Asymptomatic Cocaine Abuse　- Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging.
Use of cocaine is widespread and associated with several cardiovascular diseases. Recent CMR studies indicate frequent myocardial scar/fibrosis in asymptomatic cocaine abusers (CA).



This study used a combination of advanced CMR tissue characterization techniques, including late gadolinium enhancement (LGE) for focal, and extracellular volume (ECV) imaging for diffuse myocardial injury/fibrosis, with circulating biomarkers for a comprehensive characterization of myocardial injury. We included 20 cardiac asymptomatic CA and a control group of 20 healthy volunteers. The comprehensive assessment included physical examination, resting ECG, exercise ECG, cardiac biomarkers, transthoracic echocardiogram and CMR. We did not find significant differences between CA and controls either in functional CMR parameters such as LVEDVi, LVESVi, LVEF, LV mass index, or in global myocardial ECV. Neither CA nor controls had evidence of myocardial edema on T2-weighted CMR, but 8 CA (40%), and none of the controls had focal myocardial scar (P<0.01). Interestingly, CA with focal myocardial scar on LGE had significantly higher high-sensitivity troponin I (hs-TNI) compared with CA without focal scar (median, 1.7 ng/L; IQR, 1.3-2.5 ng/L vs. 0.6 ng/L; 0.4-1.3 ng/L; P<0.01).



Focal myocardial injury in terms of subtle LGE in 40% of asymptomatic CA was associated with higher hs-TNI. Comprehensive assessment including advanced ECV imaging indicates a focal rather than diffuse pattern of myocardial involvement in asymptomatic CA.
Department of General and Interventional Cardiology, University Heart Center Hamburg.
Ulf K
UK
Radunski
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf.
Ulrike
U
Fuger
Department of General and Interventional Cardiology, University Heart Center Hamburg.
Sebastian
S
Bohnen
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.
Gunnar K
GK
Lund
Philips Research Germany.
Christian
C
Stehning
Department of General and Interventional Cardiology, University Heart Center Hamburg.
Tanja
T
Zeller
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.
Enver
E
Tahir
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.
Maxim
M
Avanesov
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf.
Gerhard
G
Adam
Department of General and Interventional Cardiology, University Heart Center Hamburg.
Stefan
S
Blankenberg
Center for Psychosocial Medicine, Health North.|Center for Interdisciplinary Addiction Medicine, University of Hamburg.
Jens
J
Reimer
Department of General and Interventional Cardiology, University Heart Center Hamburg.
Kai
K
Muellerleile
D000328:Adult; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000473:pathology; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000209:etiology; D022001:Focal Adhesions; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I
Cardiac magnetic resonance imaging; Cocaine abuse; Extracellular volume imaging; Myocardial tissue characterization; T1 mapping