Acute hemodynamic effects of cigarette smoking in man assessed by systolic time intervals and echocardiography.

Abstract

SUMMARY Sixteen healthy subjects, ages 18-35 years, were studied in the supine position by means of systolic time intervals and echocardiography before and after smoking a high-nicotine cigarette (2.5 mg nicotine) and a tobacco cigarette of very low nicotine content (< 0.02 mg nicotine) to assess and compare the immediate effects upon left ventricular function.Smokers (n = 12) and nonsmokers (n = 4) behaved alike. High-and low-nicotine cigarettes both caused significant increases in heart rate, systolic and diastolic blood pressure and the triple product (systolic blood pressure X left ventricular ejection (LVET) X heart rate), prolonged LVETc and decreased the preejection period (PEP) and PEP/LVET. In addition, smoking a nicotine reference cigarette increased the echocardiographically derived LV end-diastolic volume by 7.5%, augmented ejection fraction by 4%, while significantly enhancing mean normalized circumferential fiber shortening by 12.5% and mean normalized posterior wall velocity by 9%. Smoking a tobacco cigarette of ultra-low nicotine content resulted in comparable increases in ejection fraction and mean circumferential fiber shortening, albeit on the basis of a significant decrease in end-systolic volume without alteration in end-diastolic volume.These data suggest that in the supine position smoking a high-nicotine cigarette acutely increases venous return and augments the principal determinants of myocardial oxygen consumption heart rate, contractility, preload and afterload and that cigarette smoke may contain inotropic and chronotropic substances other than nicotine.CIGARETTE SMOKING has been linked epidemiologically as a risk factor in the development of myocardial infarction and has been associated with an increase in sudden death among chronic cigarette consumers.', I The cause of this increased morbidity and mortality has not been established; among the factors under consideration are hypoxemia,3 enhanced cor-

Epidemiology and genetics of dilated cardiomyopathy in the Indian context

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Prevention of relapse in patients with congestive heart failure: the role of precipitating factors

“…Cigarette smoking increases heart rate and blood pressure, both principal determinants of myocardial oxygen consumption 14. Goldbarg et al showed in healthy individuals that the left ventricular stroke index decreased significantly at several levels of exercise after smoking, although there was no significant change at rest 15.…”

Effect of Age on Blood Pressure Response to Cigarette Smoking

“…The cardiovascular effect of cigarette smoking has been reported by many investigators [9][10][11]. They ob served that cigarette smoking has an acute effect upon the circulation, including an increase in both HR and BP, although it may have a different effect with long-term exposure [12], Moreover, these effects were mainly relat ed to the amount of tobacco smoked, the habits of inhal ing the smoke and the type of tobacco.…”