Myocardial damage in heroin abuse: immunohistochemical investigations with LCA, CD68, and CD45R0

Background. Myocardial insufficiency is suspected to be implicated in fatal lung edema complicating heroin-overdosage. The pathogenetic mechanism is not fully understood, but defects in myocardial contractility were proposed. Methods. The qualification and quantification of leukocytes, monocytes, and T-lymphocytes was done on the myocardial samples from 13 heroin/morphine related deaths, compared to six controls by histological and immunohistochemical examination. The quantification of cell types was done by counting speciffic cell type of 30 high power fealds in each myocardial sample. Mean values were then tested by Student t-test. Results. The results showed that the control group had a higher mean number of observed leukocyte common antigen (LCA) and CD45R0 positive white blood cells, without significant difference. The mean number of CD68 positive white blood cells was significantly lower in drug addicts group than in the control group (p=0.013, Cohen' s d =1.41, power 0.86). Conclusions. Deterioration of immune cell function in heroin abusers will produce in time left ventricular disfunction and susceptibility to lung edema complicating heroin-overdosage.