Effect of Heroin on Electrocardiographic Parameters

Abstract Background Heroin addiction is currently a significant health problem, and information on the electrocardiographic effects of heroin is limited. Objetivo The aim of the present study is to investigate effects of heroin addiction on electrocardiographic parameters. Methods A total of 136 individuals, including 66 individuals who smoke heroin as the study group and 70 healthy individuals with no drug addiction as the control group, were included in the study. Individuals who inject heroin were excluded. Electrocardiographic (ECG) evaluation of those using heroin was performed and compared with those of the control group. In addition, pre-treatment and post-treatment ECG of the heroin group were compared. A p-value of <0.05 was accepted as statistically significant. Results Heart rate (77.2±12.8 versus 71.4±11.2; p=0.02) were found to be higher in the heroin group compared to the control group. QT (341.50±25.80 versus 379.11±45.23; p=0.01), QTc intervals (385.12±29.11 versus 411.3±51.70; p<0.01), and T peak to end time (Tpe) (65.41±10.82 versus 73.3±10.13; p<0.01) were significantly shorter in the heroin group. No difference was observed between the groups with regard to Tpe/QT and Tpe/QTc ratios. In the subgroup analysis of the heroin group, QT (356.81±37.49 versus 381.18±40.03; p<0.01) and QTc (382.06±26.41 versus 396.06±29.80; p<0.01) intervals were significantly shorter in the pre-treatment period. Conclusion Heroin addiction significantly affects the QT, QTc, and Tpe time intervals. The arrhythmia effects of these parameters are well known. More attention to the electrocardiographic parameters of these individuals should be given. (Arq Bras Cardiol. 2020; 115(6):1135-1141)

摘要
背景：当前海洛因成瘾已成为严峻的公共卫生问题，而有关海洛因对心电图影响的研究资料相对匮乏。
研究目的：本研究旨在探讨海洛因成瘾对心电图参数的影响。
方法：本研究共纳入136名受试者，其中研究组为66名海洛因吸食者，对照组为70名无药物成瘾史的健康个体，排除注射海洛因者。对海洛因吸食者开展心电图（electrocardiographic, ECG）评估，并与对照组进行对比；此外，还对比了研究组治疗前后的心电图结果。本研究以p值<0.05作为统计学显著性判定标准。
结果：与对照组相比，研究组心率（77.2±12.8 vs 71.4±11.2；p=0.02）显著升高。研究组QT间期（341.50±25.80 vs 379.11±45.23；p=0.01）、校正QT间期（QTc，385.12±29.11 vs 411.3±51.70；p<0.01）及T波峰末间期（T peak to end time, Tpe，65.41±10.82 vs 73.3±10.13；p<0.01）均显著缩短。两组间Tpe/QT及Tpe/QTc比值无显著差异。对研究组进行亚组分析后发现，治疗前的QT间期（356.81±37.49 vs 381.18±40.03；p<0.01）与QTc间期（382.06±26.41 vs 396.06±29.80；p<0.01）同样显著缩短。
结论：海洛因成瘾可显著影响QT间期、QTc间期及T波峰末间期。上述参数与心律失常的关联已得到广泛证实，临床应更加关注此类人群的心电图参数变化。（摘自Arq Bras Cardiol. 2020; 115(6):1135-1141）