Acute effects of smoking on right ventricular function. A tissue Doppler imaging study on healthy subjects

Smoking is a risk factor for cardiovascular mortality and morbidity. Besides chronic effects, it has unfavourable effects in the acute period. Although there are plenty of data regarding its effect on left ventricle functions, the effect of cigarette smoking on right ventricular function in the acute period is unknown. The objective of this study was to investigate the effect of cigarette smoking on the right ventricular function.

Twenty healthy young male were evaluated by echocardiography before and after smoking one cigarette. Heart rate, blood pressure, mitral and tricuspid inflow parameters as well as annulus velocity parameters were obtained. Pulmonary artery acceleration time was measured as a surrogate marker for pulmonary artery pressure. Results at baseline and at minutes 5, 15, 30, 60; consecutively after smoking were compared.

There was not any significant change at left ventricular diastolic function with pulsed wave Doppler echocardiography, however right ventricular diastolic function was significantly impaired. Both right and left ventricle diastolic functions were impaired significantly with tissue Doppler echocardiography though there was no change at systolic functions. Pulmonary artery pressure increased significantly concomitant with impairment of right ventricular diastolic dysfunction. All the changes seen after smoking a cigarette almost returned to baseline levels after 30 minutes.

Cigarette smoking does not change right ventricular systolic function however impairs right ventricular diastolic function in the acute period. Its effect on diastolic function may be related to increased afterload due to increase in pulmonary artery pressure.