{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:32:43Z","timestamp":1790271163183,"version":"4.1.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003484","name":"Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003484","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cocaine-related deaths occur regularly in forensic routine work. In cases in which the detected concentration of cocaine is rather low and other causes of death apart from intoxication can be ruled out, the question arises if adulterants of cocaine might have played a crucial role. In the present study, cardiac effects of cocaine, of the adulterant levamisole and of mixtures of both were evaluated using the isolated perfused Langendorff heart. While exposed to the substances, functional parameters heart rate, left ventricular pressure and coronary flow were documented. Relevant alterations of these parameters were found for cocaine as well as for levamisole. Exposing the hearts to a mixture of both resulted in a combination of these effects; the emergence of new alterations or an obvious aggravation were not detected. Nevertheless, the results imply that the consumption of cocaine adulterated with levamisole bares an increased risk for cardiac complications, especially in the presence of preexisting cardiac pathologies.<\/jats:p>","DOI":"10.1007\/s00414-020-02300-5","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T19:02:35Z","timestamp":1588791755000},"page":"1741-1752","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of cocaine and levamisole (as adulterant) on the isolated perfused Langendorff heart"],"prefix":"10.1007","volume":"134","author":[{"given":"A.","family":"Gartz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Pawlik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Eckhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St.","family":"Ritz-Timme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Huhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"2300_CR1","unstructured":"UNODC (2017) Colombia Monitoreo de territorios afectados por cultivos ilicitos 2016. https:\/\/www.unodc.org\/documents\/colombia\/2017\/julio\/CENSO_2017_WEB_baja.pdf. Accessed 08 Jan 2020"},{"key":"2300_CR2","unstructured":"Bundeskriminalamt (2017) Rauschgiftkriminalit\u00e4t Bundeslagebild 2016. https:\/\/www.bka.de\/SharedDocs\/Downloads\/DE\/Publikationen\/JahresberichteUndLagebilder\/Rauschgiftkriminalitaet\/2016RauschgiftBundeslagebildZ.html?nn=27972. Accessed 08 Jan 2020"},{"key":"2300_CR3","unstructured":"Bundeskriminalamt (2017) Presseinformation Rauschgifttote. https:\/\/www.drogenbeauftragte.de\/fileadmin\/dateien-dba\/Drogenbeauftragte\/4_Presse\/1_Pressemitteilungen\/2017\/2017_II_Quartal\/PK_RG_Presseinformation__08052017_BKA-DdB.pdf. Accessed 08 Jan 2020"},{"key":"2300_CR4","unstructured":"Bundeskriminalamt (2017) Bundeslagebericht Rauschgift 2106 - Tabellenanhang. https:\/\/www.bka.de\/SharedDocs\/Downloads\/DE\/Publikationen\/JahresberichteUndLagebilder\/Rauschgiftkriminalitaet\/2016RauschgiftBundeslagebildTabellen.html?nn=27972. Accessed 08 Jan 2020"},{"key":"2300_CR5","first-page":"1","volume-title":"Karch\u2019s pathology of drug abuse","author":"SB Karch","year":"2015","unstructured":"Karch SB, Drummer OH (2015) Cocaine. In: Karch\u2019s pathology of drug abuse, 5th edn. CRC Press, Boca Raton, pp 1\u2013123","edition":"5"},{"key":"2300_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0089710","volume":"9","author":"R Kozor","year":"2014","unstructured":"Kozor R, Grieve SM, Buchhoz S, Kaye S, Darke S, Bhindi R, Figtree GA (2014) Regular cocaine use is associated with increased systolic blood pressure, aortic stiffness and left ventricular mass in young otherwise healthy individuals. PLoS One 9:1\u20138","journal-title":"PLoS One"},{"key":"2300_CR7","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1093\/eurheartj\/ehp557","volume":"31","author":"J Lucena","year":"2010","unstructured":"Lucena J, Blanco M, Jurado C, Rico A, Salquero M, Vazquez R, Thiene G, Basso C (2010) Cocaine-related sudden death: a prospective investigation in South-West Spain. Eur Heart J 