Frequency of left ventricular dysfunction and other echocardiographic abnormalities in human immunodeficiency virus seronegative intravenous drug users

Abstract

Dilated cardiomyopathy has been recognized as a complication of human immunodeficiency virus (HIV) infection and may occur in approximately 10 to 20% of patients with acquired immunodeficiency syndrome (AIDS). 1,2. At our institution over a 3-year period of time, we have identified 60 HIV seropositive patients with global left ventricular (LV) hypokinesia on 2-dimensional echocardiography; 28 (41%) were intravenous drug users. Cardiomyopathy has been associated with illicit drug use in several case reports or series, 3–5 and in 1 retrospective review of coronary angiograms in cocaine users, depression of LV ejection fraction was observed in the presence of normal coronary arteries. 6 Although intravenous cocaine has been shown to directly depress myocardial function in dogs, 7 the precise role of illicit drug use, particularly that of cocaine, in the development of cardiomyopathy remains unclear. 8–10 The extent to which cardiomyopathy among intravenous drug users is related to HIV infection, to the cardiotoxic effects of illicit drug use, or to other factors has not been adequately studied. This study examines the prevalence of LV dysfunction and characterizes the echocardiographic findings among a group of HIV seronegative intravenous drug users.