Evaluation of left ventricular systolic function in opium users by strain echocardiography
Khadije Mohammadi1, Shirin Habibi-Khorasani2, Hamidreza Nasri1
1Cardiovascular Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Insights
Opium use significantly impairs systolic heart function, reducing ejection fraction and global longitudinal strain. This suggests opium addiction is a risk factor for heart failure, requiring greater focus in preventive cardiology.
Area of Science:
- Cardiology
- Cardiovascular Research
- Integrative Medicine
Background:
- Heart failure presents a significant global health challenge due to high mortality and healthcare burdens.
- The impact of opium consumption on systolic heart function remains a subject of ongoing research and debate.
Purpose of the Study:
- To compare systolic left ventricular function in individuals using opium versus non-users.
- To investigate the association between opium use, systolic heart function, and serum apelin levels.
Main Methods:
- A case-control study involving 50 opium users (minimum 3 years of use) and 50 matched non-users.
- Serum apelin levels measured via ELISA; systolic function assessed using strain echocardiography.
- Participants evaluated at Shafa Hospital, Kerman, Iran, adhering to DSM-5 criteria for addiction.
Main Results:
- Opium users exhibited significantly lower ejection fraction (EF) and global longitudinal strain (GLS) compared to controls (P < 0.001).
- Serum apelin levels were markedly reduced in opium users (3.4) versus non-users (9.7) (P < 0.001).
- A total of 100 participants (50 users, 50 controls), aged 34-36, with 84% males in both groups.
Conclusions:
- Opium use detrimentally affects systolic left ventricular function, evidenced by reduced EF and GLS.
- Opium consumption should be recognized as a potential risk factor for developing heart failure.
- Increased attention to opium use is warranted within preventive cardiology strategies.
Aims:
Heart failure is known as a health problem in the world due to its mortality and burdens on the health care system. Studies remain controversial about the effect of opium usage on systolic heart function. Therefore, the aim of this study was to compare systolic left ventricular function in opium users with non-addict people by strain echocardiography and its association with serum apelin level.
Methods:
This case-control study was conducted in 2022 at Shafa Hospital in Kerman, Iran, on 50 opium users who referred to the addiction treatment centres and had no history of other substance usage. The addiction is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and a history of opium consumption for at least 3 years. Fifty healthy people (non-opium users) who were matched in terms of age and sex were enrolled as a control group. Demographic information of the participants, including age, gender and amount of opium usage, was recorded by questionnaire. Citrated blood samples were taken from all participants in the study, and serum apelin was measured by the enzyme-linked immunosorbent assay (ELISA) method. They underwent transthoracic echocardiography by an expert cardiologist using the same device (Philips Affiniti 50). Echocardiographic systolic parameters have been recorded and compared between the two groups.
Results:
In this study, 100 participants, including 50 opium users and 50 non-opium users (as a control group), were investigated. The mean age was 36.4 ± 5.08 in the opium users' group and 34.14 ± 7.2 in the control group. As both groups were matched, there were 8 (16%) women and 42 (84%) men in each of the two groups. The mean amount of ejection fraction (EF) and global longitudinal strain (GLS) were significantly lower in opium users than in the control group (P < 0.001). The results also demonstrated that the serum level of apelin in the addicted persons was lower when compared with the non-addicted persons (3.4 vs. 9.7; P < 0.001).
Conclusions:
Evaluation of systolic left ventricular function in opium users by strain echocardiography showed that opium affects the systolic function of the heart, as observed by a significant reduction in EF and GLS. So opium usage can be considered a risk factor for heart failure and needs more attention in preventive cardiology.
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