Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Pharmacol Toxicol. 2022 Mar 23;23(1):17. doi: 10.1186/s40360-022-00558-6.
Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity.
Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018-November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this finding between two groups based on high-sensitivity troponin I results.
Mean age of the patients was 34.5 ± 11.1 years (males: 67%). Twenty (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P = 0.013 and 83% vs. 16%, P < 0.001, respectively). Patients with elevated troponin had reduced left ventricular ejection fraction in comparison to normal group during admission (43.1 ± 15.4% vs. 55%, P < 0.001) and this left ventricular ejection fraction remained abnormal after 30 days (43.7 ± 21.6%). Patients in positive high-sensitivity troponin I group had higher regional wall motion abnormality frequency both at admission and 30 days later compared to the other group (0 day: 42% vs. 0, P < 0.001, 30th days: 25% vs. 4%, P = 0.020).
Patients with simultaneous methadone toxicity and positive high-sensitivity troponin I had worse cardiac outcomes and this biomarker could be probably used for better implementation of therapeutic interventions and prognosis.
美沙酮是一种主要用于戒毒治疗的合成阿片类药物，随着其使用量的增加，美沙酮引起的心脏毒性的可能性可能会增加。本研究旨在确定高敏肌钙蛋白 I 水平作为美沙酮中毒性心肌损伤预测因子的相关性。
本前瞻性病例对照研究于 2018 年 10 月至 2020 年 11 月纳入 60 例美沙酮中毒患者。患者入院时评估高敏肌钙蛋白 I 水平和心电图。所有患者入院时和 30 天后均进行超声心动图检查，并根据高敏肌钙蛋白 I 结果比较两组之间的检查结果。
患者的平均年龄为 34.5±11.1 岁（男性占 67%）。20（20%）例患者高敏肌钙蛋白结果阳性。在高敏肌钙蛋白 I 阳性者中，最常观察到长 QT 间期和胸前导联 T 波倒置（75%比 35%，P=0.013 和 83%比 16%，P<0.001）。与正常组相比，高肌钙蛋白组入院时左心室射血分数降低（43.1±15.4%比 55%，P<0.001），30 天后仍保持异常（43.7±21.6%）。与其他组相比，高敏肌钙蛋白 I 阳性组入院时和 30 天后的区域性壁运动异常频率更高（0 天：42%比 0，P<0.001，30 天：25%比 4%，P=0.020）。
同时患有美沙酮中毒和高敏肌钙蛋白 I 阳性的患者心脏预后更差，该生物标志物可能用于更好地实施治疗干预和预后。
