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doi:10.1378/chest.06-2056
(Chest. 2007; 131:1142-1148)
© 2007 American College of Chest Physicians
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Chronic and Acute Effects of Smoking on Left and Right Ventricular Relaxation in Young Healthy Smokers*

Barbara Lichodziejewska, MD, PhD; Katarzyna Kurnicka, MD; Katarzyna Grudzka, MD; Jerzy Malysz, MD; Michal Ciurzynski, MD, PhD and Danuta Liszewska-Pfejfer, MD, PhD

* From the Department of Internal Medicine and Cardiology, Institute of Dentistry, Warsaw Medical University, Warsaw, Poland.

Correspondence to: Barbara Lichodziejewska, MD, PhD, Department of Internal Medicine and Cardiology, Institute of Dentistry, Warsaw Medical University, 02–005 Warsaw, Lindleya 4, Poland; e-mail: barlicho{at}wp.pl

Abstract

Background: Left ventricular (LV) diastolic dysfunction has been observed in cigarette smokers with coronary artery disease. The aim of the study was to assess LV and right ventricular (RV) diastolic function in healthy, young, and slim smokers before and after smoking one cigarette.

Material and methods: The participants were 66 healthy volunteers (age < 40 years; body mass index < 25 kg/m2): 33 smokers (study group [HS]) and 33 nonsmokers (control group). Echocardiographic examination was done in the HS before smoking one cigarette (HS-1) and after smoking one cigarette (HS-2). To assess diastolic function of LV and RV mitral valve flow (MVF), pulmonary venous flow (PVF) and tricuspid valve flow (TVF) were evaluated.

Results: MVF early to late phase ratio (E/A) was significantly lower in HS-1 and HS-2 than in the control group. The PVF systolic to diastolic phase ratio (S/D) was significantly higher in HS-1 and HS-2 than in the control group. These changes suggest LV diastolic function impairment in the HS, but the MVF pattern remained within the normal range. PVF S/D showed systolic dominance (S/D > 1) typical for impaired LV relaxation and abnormal for this age group. TVF E/A was significantly lower in HS-2 than in HS-1 and control subjects and suggests RV diastolic dysfunction.

Conclusions: The following conclusion are made: (1) MVF and PVF demonstrate LV relaxation impairment in healthy smokers before and after smoking one cigarette; (2) the assessment of PVF is a good method reflecting LV diastolic function changes, even when MVF remains normal; and (3) TVF shows RV relaxation impairment after smoking one cigarette in healthy smokers.

Key Words: cigarette smoking • echocardiography, diastolic function • heart • left ventricle • right ventricle






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