Key result
Chronic cocaine use in sudden death victims is linked to ~100% more LBB connective and adipose tissue.
Why the study?
Cocaine abuse is associated with arrhythmias and sudden death, but histopathological changes in the cardiac conduction system and its vascularization required comparison with non-users.
Does chronic cocaine use cause histopathological lesions in the cardiac conduction system and its vascularization in young adults?
Case-Control (n=40)
Does chronic cocaine use cause histopathological lesions in the cardiac conduction system and its vascularization in young adults?
Chronic cocaine use is associated with significant histopathological changes in the cardiac conduction system and its vascularization, providing a potential morphological substrate for arrhythmias and sudden death.
May link cocaine to conduction fibrosis in sudden death; hypothesis-generating from Level 4 data and requires prospective confirmation.
Cocaine abuse is associated with multiple cardiovascular events, including myocardial infarction, arrhythmias, and sudden death. A total of 40 hearts were studied. The purpose of this study was to compare the cardiac conduction tissue and its vascularization in 20 young adults without a history of drug use and/or arrhythmias and 20 hearts of young adults with a history of chronic cocaine use who have died of sudden unexpected death, in which toxicological analyzes were performed in blood and urine as a means to establish chronic cocaine use. We have applied serial histological sections, techniques of morphometry, and image analysis to quantify the density and affectation of connective/adipose tissue of the conduction system and intramyocardial vessels. The conduction system after chronic cocaine use showed potentially lethal changes with an increase in connective/adipose tissue at the level of the intranodal or perinodal tissue of the sinus node in 35% (7 hearts) and the atrioventricular node in 75% (15 hearts), with the most affected structure being the left bundle branch and the AV nodal artery (100%, 20 hearts). In conclusion, the histopathologic changes in nodes, the perinodal area, and small vessels may be a morphological substrate that offers an explanation about the mechanism of arrhythmias and sudden death in this population.
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Sánchez‐Quintana et al. (2022) conducted a case-control in Chronic cocaine abuse and sudden unexpected death (n=40). Chronic cocaine use vs. No history of drug use and/or arrhythmias was evaluated on Increase in connective/adipose tissue in the left bundle branch and AV nodal artery. Chronic cocaine use in young adults who died of sudden death was associated with increased connective and adipose tissue in the AV node (75%) and left bundle branch and AV nodal artery (100%).
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