31:318\u2013329","journal-title":"Eur Heart J"},{"key":"2300_CR8","unstructured":"Osswald D, R\u00fcegg M (2016) Im Kokain ist das Wurmmittel drin. https:\/\/blog.tagesanzeiger.ch\/datenblog\/index.php\/12248\/kokain, Accessed 08 Jan 2020"},{"key":"2300_CR9","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.forsciint.2018.02.001","volume":"285","author":"M Knuth","year":"2018","unstructured":"Knuth M, Temme O, Daldrup T, Pawlik E (2018) Analysis of cocaine adulterants in human brain in cases of drug-related death. Forensic Sci Int 285:86\u201392","journal-title":"Forensic Sci Int"},{"key":"2300_CR10","doi-asserted-by":"publisher","first-page":"231","DOI":"10.3109\/15563650.2012.665455","volume":"50","author":"A Larocque","year":"2012","unstructured":"Larocque A, Hoffman RS (2012) Levamisole in cocaine: unexpected news from an old acquaintance. Clin Toxicol 50:231\u2013241","journal-title":"Clin Toxicol"},{"key":"2300_CR11","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.1093\/anatox\/35.3.176","volume":"35","author":"KL Lynch","year":"2011","unstructured":"Lynch KL, Dominy SS, Graf J, Kral AH (2011) Detection of levamisole exposure in cocaine users by liquid chromatography \u2013 tandem mass spectrometry. Anal Toxicol 35:2009\u20132011","journal-title":"Anal Toxicol"},{"key":"2300_CR12","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.neuint.2013.11.010","volume":"73","author":"T Hofmaier","year":"2014","unstructured":"Hofmaier T, Luf A, Seddik A, Stockner T, Holy M, Freissmuth M, Ecker GF, Schmid R, Sitte HH, Kudlacek O (2014) Aminorex, a metabolite of the cocaine adulterant levamisole, exerts amphetamine like actions at monoamine transporters. Neurochem Int 73:32\u201341","journal-title":"Neurochem Int"},{"key":"2300_CR13","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1093\/jat\/33.9.620","volume":"33","author":"LP Raymon","year":"2009","unstructured":"Raymon LP, Isenschmidt DS (2009) The possible role of levamisole in illicit cocaine preparations. J Anal Toxicol 33:620\u2013622","journal-title":"J Anal Toxicol"},{"key":"2300_CR14","doi-asserted-by":"publisher","first-page":"e303","DOI":"10.1016\/j.lpm.2013.07.005","volume":"42","author":"A Seferian","year":"2013","unstructured":"Seferian A, Chaumais MC, Savale L, G\u00fcnther S, Tubert-Bittner P, Humbert M, Montani D (2013) Drugs induced pulmonary arterial hypertension. Presse Med 42:e303\u2013e310","journal-title":"Presse Med"},{"key":"2300_CR15","first-page":"55","volume":"305","author":"G Onuaguluchi","year":"1990","unstructured":"Onuaguluchi G, Igbo IN (1990) Electrocardiographic changes induced by levamisole hydrochloride in the rat. Arch Int Pharmacodyn Ther 305:55\u201362","journal-title":"Arch Int Pharmacodyn Ther"},{"key":"2300_CR16","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1016\/j.psym.2013.02.012","volume":"54","author":"C Auffenberg","year":"2013","unstructured":"Auffenberg C, Rosenthal LJ, Dresner N (2013) Levamisole: a common cocaine adulterant with life-threatening side effects. Psychosomatics 54:590\u2013593","journal-title":"Psychosomatics"},{"key":"2300_CR17","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1161\/01.CIR.99.1.156","volume":"99","author":"AP Fishman","year":"1999","unstructured":"Fishman AP (1999) Aminorex to Fen\/Phen an epidemic foretold. Circulation 99:156\u2013161","journal-title":"Circulation"},{"key":"2300_CR18","doi-asserted-by":"crossref","unstructured":"Karch SB, Busard\u00f2 FP, Vaiano F, Portelli F, Zaami S, Bertol E. (2016) Levamisole adulterated cocaine and pulmonary vasculitis: presentation of two lethal cases and brief literature review. Forensic Sci Int 96\u2013102","DOI":"10.1016\/j.forsciint.2016.01.015"},{"key":"2300_CR19","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s002800050770","volume":"41","author":"JM Reid","year":"1998","unstructured":"Reid JM, Kovach S, O'Connell MJ, Bagniewski PG (1998) Clinical and pharmacokinetic studies of high-dose levamisole in combination with 5-fluorouracil in patients with advanced cancer. Cancer Chemother Pharmacol 41:477\u2013484","journal-title":"Cancer Chemother