Long-term cocaine use is related to cardiac diastolic dysfunction in an African-American population in Baltimore, Maryland

Background: Only limited studies have been done on the effects of long-term cocaine use on the human heart, and the results remain controversial. In this study, we examined and compared the diastolic function of non-cocaine users and chronic cocaine users to reveal the impact of long-term cocaine use on the human heart. Methods: Two-dimensional echocardiogram and pulsed Doppler transmitral blood flow pattern were obtained from 138 recruited study participants with different cocaine histories. The indices of cardiac structure and function were measured from the echocardiogram of each participant. Student's t-test was used to compare the average echocardiographic measurements of the non-cocaine user group and the cocaine user group. Multivariate regression analysis was deployed to eliminate the effects of age, gender, blood pressure, and HIV infection on the functional measurements of the two groups. Results: The cocaine user group had a significantly longer average deceleration time than did the non-cocaine user group (208.1±38.2 vs. 167.5±39.1 ms, P<0.001). A linear association existed between the deceleration time and the log-transformed duration of cocaine use (β=0.00351, S.E.=0.00104, P=0.001). Cocaine users in this study were approximately five times more likely to have an elongated deceleration time (>200 ms) than were non-users (OR, 4.799; 95% CI, 1.000-23.044; P=0.05). No significant differences were observed in the other measured diastolic functional parameters, such as isovolumic ventricular relaxation time, E wave, A wave, and E/A ratio. Conclusions: Long-term cocaine use is linked to decline in diastolic function.