title: Ventricular arrhythmias induced by long-term use of ephedrine in two competitive athletes.
abstract: Ephedrine is a sympathomimetic substance used by sportsmen as a doping substance because of its stimulating and slimming effects. We report two cases of ventricular arrhythmias induced by abuse of ephedrine in two competitive athletes. Endomyocardial biopsies guided by electroanatomic mapping revealed contraction-band necrosis, a myocardial injury frequently observed in cases of catecholamine excess. Our cases suggest that long-term abuse of ephedrine may result in myocardial damage, and that these structural alterations may promote areas of slow conduction favoring re-entrant ventricular tachyarrhythmias and a long-lasting risk of ventricular arrhythmias.
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, Via Parea, 4, 20138, Milan, Italy, michela.casella@ccfm.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Izzo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.forename: Eleonora
authors.initials: E
authors.lastname: Russo
authors.forename: Daniele
authors.initials: D
authors.lastname: Colombo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bologna
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Paolo
authors.initials: P
authors.lastname: Zeppilli
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
mesh_terms: D000328:Adult; D056352:Athletes; D001642:Bicycling; D001706:Biopsy; D001914:Boxing; D017115:Catheter Ablation; D003163:Competitive Behavior; D004300:Doping in Sports; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D004809:Ephedrine / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D058573:Performance-Enhancing Substances / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*; D017180:Tachycardia, Ventricular / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery
chemical_list: D058573:Performance-Enhancing Substances; D004809:Ephedrine