Pharmacol"},{"key":"2300_CR20","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1002\/bdd.2510070110","volume":"7","author":"E Kouassi","year":"1986","unstructured":"Kouassi E, Caill\u00e9 G, L\u00e9ry L, Larivi\u00e8re L, V\u00e9zina M (1986) Novel assay and pharmacokinetics of levamisole and p-hydroxylevamisole in human plasma and urine. Biopharm Drug Dispos 7:71\u201389","journal-title":"Biopharm Drug Dispos"},{"key":"2300_CR21","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1002\/dta.1619","volume":"6","author":"C Hess","year":"2014","unstructured":"Hess C, Ritke N, Sydow K, Mehling LM, Ruehs H, Madea B, Musshoff F (2014) Determination of levamisole, aminorex, and pemoline in plasma by means of liquid chromatography-mass spectrometry and application to a pharmacokinetic study of levamisole. Drug Test Anal 6:1049\u20131054","journal-title":"Drug Test Anal"},{"key":"2300_CR22","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s00414-017-1726-z","volume":"132","author":"M Falk","year":"2017","unstructured":"Falk M, Huhn R, Behmenburg F, Ritz-Timme S, Mayer F (2017) Biomechanical stress in myocardial infarctions: can endothelin-1 and growth differentiation factor 15 serve as immunohistochemical markers? Int J Legal Med 132:509\u2013518","journal-title":"Int J Legal Med"},{"key":"2300_CR23","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/00005344-199403000-00022","volume":"23","author":"BZ Simkhovich","year":"1994","unstructured":"Simkhovich BZ, Kloner RA, Alker KJ, Giaconi J (1994) Time course of direct cardiotoxic effects of high cocaine concentration in isolated rabbit heart. J Cardiovasc Pharmacol 23:509\u2013516","journal-title":"J Cardiovasc Pharmacol"},{"key":"2300_CR24","first-page":"85","volume":"135","author":"JC Vitullo","year":"1989","unstructured":"Vitullo JC, Karam R, Mekhail N, Wicker P, Engelmann GL, Khairallah PA (1989) Cocaine-induced small vessel spasm in isolated rat hearts. Am J Pathol 135:85\u201391","journal-title":"Am J Pathol"},{"key":"2300_CR25","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1161\/CIRCULATIONAHA.110.940569","volume":"122","author":"BG Schwartz","year":"2010","unstructured":"Schwartz BG, Rezkalla S, Kloner RA (2010) Cardiovascular effects of cocaine. Circulation 122:2558\u20132569","journal-title":"Circulation"},{"key":"2300_CR26","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.1016\/j.annemergmed.2007.11.008","volume":"51","author":"JE Hollander","year":"2008","unstructured":"Hollander JE (2008) Cocaine intoxication and hypertension. Ann Emerg Med 51:S18\u2013S20","journal-title":"Ann Emerg Med"},{"key":"2300_CR27","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/ajad.12524","volume":"26","author":"JJ Mahoney III","year":"2017","unstructured":"Mahoney JJ III, Haile CN, De La Gazra IIR, Thakkar H, Newton TF (2017) Electrocardiographic characteristics in individuals with cocaine use disorder. Am J Addict 26:221\u2013227","journal-title":"Am J Addict"},{"key":"2300_CR28","first-page":"294","volume":"249","author":"E Pawlik","year":"2015","unstructured":"Pawlik E, Mahler H, Hartung B, Pl\u00e4sser G, Daldrup T (2015) Drug-related death: adulterants from cocaine preparations in lung tissue and blood. For Sci Int 249:294\u2013303","journal-title":"For Sci Int"},{"key":"2300_CR29","doi-asserted-by":"publisher","first-page":"36372","DOI":"10.1074\/jbc.M403096200","volume":"279","author":"D Rayes","year":"2004","unstructured":"Rayes D, De Rosa MJ, Bartos M, Bouzat C (2004) Molecular basis of the differential sensitivity of nematode and mammalian muscle to the anthelmintic agent levamisole. J Biol Chem 279:36372\u201336381","journal-title":"J Biol Chem"},{"key":"2300_CR30","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1378\/chest.130.6.1657","volume":"130","author":"KM Chin","year":"2006","unstructured":"Chin KM, Channick RN, Rubin LJ (2006) Is methamphetamine use associated with idiopathic pulmonary arterial hypertension? Chest 130:1657\u20131663","journal-title":"Chest"},{"key":"2300_CR31","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-57995-0","volume-title":"Hagers Handbuch der Pharmazeutischen Praxis, Band 8, Stoffe