Mohammadi Khadije, Habibi-Khorasani Shirin, Nasri Hamidreza, Toudeshki Kimia Karimi, Mirtajaddini Marzieh, Davari Nazanin
Cardiovascular Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
ESC Heart Fail. 2024 Dec;11(6):4308-4313. doi: 10.1002/ehf2.14843. Epub 2024 Aug 29.
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.
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.
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).
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.
心力衰竭因其死亡率和对医疗保健系统的负担而成为全球范围内的一个健康问题。关于鸦片使用对心脏收缩功能的影响，研究结果仍存在争议。因此，本研究的目的是通过应变超声心动图比较鸦片使用者与非成瘾者的左心室收缩功能，并探讨其与血清阿片肽水平的关系。
本病例对照研究于2022年在伊朗克尔曼的沙法医院进行，研究对象为50名前往成瘾治疗中心就诊且无其他物质使用史的鸦片使用者。成瘾的定义依据《精神疾病诊断与统计手册》第五版（DSM-5），且有至少3年的鸦片使用史。选取50名年龄和性别匹配的健康人（非鸦片使用者）作为对照组。通过问卷记录参与者的人口统计学信息，包括年龄、性别和鸦片使用量。采集所有研究参与者的枸橼酸盐抗凝血样，采用酶联免疫吸附测定（ELISA）法测定血清阿片肽水平。由一名专业心脏病专家使用同一设备（飞利浦Affiniti 50）对他们进行经胸超声心动图检查。记录并比较两组的超声心动图收缩参数。
本研究共纳入100名参与者，包括50名鸦片使用者和50名非鸦片使用者（作为对照组）。鸦片使用者组的平均年龄为36.4±5.08岁，对照组为34.14±7.2岁。由于两组进行了匹配，两组中各有8名（16%）女性和42名（84%）男性。鸦片使用者的平均射血分数（EF）和整体纵向应变（GLS）显著低于对照组（P<0.001）。结果还表明，成瘾者的血清阿片肽水平低于非成瘾者（3.4对9.7；P<0.001）。
通过应变超声心动图评估鸦片使用者的左心室收缩功能表明，鸦片会影响心脏的收缩功能，表现为EF和GLS显著降低。因此，鸦片使用可被视为心力衰竭的一个危险因素，在预防心脏病学中需要更多关注。
