Acute effects of passive smoking on the coronary circulation in healthy young adults.
BACKGROUND
Recent studies have shown that passive smoking is a risk factor for ischemic heart disease and may be associated with vascular endothelial dysfunction. The acute effects of passive smoking on coronary circulation in nonsmokers are not known.


OBJECTIVE
To determine the acute effects of passive smoking on coronary circulation using coronary flow velocity reserve (CFVR), assessed by noninvasive transthoracic Doppler echocardiography.


METHODS
Cross-sectional study conducted from September 2000 to November 2000 among 30 Japanese men (mean age, 27 years; 15 healthy nonsmokers and 15 asymptomatic active smokers) without history of hypertension, diabetes mellitus, or hyperlipidemia.


METHODS
Coronary flow velocity reserve, calculated as the ratio of hyperemic to basal coronary flow velocity induced by intravenous infusion of adenosine triphosphate and measured in each participant before and after a 30-minute exposure to environmental tobacco smoke.


RESULTS
Heart rate and blood pressure responses to adenosine triphosphate infusion were not affected by passive smoking exposure in either group. Passive smoking exposure had no effect on basal coronary flow velocity in either group. Mean (SD) CFVR in nonsmokers was significantly higher than that in active smokers before passive smoking exposure (4.4 [0.91] vs 3.6 [0.88], respectively; P =.02), while CFVR after passive smoking exposure did not differ between groups (P =.83). Passive smoking exposure significantly reduced mean (SD) CFVR in nonsmokers (4.4 [0.91] vs 3.4 [0.73], respectively; P<.001).


CONCLUSIONS
Passive smoking substantially reduced CFVR in healthy nonsmokers. This finding provides direct evidence that passive smoking may cause endothelial dysfunction of the coronary circulation in nonsmokers.
Otsuka
R
R
Department of Internal Medicine and Cardiology, Osaka City University Medical School, 1-4-3 Asahimachi Abeno-ku, Osaka City, Japan 545-8585.
Watanabe
H
H
Hirata
K
K
Tokai
K
K
Muro
T
T
Yoshiyama
M
M
Takeuchi
K
K
Yoshikawa
J
J
D000255:Adenosine Triphosphate / Q000008:administration & dosage; D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002248:Carbon Monoxide; D002263:Carboxyhemoglobin / Q000378:metabolism; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000502:physiology*; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular; D006339:Heart Rate; D006801:Humans; D008297:Male; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution; D002248:Carbon Monoxide; D000255:Adenosine Triphosphate; D002263:Carboxyhemoglobin