E-O","author":"F von Bruchhausen","year":"1993","unstructured":"von Bruchhausen F, Dannhardt G, Ebel S, Frahm AW, Hackenthal E, Holzgrabe U (1993) Hagers Handbuch der Pharmazeutischen Praxis, Band 8, Stoffe E-O. Springer, Berlin"},{"key":"2300_CR32","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/j.addbeh.2012.01.011","volume":"37","author":"PT Harrell","year":"2012","unstructured":"Harrell PT, Trenz RC, Scherer M, Pacek LR, Latimer WW (2012) Cigarette smoking, illicit drug use, and routes of administration among heroin and cocaine users. Addict Behav 37:678\u2013681","journal-title":"Addict Behav"},{"key":"2300_CR33","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.addbeh.2009.11.003","volume":"35","author":"DH Epstein","year":"2010","unstructured":"Epstein DH, Marrone GF, Heishman SJ, Schmittner J, Preston KL (2010) Tobacco, cocaine, and heroin: craving and use during daily life. Addict Behav 35:318\u2013324","journal-title":"Addict Behav"},{"key":"2300_CR34","volume-title":"Durch Rauchen und Passivrauchen verursachte Erkrankungen des Herz-Kreislaufsystems","author":"B Kr\u00f6nig","year":"2008","unstructured":"Kr\u00f6nig B, Raupach T, Schaller K, P\u00f6tschke-Langer (2008) Durch Rauchen und Passivrauchen verursachte Erkrankungen des Herz-Kreislaufsystems. Deutsches Krebsforschungszentrum, Heidelberg"},{"key":"2300_CR35","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/S0376-8716(99)00109-X","volume":"59","author":"MM Vanyukov","year":"2000","unstructured":"Vanyukov MM, Tarter RE (2000) Genetic studies of substance abuse. Drug Alcohol Depend 59:101\u2013123","journal-title":"Drug Alcohol Depend"},{"key":"2300_CR36","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0376-8716(98)00066-0","volume":"51","author":"JC Crabbe","year":"1998","unstructured":"Crabbe JC, Phillips TJ (1998) Genetics of alcohol and other abused drugs. Drug Alcohol Depend 51:61\u201371","journal-title":"Drug Alcohol Depend"},{"key":"2300_CR37","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1523\/JNEUROSCI.4037-08.2009","volume":"29","author":"M Thomsen","year":"2009","unstructured":"Thomsen M, Hall FS, Uhl GR, Caine SB (2009) Dramatically decreased cocaine self-administration in dopamine but not serotonin transporter knock-out mice. J Neurosci 29:1087\u20131092","journal-title":"J Neurosci"},{"key":"2300_CR38","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s00213-011-2225-4","volume":"216","author":"LS Schmidt","year":"2011","unstructured":"Schmidt LS, Thomsen M, Weikop P, Dencker D, Wesse J, Woldbye DPD, Wortwein G, Fink-Jensen A (2011) Increased cocaine self-administration in M4 muscarinic acetylcholine receptor knockout mice. Psychopharmacology 216:367\u2013378","journal-title":"Psychopharmacology"},{"key":"2300_CR39","first-page":"252","volume":"8","author":"I Sillaber","year":"2002","unstructured":"Sillaber I, Henniger MSH (2002) Genetik und Drogensucht. BIOspektrum 8:252\u2013255","journal-title":"BIOspektrum"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-020-02300-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-020-02300-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-020-02300-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T23:55:06Z","timestamp":1620258906000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-020-02300-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,6]]},"references-count":39,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["2300"],"URL":"https:\/\/doi.org\/10.1007\/s00414-020-02300-5","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,6]]},"assertion":[{"value":"1 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All experiments were performed in accordance with the German legislation on protection of animals and the Guide for the Care and Use of Laboratory Animals published by the US National Institutes of Health (NIH Publication No. 85-23, revised 1996). The protocol for the Langendorff system was approved by the local Animal Ethics Committee (project no. O 27\/11). The study did not include human participants or experiments with human tissues.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}