associated Cardiomyopathy","volume":"22","author":"Osekowski","year":"2022","journal-title":"Am. J. Cardiovasc. Drugs"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Vorla, M., and Kalra, D.K. (2024). Meta-Analysis of the Safety and Efficacy of Direct Oral Anticoagulants for the Treatment of Left Ventricular Thrombus. Pharmaceuticals, 17.","DOI":"10.3390\/ph17060708"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"40","DOI":"10.2459\/JCM.0000000000001683","article-title":"Efficacy of direct oral anticoagulants vs. warfarin in left ventricular thrombus in myocardial infarction: Systematic review and meta-analysis","volume":"26","author":"Attachaipanich","year":"2025","journal-title":"J. Cardiovasc. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1002\/ehf2.12572","article-title":"Methamphetamine-related cardiovascular diseases","volume":"7","author":"Schwarzbach","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1161\/STR.0000000000000024","article-title":"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack","volume":"45","author":"Kernan","year":"2014","journal-title":"Stroke"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jchf.2017.10.006","article-title":"Clinical Characteristics and Outcome of Methamphetamine-Associated Pulmonary Arterial Hypertension and Dilated Cardiomyopathy","volume":"6","author":"Kwong","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s12012-015-9350-y","article-title":"Methamphetamine-Associated Congestive Heart Failure: Increasing Prevalence and Relationship of Clinical Outcomes to Continued Use or Abstinence","volume":"16","author":"Sliman","year":"2016","journal-title":"Cardiovasc. Toxicol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.amjcard.2019.09.030","article-title":"Comparison of Clinical Characteristics and Outcomes of Patients with Reversible Versus Persistent Methamphetamine-Associated Cardiomyopathy","volume":"125","author":"Zhao","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1136\/heartjnl-2020-317635","article-title":"Clinical and echocardiographic outcomes in heart failure associated with methamphetamine use and cessation","volume":"107","author":"Bhatia","year":"2021","journal-title":"Heart"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1016\/j.jemermed.2024.03.019","article-title":"Risk Factors and Emergency Department Outcomes in Methamphetamine-Associated Cardiomyopathy: A Case-Control Study","volume":"67","author":"Suto","year":"2024","journal-title":"J. Emerg. Med."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Cai, Y., Dai, Z., Wen, S., and Bhandari, R. (2020). Risk factors associated with infection of blood-borne virus among people who used methamphetamine. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05464-y"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Gay, A., Cabe, J., De Chazeron, I., Lambert, C., Defour, M., Bhoowabul, V., Charpeaud, T., Tremey, A., Llorca, P.-M., and Pereira, B. (2022). Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in Stimulant Drugs and Behavioral Addiction: A Meta-Analysis. J. Clin. Med., 11.","DOI":"10.3390\/jcm11030624"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"114904","DOI":"10.1016\/j.psychres.2022.114904","article-title":"High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex reduces drug craving and improves decision-making ability in methamphetamine use disorder","volume":"317","author":"Wang","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/00981389.2023.2278777","article-title":"Centering persons who use drugs: Addressing social determinants of health among patients hospitalized with substance use disorders","volume":"63","author":"Roberts","year":"2024","journal-title":"Soc. Work. Health Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1080\/10826084.2016.1200620","article-title":"Effectiveness of a Brief Home-Based Social Work Motivational Intervention for Male Methamphetamine Users in Tehran: A Randomized Clinical Trial","volume":"51","author":"Maarefvand","year":"2016","journal-title":"Subst. Use Misuse"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/imj.13050","article-title":"Methamphetamine-associated cardiomyopathy: Patterns and predictors of recovery","volume":"46","author":"Voskoboinik","year":"2016","journal-title":"Intern. Med. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijcard.2021.12.024","article-title":"Systolic dysfunction in patients with methamphetamine use and heart failure with preserved ejection fraction","volume":"348","author":"Bhatia","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_59","first-page":"2403","article-title":"Methamphetamine-associated reversible cardiomyopathy and stroke risk","volume":"18","author":"Yew","year":"2014","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1016\/j.amjmed.2015.08.006","article-title":"Methamphetamine Cardiotoxicity: Unique Presentation with Multiple Bi-Ventricular Thrombi","volume":"129","author":"Janardhanan","year":"2016","journal-title":"Am. J. Med."},{"key":"ref_61","first-page":"5083624","article-title":"Cardiac and Systemic Thrombus Caused by Drug Abuse","volume":"2019","author":"Eliveha","year":"2019","journal-title":"Case Rep. Cardiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s43044-019-0026-y","article-title":"Wild at heart: 34-year-old male with new onset dyspnea, heart failure and history of amphetamine use; a case report","volume":"71","author":"Navid","year":"2019","journal-title":"Egypt. Heart J."},{"key":"ref_63","first-page":"e17804","article-title":"Left Ventricular Thrombus Formation in a Young Female with a Severely Reduced Left Ventricular Ejection Fraction and a Recent Non-ST Segment Elevation-Acute Coronary Syndrome","volume":"13","author":"Patel","year":"2021","journal-title":"Cureus"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"23247096221078704","DOI":"10.1177\/23247096221078704","article-title":"Acute Myocardial Infarction Associated with a Mobile Left Ventricular Thrombi","volume":"10","author":"Morataya","year":"2022","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"192","DOI":"10.31486\/toj.21.0097","article-title":"Multiple Biventricular Thrombi Associated with Methamphetamine-Associated Cardiomyopathy","volume":"22","author":"Zaidi","year":"2022","journal-title":"Ochsner J."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/ajum.12404","article-title":"Acute aortic occlusion: A point-of-care ultrasound case report","volume":"27","author":"Newman","year":"2024","journal-title":"Australas J. Ultrasound Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1093\/ehjci\/jead320","article-title":"Methamphetamine-associated cardiomyopathy","volume":"25","author":"Zuern","year":"2024","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"cr.2025-0003","DOI":"10.5797\/jnet.cr.2025-0003","article-title":"Mechanical Thrombectomy for Methamphetamine-Associated Cardiomyopathy with Left Ventricular Thrombus: A Case Report","volume":"19","author":"Fujioka","year":"2025","journal-title":"J. Neuroendovasc. Ther."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"03000605251324593","DOI":"10.1177\/03000605251324593","article-title":"Multiple cardioembolic attacks with a huge ventricular thrombus in dilated cardiomyopathy: A case report and comprehensive review","volume":"53","author":"Moayerifar","year":"2025","journal-title":"J. Int. Med. 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