Asymptomatic Cocaine Abuse　― Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging ―

Radunski, Ulf K; Fuger, Ulrike; Bohnen, Sebastian; Lund, Gunnar; Stehning, Christian; Zeller, Tanja; Tahir, Enver; Avanesov, Maxim; Adam, Gerhard; Blankenberg, Stefan; Reimer, Jens; Muellerleile, Kai

doi:10.1253/circj.cj-16-0941

Cited by 8 publications

(5 citation statements)

References 48 publications

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“…Exclusion criteria included coronary artery disease, relevant valvular dysfunction, post-operative status (myectomy, alcohol septal ablation), glomerular filtration rate (GFR) < 30 ml/min/1.73 m 2 . The control group consisted of recently published healthy individuals [ 7 ]. Diastolic dysfunction (DD) was assessed and categorized by echocardiography in agreement with current guidelines [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

et al. 2021

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Aims CMR feature tracking strain (CMR-FT) provides prognostic information. However, there is a paucity of data in hypertrophic cardiomyopathy (HCM). We sought to analyze global CMR-FT parameters in all four cardiac chambers and to assess associations with NT-proBNP and cardiac troponin T (hsTnT) in patients with HCM. Methods This retrospective study included 144 HCM patients and 16 healthy controls with CMR at 1.5 T. Analyses were performed on standard steady-state free precession cine (SSFP) CMR data using a commercially available software. Global left ventricular (LV) strain was assessed as longitudinal (LVLAX-GLS), circumferential (LVLAX-GCS) and radial strain (LVLAX-GRS) on long -axis (LAX) and as LVSAX-GCS and LVSAX-GRS on short- axis (SAX). Right ventricular (RV-GLS), left atrial (LA-GLS) and right atrial (RA-GLS) strain were assessed on LAX. Results We found LVLAX-GLS [− 18.9 (− 22.0, − 16.0), − 23.5 (− 25.5, − 22.0) %, p = 0.0001), LVSAX-GRS [86.8 (65.9–115.5), 119.6 (91.3–143.7) %, p = 0.001] and LALAX-GLS [LA2CH-GLS 29.2 (19.1–37.7), LA2CH-GLS 38.2 (34.3–47.1) %, p = 0.0036; LA4CH-GLS 22.4 (14.6–30.7) vs. LA4CH-GLS 33.4 (28.4–37.3) %, p = 0.0033] to be impaired in HCM compared to healthy controls despite normal LVEF. Furthermore, LV and LA strain parameters were impaired in HCM with elevated NT-proBNP and/or hsTnT, despite preserved LVEF compared to HCM with normal biomarker levels. There was a moderate correlation of LV and LA CMR-FT with levels of NT-proBNP and hsTnT. Conclusion CMR-FT reveals LV and LA dysfunction in HCM despite normal LVEF. The association between impaired LV strain and elevated NT-proBNP and hsTnT indicates a link between unapparent functional abnormalities and disease severity in HCM. Graphic abstract Typical CMR-FT findings in patients with hypertrophic cardiomyopathy

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Section: Methodsmentioning

confidence: 99%

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

et al. 2021

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“…Regarding chronic use, five retrospective cohort studies compared the left ventricular ejection fractions between asymptomatic adult cocaine users and non-users (Table S3-4) [25][26][27][28][29] . Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Table S3-6 shows the studies along with the effect sizes calculated from the primary data in each manuscript. Eight echocardiogram studies examined the left ventricular mass index (LVMi) of chronic users versus non-users [25][26][27][28][29][39][40][41] . Three studies were discarded from meta-analyses due to unmatched groups 34,38,39 .…”

Section: Resultsmentioning

confidence: 99%

“…There were sufficient studies to perform subgroup analyses by dividing the two measurement modalities: autopsy and echocardiogram ( Figure S2 www.nature.com/scientificreports/ Cocaine and left ventricular end diastolic volume. Six studies (Table S3-7) had sufficient primary data to extract the effect size of chronic cocaine use on left ventricular end diastolic volume (LVED) [25][26][27][28][29]40 . The difference in LVED between the user and non-user groups was significant as shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

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Cocaine, cardiomyopathy, and heart failure: a systematic review and meta-analysis

Arenas

Beltrán

Zhou

et al. 2020

Sci Rep

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Although the cardiotoxic effects of cocaine are universally recognized, the association between cocaine and cardiomyopathy and/or heart failure is poorly understood. To conduct a comprehensive review and meta-analysis on the association between cocaine, heart failure, and cardiomyopathy, we first conducted a broad-term search in PubMed, Embase, Web of Science, and Scopus for human studies containing primary data on the relationship between cocaine and heart failure or cardiomyopathy. We were interested in studies with data beyond acute coronary syndromes. Retrieved studies were grouped into different categories based on possible hypotheses to test by meta-analysis. A second search with specific terms was then conducted. For grouped studies with sufficient clinical and methodological homogeneity, effect sizes were calculated and combined for meta-analysis by the Random Effects model. There is in general a need for more primary data studies that investigate heart failure and/or cardiomyopathy in cocaine users for mechanisms independent of ischemia. There were, however, enough studies to combine by meta-analyses that showed that chronic cocaine use is associated with anatomical and functional changes more consistent with diastolic heart failure instead of the commonly taught dilated cardiomyopathy pathway. In patients without a history of ACS, chronic cocaine use was not associated with significantly reduced EF. The few studies on acute cocaine had conflicting results on whether single-dose intravascular cocaine results in acute heart failure. Studies identified that included beta-blockade therapy in cocaine users with cardiac disease suggest that beta-blockers are not unsafe and that may be effective in the treatment of cocaine-associated heart failure. Chronic cocaine use is associated with anatomical and physiological changes of the heart muscle that are potentially reversible with beta-blockade therapy.

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“…As a reference, 20 volunteers without cardiovascular disease or risk factors, no cardiovascular medication, and normal cardiac biomarkers and ECG were recruited and underwent CMR imaging in a prior study. 24 Blood samples were available for 10 of these individuals and were used in the present study.…”

Section: Methodsmentioning

confidence: 99%

Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction

Bacmeister,

Cavus,

Bohnen

et al. 2024

JAHA

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Background Biomarkers simplifying the diagnostic workup by discriminating between non–ST‐segment–elevation myocardial infarction (NSTEMI) and infarct‐like myocarditis are an unmet clinical need. Methods and Results A total of 105 subjects were categorized into groups as follows: ST‐segment−elevation myocardial infarction (n=36), NSTEMI (n=22), infarct‐like myocarditis (n=19), cardiomyopathy‐like myocarditis (n=18), and healthy control (n=10). All subjects underwent cardiac magnetic resonance imaging, and serum concentrations of matrix metalloproteinase‐1 (MMP‐1) and procollagen type I carboxy terminal propeptide (PICP) were measured. Biomarker concentrations in subjects presenting with acute coronary syndrome and non‐ST‐segment‐elevation, for example NSTEMI or infarct‐like myocarditis, categorized as the non−ST‐segment−elevation acute coronary syndrome−like cohort, were of particular interest for this study. Compared with healthy controls, subjects with myocarditis had higher serum concentrations of MMP‐1 and PICP, while no difference was observed in individuals with myocardial infarction. In the non−ST‐segment−elevation acute coronary syndrome−like cohort, MMP‐1 concentrations discriminated infarct‐like myocarditis and NSTEMI with an area under the receiver operating characteristic curve (AUC) of 0.95 (95% CI, 0.89−1.00), whereas high‐sensitivity cardiac troponin T performed inferiorly (AUC, 0.74 [95% CI, 0.58−0.90]; P =0.012). Application of an optimal MMP‐1 cutoff had 94.4% sensitivity (95% CI, 72.7%−99.9%) and 90.9% specificity (95% CI, 70.8%−98.9%) for the diagnosis of infarct‐like myocarditis in this cohort. The AUC of PICP in this context was 0.82 (95% CI, 0.68−0.97). As assessed by likelihood ratio tests, incorporating MMP‐1 or PICP with age and C‐reactive protein into composite prediction models enhanced their diagnostic performance. Conclusions MMP‐1 and PICP could potentially be useful biomarkers for differentiating between NSTEMI and infarct‐like myocarditis in individuals with non−ST‐segment−elevation acute coronary syndrome‐like presentation, though further research is needed to validate their clinical applicability.

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Asymptomatic Cocaine Abuse　― Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging ―

Cited by 8 publications

References 48 publications

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

Cocaine, cardiomyopathy, and heart failure: a systematic review and meta-analysis

Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction

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Asymptomatic Cocaine Abuse ― Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging ―

Cited by 8 publications

References 48 publications

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy

Cocaine, cardiomyopathy, and heart failure: a systematic review and meta-analysis

Serum Concentrations of Matrix Metalloproteinase‐1 and Procollagen Type I Carboxy Terminal Propeptide Discriminate Infarct‐Like Myocarditis and Non−ST‐Segment−Elevation Myocardial Infarction

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Asymptomatic Cocaine Abuse　― Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging ―