Early improvement in peripheral vascular tone following smoking cessation using nicotine replacement therapy: aortic wave reflection analysis.
OBJECTIVE
Cigarette smoking induces cardiovascular pathology and worsens arterial stiffness. Arterial stiffness can be assessed noninvasively based on 2 indices: pulse-wave velocity (PWV), indicating aortic stiffness, and the augmentation index (AIx), indicating aortic wave reflection. The impact of smoking cessation (SC) with nicotine replacement therapies (NRT) on arterial stiffness remains unknown.


METHODS
AIx and PWV were studied prospectively (using a SphygmoCor system) in 26 long-term smokers (>10 cigarettes/day; mean age 43 ± 6 years) before (visit 1) and 28 and 56 days (visit 2 and visit 3) after SC supported by NRT. Abstinence was ascertained when exhaled carbon monoxide (CO) was <10 ppm; the quantity of NRT absorbed was assessed based on the serum cotinine level.


RESULTS
Sixteen of 24 patients (67%) were abstinent at the end of the study; 8/24 had cut down on smoking, and 2 were lost to follow-up. CO and serum cotinine levels fell after SC. The mean AIx for the population as a whole was 23.4% at visit 1, with a significant early reduction by visit 2 (16.2%) and visit 3 (13.9%) (ANOVA, p < 0.001). The PWV, peripheral blood pressure, and heart rate were unchanged.


CONCLUSIONS
The improvement in AIx and the stability of PWV after SC with NRT indicate improved peripheral vascular tone. This impact may account for the early clinical benefit of SC observed even when associated with NRT.
Roux
Antoine
A
Pôle Cardiologie, CHU Clermont-Ferrand, Clermont-Ferrand, France. anroux@chu-clermontferrand.fr
Motreff
Pascal
P
Perriot
Jean
J
Pereira
Bruno
B
Lusson
Jean-René
JR
Duale
Christian
C
Morand
Dominique
D
Dubray
Claude
C
D000328:Adult; D001011:Aorta / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology; D016540:Smoking Cessation / Q000379:methods*; D014661:Vasoconstriction / Q000502:physiology*
D018722:Nicotinic Agonists; D009538:Nicotine