Long term effects of cocaine on the heart assessed by cardiovascular magnetic resonance at 3T.
BACKGROUND
Cocaine 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.


METHODS
Consecutive (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.


RESULTS
Years 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.


CONCLUSIONS
CMR 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.
Alicia M
AM
Maceira
Carmen
C
Ripoll
Juan
J
Cosin-Sales
Begoña
B
Igual
Mirella
M
Gavilan
Jose
J
Salazar
Vicente
V
Belloch
NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital & Imperial College, London, UK. d.pennell@ic.ac.uk.
Dudley J
DJ
Pennell
D000328:Adult; D058070:Asymptomatic Diseases; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000150:complications*; D003287:Contrast Media; D004489:Edema, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D005355:Fibrosis; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
D003287:Contrast Media