Barkhordari Hoda, Masoumi Mohammad, Moazenzadeh Mansour, Esmaili Hamidreza, Rashidinejad Hamidreza
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
J Res Pharm Pract. 2025 Aug 7;14(2):59-65. doi: 10.4103/jrpp.jrpp_15_25. eCollection 2025 Apr-Jun.
Methadone treatment is effective for managing opioid use disorder (OUD) but raises concerns about its impact on cardiac function. This study aimed to assess the prevalence of cardiac dysfunction among individuals under methadone treatment.
This cross-sectional study involved 200 OUD patients admitted to addiction treatment centers of Kerman, Iran, who were at least 1 year under methadone maintenance therapy. Participants were enrolled using a convenience sampling method. Exclusion criteria included concurrent alcohol or nonopioid drug abuse, underlying diseases affecting cardiac function (diabetes, hypertension, and chronic renal failure), hepatic diseases, or use of drugs affecting methadone metabolism. Data on methadone dose, treatment duration, and cardiac parameters assessed through echocardiography and electrocardiography were collected.
A total of 200 OUD patients aged 46.34 ± 13.93 years (72% male) were included. The average duration of methadone use was 2.17 ± 1.34 years, and the average dose was 52.10 ± 27.46 mg/day. 38% of subjects had QT prolongation, while echocardiographic assessment revealed various cardiac abnormalities: 17.5% with systolic dysfunction, 12.5% with abnormal left ventricular end-diastolic diameter, 66.5% with diastolic dysfunction, and 15.5% with increased systolic pulmonary artery pressure. Significant correlations were observed between methadone dose and duration with all measured cardiac parameters.
This study demonstrated an association between methadone treatment characteristics (higher dose and longer duration) and cardiac dysfunction. These findings suggest dose- and time-dependent cardiotoxic effects of methadone. Clinicians should implement cardiac monitoring, dose minimization, and risk-reduction strategies for patients on long-term methadone therapy.
美沙酮治疗对管理阿片类物质使用障碍（OUD）有效，但引发了对其对心脏功能影响的担忧。本研究旨在评估接受美沙酮治疗的个体中心脏功能障碍的患病率。
这项横断面研究纳入了200名入住伊朗克尔曼成瘾治疗中心的OUD患者，他们接受美沙酮维持治疗至少1年。采用便利抽样方法招募参与者。排除标准包括同时存在酒精或非阿片类药物滥用、影响心脏功能的基础疾病（糖尿病、高血压和慢性肾衰竭）、肝脏疾病或使用影响美沙酮代谢的药物。收集了美沙酮剂量、治疗持续时间以及通过超声心动图和心电图评估的心脏参数数据。
共纳入200名年龄为46.34±13.93岁的OUD患者（72%为男性）。美沙酮使用的平均持续时间为2.17±1.34年，平均剂量为52.10±27.46毫克/天。38%的受试者存在QT间期延长，而超声心动图评估显示出各种心脏异常：17.5%存在收缩功能障碍，12.5%左心室舒张末期内径异常，66.5%存在舒张功能障碍，15.5%收缩期肺动脉压升高。观察到美沙酮剂量和持续时间与所有测量的心脏参数之间存在显著相关性。
本研究表明美沙酮治疗特征（更高剂量和更长持续时间）与心脏功能障碍之间存在关联。这些发现提示美沙酮存在剂量和时间依赖性心脏毒性作用。临床医生应对长期接受美沙酮治疗的患者实施心脏监测、剂量最小化和风险降低策略。
