Speckle-tracking strain assessment of left ventricular dysfunction in synthetic cannabinoid and heroin users

Anatol J Cardiol. 2018 Jun;19(6):388-393. doi: 10.14744/AnatolJCardiol.2018.76429.


Objective: There is growing evidence regarding the numerous adverse effects of synthetic cannabinoids (SCBs) on the cardiovascular system; however, no studies have shown the cardiovascular effects of opioids using strain echocardiography. This study examines the cardiac structure and function using echocardiographic strain imaging in heroin and synthetic cannabinoid users.

Methods: This double-blind study included patients who were admitted or referred to a rehabilitation center for heroin (n=31) and synthetic cannabinoid users (n=30). Heroin users and synthetic cannabinoid users were compared with healthy volunteers (n=32) using two-dimensional (2D) speckle-tracking (ST) echocardiography.

Results: No differences were found in the baseline characteristics and 2D echocardiography values. The mean global longitudinal strain value was -20.5%±2.4% for SCB users, -22.3%±2.4% for opioid users, and -22.5%±2.2% for healthy volunteers (p=0.024). The mean apical 2-chamber (AP2C) L-strain values were -20.1%±3.1%, -22.4%±3.0%, and -22.3%±2.8% for SCB users, opioid users, and healthy volunteers, respectively (p=0.032). The mean apical 4-chamber (AP4C) L-strain values were -20.7%±2.5% for SCB users, -23.2%±3.2% for opioid users, and -23.8%±3.1% for healthy volunteers (p<0.001).

Conclusion: SCBs are potential causes of subclinical left ventricular dysfunction.

MeSH terms

  • Cannabinoids / adverse effects*
  • Cannabinoids / chemical synthesis
  • Case-Control Studies
  • Double-Blind Method
  • Echocardiography
  • Female
  • Heroin / adverse effects*
  • Humans
  • Male
  • Prospective Studies
  • Sensitivity and Specificity
  • Substance-Related Disorders / diagnostic imaging*
  • Ventricular Dysfunction, Left / chemically induced*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Young Adult


  • Cannabinoids
  • Heroin