Chronic and Acute Effects of Smoking on the Left and Right Ventricular Relaxation in Young Healthy Smokers

Chronic and Acute Effect of Smoking on the Left and Right Ventricular Systolic and Diastolic Function in Young Healthy Smokers

Impairment of relaxation, the early phase of ventricular diastole is the first stage of heart diastolic dysfunction. Left ventricular diastolic function can be determined noninvasively by Echo- Doppler - derived mitral valve flow velocities. The addition of pulmonary venous flow pattern enables more accurate assessment of left ventricle diastolic function. The role of the right ventricle in haemodynamic function of the heart is now emphasized. The right ventricle diastolic function can be assess by recording the Doppler tricuspid valve flow pattern. Impaired LV diastolic function usually precedes systolic dysfunction and may cause clinical signs of congestive heart failure. Cigarette smoking is one of the major risk factors for cardiovascular diseases. The aim of the study was to assess left and right ventricular diastolic function in healthy, young and slim smokers before and after smoking one cigarette.

Echocardiographic examination: before and after smoking one cigarette Echocardiographic evaluation of mitral valve flow, pulmonary venous flow, tricuspid valve flow and hepatic vein flow to assess diastolic function of ventricles.

Echocardiographic examination: in left lateral position after 10 minutes rest. The first examination: after a 2-hour non-smoking period, the second: immediately after smoking one cigarette containing 0.9 mg of nicotine. The duration of the second examination: no more than 15 minutes.

Echocardiography equipment: Hewlett-Packard SONOS 2000 (Andover, Massachusetts) imaging system. The transducer's frequency: 2 MHz.

From the apical four chamber view the visualisation of transmitral flow, pulmonary venous flow and transtricuspid flow. From subcostal view the visualisation of right superior hepatic vein and the hepatic vein flow.

Inclusion Criteria:

• Smokers smoking over 10 cigarettes per day over the last 5 years
• Body mass index < 25 kg/m2
• Normal blood pressure and normal parameters of echocardiographic examination (wall thickness, left- and right- chamber size, valvular function and left and right ventricular systolic function)
• Normal results of routine physical examination, chest x-ray, standard rest electrocardiogram and routine laboratory tests.

Exclusion Criteria:

• Body mass index > 25 kg/m2
• Abnormal blood pressure
• Abnormal parameters of echocardiographic examination (wall thickness, left- and right- chamber size, valvular function and left and right ventricular systolic function)
• Abnormal results of routine physical examination, chest x-ray, standard rest electrocardiogram and routine laboratory tests.