TY - JOUR
T1 - Effects of the intracoronary infusion of cocaine on left ventricular systolic and diastolic function in humans
AU - Pitts, William R.
AU - Vongpatanasin, Wanpen
AU - Cigarroa, Joaquin E.
AU - David Hillis, L.
AU - Lange, Richard A.
PY - 1998/4/7
Y1 - 1998/4/7
N2 - 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. Methods and Results: In 20 patients (14 men and 6 women aged 39 to 72 years) referred for cardiac catherization 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 3.04 ± 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.
AB - 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. Methods and Results: In 20 patients (14 men and 6 women aged 39 to 72 years) referred for cardiac catherization 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 3.04 ± 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.
KW - Cocaine
KW - Diastole
KW - Systole
KW - Ventricles
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M3 - Article
C2 - 9570197
AN - SCOPUS:0032492755
SN - 0009-7322
VL - 97
SP - 1270
EP - 1273
JO - Circulation
JF - Circulation
IS - 13
ER -