title: Early improvement in peripheral vascular tone following smoking cessation using nicotine replacement therapy: aortic wave reflection analysis.
abstract: 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.
authors.affiliation: Pôle Cardiologie, CHU Clermont-Ferrand, Clermont-Ferrand, France. anroux@chu-clermontferrand.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Roux
authors.forename: Pascal
authors.initials: P
authors.lastname: Motreff
authors.forename: Jean
authors.initials: J
authors.lastname: Perriot
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.forename: Jean-René
authors.initials: JR
authors.lastname: Lusson
authors.forename: Christian
authors.initials: C
authors.lastname: Duale
authors.forename: Dominique
authors.initials: D
authors.lastname: Morand
authors.forename: Claude
authors.initials: C
authors.lastname: Dubray
mesh_terms: 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*
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine