Effects of the intracoronary infusion of cocaine on left ventricular systolic and diastolic function in humans.
BACKGROUND
In dogs, a large amount of intravenous cocaine causes a profound deterioration of left ventricular (LV) systolic function and an increase in LV end-diastolic pressure. This study was done to assess the influence of a high intracoronary cocaine concentration on LV systolic and diastolic function in humans.


RESULTS
In 20 patients (14 men and 6 women aged 39 to 72 years) referred for cardiac catheterization for the evaluation of chest pain, we measured heart rate, systemic arterial pressure, LV pressure and its first derivative (dP/dt), and LV volumes and ejection fraction before and during the final 2 to 3 minutes of a 15-minute intracoronary infusion of saline (n=10, control subjects) or cocaine hydrochloride 1 mg/min (n=10). No variable changed with saline. With cocaine, the drug concentration in blood obtained from the coronary sinus was 3.0+/-0.4 (mean+/-SD) mg/L, similar in magnitude to the blood cocaine concentration reported in abusers dying of cocaine intoxication. Cocaine induced no significant change in heart rate, LV dP/dt (positive or negative), or LV end-diastolic volume, but it caused an increase in systolic and mean arterial pressures, LV end-diastolic pressure, and LV end-systolic volume, as well as a decrease in LV ejection fraction.


CONCLUSIONS
In humans, the intracoronary infusion of cocaine sufficient in amount to achieve a high drug concentration in coronary sinus blood causes a deterioration of LV systolic and diastolic performance.
Pitts
W R
WR
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9047, USA.
Vongpatanasin
W
W
Cigarroa
J E
JE
Hillis
L D
LD
Lange
R A
RA
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D003042:Cocaine / Q000009:adverse effects*; D003971:Diastole / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects*; D013599:Systole / Q000187:drug effects; D014662:Vasoconstrictor Agents / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*
D014662:Vasoconstrictor Agents; D003042:Cocaine