Speckle Tracking Strain Assessment of Left Ventricle in Synthetic Cannabinoid and Heroin Users

Abstract

ObjectiveThere is growing evidence regarding the numerous adverse effects of synthetic cannabinoids (SCBs) on the cardiovascular system; however, no studies have shown the cardiovascular effects of opioids using strain echocardiography. This study examines the cardiac structure and function using echocardiographic strain imaging in heroin and synthetic cannabinoid users.MethodsThis double-blind study included patients who were admitted or referred to a rehabilitation center for heroin (n=31) and synthetic cannabinoid users (n=30). Heroin users and synthetic cannabinoid users were compared with healthy volunteers (n=32) using two-dimensional (2D) speckle-tracking (ST) echocardiography.ResultsNo differences were found in the baseline characteristics and 2D echocardiography values. The mean global longitudinal strain value was −20.5%±2.4% for SCB users, −22.3%±2.4% for opioid users, and −22.5%±2.2% for healthy volunteers (p=0.024). The mean apical 2-chamber (AP2C) L-strain values were −20.1%±3.1%, −22.4%±3.0%, and −22.3%±2.8% for SCB users, opioid users, and healthy volunteers, respectively (p=0.032). The mean apical 4-chamber (AP4C) L-strain values were −20.7%±2.5% for SCB users, −23.2%±3.2% for opioid users, and −23.8%±3.1% for healthy volunteers (p<0.001).ConclusionSCBs are potential causes of subclinical left ventricular dysfunction.

Efeitos da Heroína nos Parâmetros Eletrocardiográficos

“… 11 Demirkıran et al, 12 demonstraram que os canabinóides sintéticos afetaram negativamente a função ventricular esquerda, ao passo que a heroína não. 12 O uso de heroína não parece ter efeito sobre as funções ventriculares esquerdas de acordo com os resultados desses estudos; por outro lado, irregularidades atriais e miocárdicas com amostra histopatológica 13 e contagem de leucócitos miocárdicos intersticiais, contagem de linfócitos T e macrófagos promovem aumento de cinco vezes nas amostras miocárdicas. 14 Os efeitos cardíacos da heroína não se limitam aos efeitos miotóxicos.…”

“… 11 Demirkıran et al 12 demonstrated that synthetic cannabinoids negatively affected the left ventricular function, whereas heroin did not. 12 Heroin use does not seem to have any effects on the left ventricular functions according to the results of these studies; on the other hand, atrial and myocardial irregularities with histopathological sampling 13 and interstitial myocardial leukocyte count, T lymphocyte and macrophage counts were observed to promote a five-fold increase in myocardial samples. 14 The cardiac effects of heroin are not limited to myotoxic effects.…”

Letter to editor

“…We read the article entitled as “Speckle-tracking strain assessment of left ventricular dysfunction in synthetic cannabinoid and heroin users” with great interest (1). We congratulate the authors for performing such a trial regarding addictive substance and strain echocardiography and have some minor comments regarding the trial methodology.…”