Effects of the intracoronary infusion of cocaine on left ventricular systolic and diastolic function in humans

William R. Pitts, Wanpen Vongpatanasin, Joaquin E. Cigarroa, L. David Hillis, Richard A. Lange

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    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)1270-1273
    Number of pages4
    JournalCirculation
    Volume97
    Issue number13
    DOIs
    StatePublished - Apr 7 1998

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    Keywords

    • Cocaine
    • Diastole
    • Systole
    • Ventricles

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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