Changes of diastolic function induced by cigarette smoking: an echocardiographic study in patients with coronary artery disease.
In 28 chronic smokers (11 women, 17 men, 53 +/- 10 years old) with coronary artery disease (greater than 75% stenosis), left ventricular (LV) relaxation and filling behavior was assessed before and after inhalation of 0.9 mg nicotine (1 cigarette) by echocardiography. The following acute nicotine-mediated changes were noted (one-sided Wilcoxon test): heart rate increased from 67 to 81 beats/min (p greater than .001); the early diastolic flow (E wave) integral decreased from 49 to 39 mm (p less than .001); the late diastolic flow integral (A wave) increased from 36 to 41 mm (p less than .01). Consecutively, the ratio between E and A wave flow integrals decreased from 1.4 to 0.9 (p less than .001); the atrial contribution to LV filling rose from 42 to 53% (p less than .001); and the isovolumetric relaxation period increased from 89 to 122 ms (p less than .001). In cigarette smokers with coronary artery disease acute administration of nicotine hence causes a shift of mitral blood flow from early (E wave) to late (A wave) diastole and a prolongation of the isovolumetric relaxation time. Thus, cigarette smoking significantly affects LV diastolic function independently of its role as a risk factor for coronary atherosclerosis.
Störk
T
T
University Hospital Rudolf Virchow, Department of Cardiology & Radiology, Berlin, Federal Republic of Germany.
Eichstädt
H
H
Möckel
M
M
Bortfeldt
R
R
Müller
R
R
Hochrein
H
H
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology*; D003971:Diastole / Q000187:drug effects / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000494:pharmacology*; D012907:Smoking / Q000503:physiopathology*
D009538:Nicotine