title: Acute effects on the ventricular function in Swedish snuffers: an echocardiographic study.
abstract: OBJECTIVE
  Cigarettes and Swedish snuff contain nicotine, which influence the cardiovascular system. Cigarette smoke has been shown to give an acute impairment in diastolic heart parameters. The systolic and diastolic heart function in snuff users is not thoroughly enough investigated. The aim of this study was to investigate if Swedish snuff will give an acute decrease in systolic and diastolic heart parameters in the left and right ventricles in healthy Swedish snuffers.
  
  
  RESULTS
  Thirty healthy volunteers were examined with echocardiography. The study involved recordings from four different times: before snuff intake, 5 and 30 min after intake and finally 30 min after snuff withdrawal. The systolic and diastolic heart parameters were collected with conventional echocardiographic methods. In addition, the heart frequency and blood pressure response were measured. The pulse and blood pressure response were significantly altered (P < 0.01) during the test. Left ventricular ejection fraction and the amplitudes of mitral and tricuspid annulus motion did not alter significantly. The main finding in the study was the significant decrease (P < 0.05) in several diastolic heart parameters for both the left and right ventricles.
  
  
  CONCLUSIONS
  This study shows that snuff intake causes a significant decrease in E/A ratio and a delay in ventricular relaxation and therefore a decrease in diastolic heart function in the left and right ventricles. The mechanism behind these alterations is probably very complex, but a combination of nicotine effects and loading conditions is probably the main factor.
authors.affiliation: Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden. daniel.sundstrom@orebroll.se
authors.forename: D
authors.initials: D
authors.lastname: Sundström
authors.forename: M
authors.initials: M
authors.lastname: Waldenborg
authors.forename: K
authors.initials: K
authors.lastname: Emilsson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure; D003971:Diastole; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013548:Sweden; D013599:Systole; D013997:Time Factors; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult