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

• Radunski Ulf K.

  Department of General and Interventional Cardiology, University Heart Center Hamburg

• Fuger Ulrike

  Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf

• Bohnen Sebastian

  Department of General and Interventional Cardiology, University Heart Center Hamburg

• Lund Gunnar K.

  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf

• Stehning Christian

  Philips Research Germany

• Zeller Tanja

  Department of General and Interventional Cardiology, University Heart Center Hamburg

• Tahir Enver

  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf

• Avanesov Maxim

  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf

• Adam Gerhard

  Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf

• Blankenberg Stefan

  Department of General and Interventional Cardiology, University Heart Center Hamburg

• Reimer Jens

  Center for Psychosocial Medicine, Health North Center for Interdisciplinary Addiction Medicine, University of Hamburg

• Muellerleile Kai

  Department of General and Interventional Cardiology, University Heart Center Hamburg

抄録

Background:Use of cocaine is widespread and associated with several cardiovascular diseases. Recent CMR studies indicate frequent myocardial scar/fibrosis in asymptomatic cocaine abusers (CA). Methods and Results:This study used a combination of advanced CMR tissue characterization techniques, including late gadolinium enhancement (LGE) for focal, and extracellular volume (ECV) imaging for diffuse myocardial injury/fibrosis, with circulating biomarkers for a comprehensive characterization of myocardial injury. We included 20 cardiac asymptomatic CA and a control group of 20 healthy volunteers. The comprehensive assessment included physical examination, resting ECG, exercise ECG, cardiac biomarkers, transthoracic echocardiogram and CMR. We did not find significant differences between CA and controls either in functional CMR parameters such as LVEDVi, LVESVi, LVEF, LV mass index, or in global myocardial ECV. Neither CA nor controls had evidence of myocardial edema on T2-weighted CMR, but 8 CA (40%), and none of the controls had focal myocardial scar (P<0.01). Interestingly, CA with focal myocardial scar on LGE had significantly higher high-sensitivity troponin I (hs-TNI) compared with CA without focal scar (median, 1.7 ng/L; IQR, 1.3–2.5 ng/L vs. 0.6 ng/L; 0.4–1.3 ng/L; P<0.01). Conclusions:Focal myocardial injury in terms of subtle LGE in 40% of asymptomatic CA was associated with higher hs-TNI. Comprehensive assessment including advanced ECV imaging indicates a focal rather than diffuse pattern of myocardial involvement in asymptomatic CA.

収録刊行物

• Circulation Journal

  Circulation Journal 81 (5), 701-708, 2017

  一般社団法人 日本循環器学会

キーワード

• Cardiac magnetic resonance imaging
• Cocaine abuse
• Extracellular volume imaging
• Myocardial tissue characterization
• T1 mapping

詳細情報

• CRID: 1390282680085345664
• NII論文ID: 130005612055
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-16-0941
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 028129467
• PubMed: 28179611
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I028129467
• Web Site: https://www.jstage.jst.go.jp/article/circj/81/5/81_CJ-16-0941/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2017381433
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可