Valuation of diastolic function in patients addicted to recreational cocaine use

Background and aims. The recreational use of cocaine is associated with cardiovascular pathologies, such as ischemic cardiopathy, myocarditis and cardiomyopathies, owing to the increased catecholamine stimulus, a propensity to coronary spasm, increased coagulative activity and inflammatory and degenerative phenomena of myocardiac cells. Early alterations of the diastolic phase may be visualised by evaluating the diastolic Doppler pattern of left ventricular filling. Methods. For this purpose the authors compared blood pressure, heart rate, heart mass, protodiastolic (E wave) and telediastolic (A wave) filling rate and their ratio (E/A) on the Doppler mitral diastolic profile in a group of 10 patients addicted to the recreational use of cocaine (mean age 33±7) with those of 10 normal subjects (mean age 34±2). Results. Patients using cocaine presented mean systolic arterial blood pressures of 130±12 versus 127±8 in control subjects (p=ns); mean heart rate was statistically significant with 98±14 versus 76±12 in controls (p<0.05). There were no differences in cardiac mass between the two groups. In cocaine addicts the speed of the E wave was significantly slower: 58.4±8.6 versus 73±7.4 cm/sec (p<0.05), and the speed of the A wave was significantly higher: 70.5±10.5 versus 62.6±4.3 cm/sec (p<0.05), when compared with normal controls subjects; the E/A ratio of cocaine addicts was lower (0.75± 0.34) compared to normal subjects (1.07±0.7), (p<0.05). Conclusions. These data show that patients addicted to the recreational use of cocaine show preclinical alterations of the left ventricular diastolic phase prior to the onset of clinically evident pathologies.