Cocaine-induced vasoconstriction in the human coronary microcirculation: New evidence from myocardial contrast echocardiography

Swaminatha V. Gurudevan, Michael D. Nelson, Florian Rader, Xiu Tang, Joshua Lewis, Jimmy Johannes, J. Todd Belcik, Robert M. Elashoff, Jonathan Lindner, Ronald G. Victor

    Research output: Contribution to journalArticle

    14 Scopus citations

    Abstract

    Background-Cocaine is a major cause of acute coronary syndrome, especially in young adults; however, the mechanistic underpinning of cocaine-induced acute coronary syndrome remains limited. Previous studies in animals and in patients undergoing cardiac catheterization suggest that cocaine constricts coronary microvessels, yet direct evidence is lacking. Methods and Results-We used myocardial contrast echocardiography to test the hypothesis that cocaine causes vasoconstriction in the human coronary microcirculation. Measurements were performed at baseline and after a low, nonintoxicating dose of intranasal cocaine (2 mg/kg) in 10 healthy cocaine-naïve young men (median age, 32 years). Postdestruction time-intensity myocardial contrast echocardiography kinetic data were fit to the equation y=A(1-e) to quantify functional capillary blood volume (A), microvascular flow velocity (β), and myocardial perfusion (A×β). Heart rate, mean arterial pressure, and left ventricular work (2-dimensional echocardiography) were measured before and 45 minutes after cocaine. Cocaine increased mean arterial pressure (by 14±2 mm Hg [mean±SE]), heart rate (by 8±3 bpm), and left ventricular work (by 50±18 mm Hg·mL·bpm). Despite the increases in these determinants of myocardial oxygen demand, myocardial perfusion decreased by 30% (103.7±9.8 to 75.9±10.8 arbitrary units [AU]/s; P

    Original languageEnglish (US)
    Pages (from-to)598-604
    Number of pages7
    JournalCirculation
    Volume128
    Issue number6
    DOIs
    Publication statusPublished - Aug 6 2013

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    Keywords

    • cocaine
    • echocardiography
    • microcirculation
    • myocardial perfusion imaging

    ASJC Scopus subject areas

    • Physiology (medical)
    • Cardiology and Cardiovascular Medicine

    Cite this

    Gurudevan, S. V., Nelson, M. D., Rader, F., Tang, X., Lewis, J., Johannes, J., ... Victor, R. G. (2013). Cocaine-induced vasoconstriction in the human coronary microcirculation: New evidence from myocardial contrast echocardiography. Circulation, 128(6), 598-604. https://doi.org/10.1161/CIRCULATIONAHA.113.002937