Global longitudinal strain is compromised in patients with elevated blood cobalt levels secondary to metal-on-metal hip implants

Metal-on-metal (MoM) hip arthroplasties are known to release metal ions including cobalt into the blood stream. Elevated blood cobalt at levels over 250µg/l have been shown to be a risk factor for developing systemic complications including neurological, endocrine and cardiovascular symptoms. Published case reports document cardiomyopathy, a need for cardiac transplantation and, in some cases, death in patients with severely elevated blood cobalt. Clinical studies have found conflicting evidence of cobalt-induced cardiomyopathy in patients with MoM hips. The extent of cardiovascular injury in patients with elevated blood cobalt levels above 250µg/l has not previously been examined and is the focus of the current study.