Magnano Anthony R, Talathoti Naresh B, Hallur Ravindra, Jurus Derek T, Dizon Jose, Holleran Steve, Bloomfield Daniel M, Collins Eric, Garan Hasan
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York, USA.
Am J Cardiol. 2006 Apr 15;97(8):1244-6. doi: 10.1016/j.amjcard.2005.11.046. Epub 2006 Mar 3.
The proarrhythmic effects of cocaine may be mediated in part by its effects on cardiac repolarization properties. This study evaluated the acute effects of smoking cocaine 25 mg on the electrocardiograms of 14 habitual cocaine users during a 12-minute observation period. After cocaine administration, heart rate increased by a mean of 22 beats/min (p <0.0001). One patient developed accelerated junctional rhythm, and 5 had nonspecific ST-T-wave abnormalities. The electrocardiograms revealed significant prolongation of the QTc interval (p <0.001) after cocaine administration. In addition, T-wave amplitude decreased and U-wave amplitude increased in response to cocaine use (p <0.05). QRS duration was unchanged by cocaine, whereas the PR interval shortened slightly. The repolarization changes observed after cocaine use were similar to those reported for other sympathomimetic agents and may be a contributing factor in the association between cocaine use and ventricular arrhythmias.
可卡因的促心律失常作用可能部分是由其对心脏复极特性的影响介导的。本研究评估了14名习惯性可卡因使用者在12分钟观察期内吸食25毫克可卡因对心电图的急性影响。给予可卡因后，心率平均增加22次/分钟（p<0.0001）。1例患者出现加速性交界性心律，5例有非特异性ST-T波异常。心电图显示给予可卡因后QTc间期显著延长（p<0.001）。此外，使用可卡因后T波振幅降低，U波振幅增加（p<0.05）。可卡因对QRS时限无影响，而PR间期略有缩短。使用可卡因后观察到的复极变化与其他拟交感神经药报道的变化相似，可能是可卡因使用与室性心律失常之间关联的一个促成因素。
