Acute changes in left ventricular diastolic function: cigarette smoking versus nicotine gum.

Abstract:

BACKGROUND:Echocardiographic evidence of diastolic dysfunction has been demonstrated during acute cigarette smoking in patients with coronary artery disease. Similar studies in healthy patients have shown conflicting results. Furthermore, it is unclear whether nicotine or some other cigarette-related substance is responsible for these observations. HYPOTHESIS:The purpose of the study was to confirm or refute acute effects of cigarette smoking on diastolic function in healthy patients and to compare diastolic effects of a cigarette to smokeless nicotine delivery (nicotine gum). METHODS:In all, 27 healthy volunteers were self-assigned into one of two cohorts. A baseline echocardiogram was performed in all patients. The first cohort proceeded to smoke a cigarette and the second to chew a piece of nicotine gum. Within minutes after exposure, another echocardiogram was performed. Traditional measures of diastolic function were compared before and after substance exposure by paired t-tests. RESULTS:The cigarette cohort showed echocardiographic evidence of diastolic dysfunction after smoking. The E:A ratio (time integral) decreased from 2.95 to 2.22 (p < 0.002). Atrial reversal pulmonary velocity, atrial reversal duration, and color flow propagation all showed statistically significant alterations (p < 0.05). The nicotine gum cohort showed no change in traditional diastolic parameters. CONCLUSIONS:Diastolic function is impaired during acute exposure to cigarette smoke but unchanged after exposure to nicotine gum. It is therefore unlikely that nicotine alone is responsible for cigarette-induced acute diastolic dysfunction.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Gembala MI,Ghanem F,Mann CA,Sorrell VL

doi

10.1002/clc.4960290205

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

61-4

issue

2

eissn

0160-9289

issn

1932-8737

journal_volume

29

pub_type

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