title: Long-term cigarette smoking is associated with increased myocardial perfusion heterogeneity assessed by positron emission tomography.
abstract: The pathophysiology of smoking-related coronary events in patients with normal coronary arteries is incompletely understood. This study was conducted to explore, in subjects without symptoms of cardiovascular disease, the long-term effects of smoking on regional coronary artery vasoactivity, especially during sympathetic stimulation. In ten smoking and ten non-smoking sex- and age-matched healthy volunteers, segmental myocardial perfusion was studied using dynamic parametric nitrogen-13 ammonia positron emission tomography at rest and during sympathetic stimulation evoked by the cold pressor stimulation. Smokers demonstrated a higher myocardial perfusion at rest (116+/-17 ml/min/100 g vs 96+/-20 ml/min/100 g, P <0.01) and an impaired myocardial perfusion increase during cold pressor stimulation (1.02+/-0.15 vs 1.18+/-0.17, P <0.05). The heterogeneity of perfusion, expressed as coefficient of variation, was significantly different between the smoking and the non-smoking group. The coefficient of variation of segmental myocardial perfusion was higher in smokers at rest (17.5%+/-4.2% vs 13.5%+/-1. 9%, P <0.05) and during cold pressor stimulation (17.0%+/-3.2% vs 13. 9%+/-1.8%, P <0.05). We conclude that the long-term effects of smoking in healthy volunteers are associated with (1) increased myocardial perfusion at rest, (2) impaired myocardial perfusion response to cold pressor stimulation, and (3) increased myocardial perfusion heterogeneity both at rest and during cold pressor stimulation. These results may suggest that in healthy subjects the long-term effect of smoking is related to abnormal coronary artery vasoactivity, presumably induced by an interplay of regional endothelial dysfunction and autonomic dysregulation.
authors.affiliation: Department of Cardiology and National Research PET Center, University Hospital Groningen, The Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: Meeder
authors.forename: P K
authors.initials: PK
authors.lastname: Blanksma
authors.forename: E E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: R L
authors.initials: RL
authors.lastname: Anthonio
authors.forename: A T
authors.initials: AT
authors.lastname: Willemsen
authors.forename: J
authors.initials: J
authors.lastname: Pruim
authors.forename: W
authors.initials: W
authors.lastname: Vaalburg
authors.forename: K I
authors.initials: KI
authors.lastname: Lie
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology; D016022:Case-Control Studies; D003080:Cold Temperature; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009590:Nitrogen Radioisotopes; D011311:Pressoreceptors / Q000502:physiology; D012907:Smoking / Q000503:physiopathology*; D013997:Time Factors; D014055:Tomography, Emission-Computed
chemical_list: D009590:Nitrogen Radioisotopes