Abstract
BackgroundCocaine is an addictive, sympathomimetic drug with potentially lethal effects. The prevalence and features of cocaine cardiotoxicity are not well known. We aimed to assess these effects using a comprehensive cardiovascular magnetic resonance (CMR) protocol in a large group of asymptomatic cocaine users.MethodsConsecutive (n = 94, 81 males, 36.6 ±7 years), non-selected, cocaine abusers were recruited and had a medical history, examination, ECG, blood test and CMR. The CMR study included measurement of left and right ventricular (LV, RV) dimensions and ejection fraction (EF), sequences for detection of myocardial oedema and late gadolinium enhancement (LGE). Images were compared to a cohort of healthy controls.ResultsYears of regular cocaine use were 13.9 ± 9. When compared to the age-matched healthy cohort, the cocaine abusers had increased LV end-systolic volume, LV mass index and RV end-systolic volume, with decreased LVEF and RVEF. No subject had myocardial oedema, but 30% had myocardial LGE indicating myocardial damage.ConclusionsCMR detected cardiovascular disease in 71% of this cohort of consecutive asymptomatic cocaine abusers and mean duration of abuse was related to probability of LV systolic dysfunction.
Highlights
Cocaine is an addictive, sympathomimetic drug with potentially lethal effects
cardiovascular magnetic resonance (CMR) can provide a comprehensive evaluation of the cardiovascular system and has a unique capability for tissue characterization, which has been applied to the assessment of several cardiomyopathies [16,17,18]
Some degree of cardiac involvement was shown in 71% of cocaine abusers (CA), and LV dysfunction was related to number of years of regular cocaine use, which may have practical importance in these patients’ medical care
Summary
We aimed to assess these effects using a comprehensive cardiovascular magnetic resonance (CMR) protocol in a large group of asymptomatic cocaine users. Cocaine is a highly addictive sympathomimetic drug with potentially lethal effects [1,2]. The annual prevalence of cocaine use is 0.3% to 0.5% of the world population aged 15-64 [3], corresponding to roughly 18 million people. The majority of studies that have assessed the prevalence and pattern of cardiovascular involvement due to Cardiovascular magnetic resonance (CMR) is the current gold standard technique for the assessment of ventricular dimensions and function, with high accuracy and reproducibility and reference values established for both the left [14] and right ventricles [15]. CMR can provide a comprehensive evaluation of the cardiovascular system and has a unique capability for tissue characterization, which has been applied to the assessment of several cardiomyopathies [16,17,18]
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