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

Tong, Wing H.; Lima, João A.C.; Meng, Qinghua; Flynn, Ellen; Lai, Shenghan

doi:10.1016/j.ijcard.2003.06.024

Cited by 23 publications

(25 citation statements)

References 19 publications

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“…36 Long-term cocaine use is associated with left ventricular hypertrophy 37 and prolonged deceleration time. 38 Cocaine prolongs the PR, QRS, and QT intervals. 39,40 Cocaine is associated with coronary atherosclerosis even in young users with relatively few cardiac risk factors.…”

Section: Clinicalmentioning

confidence: 99%

“…36 Long-term cocaine use is associated with left ventricular hypertrophy 37 and prolonged deceleration time. 38 The pathophysiology of cocaine-associated cardiomyopathy, however, remains unclear. Of 18 cocaine users undergoing coronary angiography with an ejection fraction Ͻ55%, 12 had coronary artery disease and regional wall motion abnormalities suggesting recent or remote MI; however, 6 did not have coronary artery disease and demonstrated global hypokinesis (4 of 6 with an ejection fraction Ͻ30%).…”

Section: Congestive Heart Failure and Cardiomyopathymentioning

confidence: 99%

“…47 Thus, a manifestation of coronary artery disease can explain cocaine-induced ventricular dysfunction in some patients, but cocaine also has a direct toxic effect on cardiac myocytes. Factors contributing to cocaineinduced cardiomyopathy may include the blocking of sodium and potassium channels within the myocardium, 35 alterations in calcium ion handling, 36 myocardial inflammation with necrosis and fibrosis, 38,93 left ventricular hypertrophy, 37,38 alterations in gene expression, 95 and concomitant alcohol consumption. 47 Cessation of cocaine is the primary therapeutic goal in cocaine-induced cardiomyopathy.…”

Section: Congestive Heart Failure and Cardiomyopathymentioning

confidence: 99%

“…36 La consommation de cocaïne au long cours induit une hypertrophie ventriculaire gauche 37 et un allongement du temps de décélération. 38 Cette drogue a également pour effet d'allonger les espaces PR et QT et d'élargir les complexes QRS. 39,40 Elle favorise l'athérosclérose coronaire, y compris chez le sujet jeune ne présentant que relativement peu de facteurs de risque cardiaque.…”

Section: Tableau 1 Effets Cardiovasculaires De La Cocaïneunclassified

“…36 La consommation de cocaïne à long terme provoque une hypertrophie ventriculaire gauche 37 et un allongement du temps de décélération. 38 Toutefois, on connaît mal le fondement physiopathologique de la cardiomyopathie induite par la cocaïne. Sur 18 cocaïnomanes ayant fait l'objet d'une coronarographie et dont la fraction d'éjection était inférieure à 55 %, 12 présentaient une maladie coronaire ainsi que des anomalies régionales de la mobilité pariétale en faveur de la survenue récente ou ancienne d'un IDM ; les 6 autres patients étaient indemnes de coronaropathie, mais présentaient une hypokinésie pariétale globale (4 d'entre eux avaient une fraction d'éjection inférieure à 30 %).…”

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Cardiovascular Effects of Cocaine

2010

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Section: Clinicalmentioning

confidence: 99%

Section: Congestive Heart Failure and Cardiomyopathymentioning

confidence: 99%

Section: Congestive Heart Failure and Cardiomyopathymentioning

confidence: 99%

Section: Tableau 1 Effets Cardiovasculaires De La Cocaïneunclassified

unclassified

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2010

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2012

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How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Pieske

Tschöpe

Boer

et al. 2020

European J of Heart Fail

418

643

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Making a firm diagnosis of chronic heart failure with preserved ejection fraction (HFpEF) remains a challenge. We recommend a new stepwise diagnostic process, the ‘HFA–PEFF diagnostic algorithm’. Step 1 (P=Pre‐test assessment) is typically performed in the ambulatory setting and includes assessment for heart failure symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes mellitus, elderly, atrial fibrillation), and diagnostic laboratory tests, electrocardiogram, and echocardiography. In the absence of overt non‐cardiac causes of breathlessness, HFpEF can be suspected if there is a normal left ventricular (LV) ejection fraction, no significant heart valve disease or cardiac ischaemia, and at least one typical risk factor. Elevated natriuretic peptides support, but normal levels do not exclude a diagnosis of HFpEF. The second step (E: Echocardiography and Natriuretic Peptide Score) requires comprehensive echocardiography and is typically performed by a cardiologist. Measures include mitral annular early diastolic velocity (e′), LV filling pressure estimated using E/e′, left atrial volume index, LV mass index, LV relative wall thickness, tricuspid regurgitation velocity, LV global longitudinal systolic strain, and serum natriuretic peptide levels. Major (2 points) and Minor (1 point) criteria were defined from these measures. A score ≥5 points implies definite HFpEF; ≤1 point makes HFpEF unlikely. An intermediate score (2–4 points) implies diagnostic uncertainty, in which case Step 3 (F1: Functional testing) is recommended with echocardiographic or invasive haemodynamic exercise stress tests. Step 4 (F2: Final aetiology) is recommended to establish a possible specific cause of HFpEF or alternative explanations. Further research is needed for a better classification of HFpEF.

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

Cited by 23 publications

References 19 publications

Cardiovascular Effects of Cocaine

Cardiovascular Effects of Cocaine

Cocaine

How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

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