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Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Smoking intensity and duration is associated with cardiac structure and function: the ECHOcardiographic Study of
J Adam Leigh1, Robert C Kaplan2, Katrina Swett1
1Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Insights
Smoking intensity and duration negatively impact heart structure and function. This study found dose-response relationships between smoking habits and adverse changes in both left and right ventricles.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular disease is a leading cause of death, particularly in smokers.
- The specific effects of smoking intensity and duration on cardiac structure and function require further investigation.
Purpose of the Study:
- To examine the relationship between cigarette smoking intensity and duration and echocardiographic measures of cardiac structure and function.
- To investigate dose-response relationships in a Hispanic/Latino population.
Main Methods:
- Utilized data from the ECHO-SOL (Echocardiographic Study of Hispanics/Latinos) cohort.
- Employed detailed tobacco exposure questionnaires and comprehensive echocardiography exams.
- Performed multivariable linear regression analyses adjusted for key cardiovascular risk factors.
Main Results:
- Increased smoking duration (earlier initiation) was linked to higher left ventricular mass (LVM) and reduced right ventricular (RV) function.
- Higher daily cigarette consumption correlated with increased LVM, worse diastolic function, altered LV geometry, and impaired RV function.
- Greater lifetime pack-years showed associations with adverse LV and RV structural and functional changes.
Conclusions:
- A significant dose-response relationship exists between smoking intensity/duration and detrimental changes in cardiac structure and function.
- Both left and right ventricular measures are unfavorably affected by cumulative tobacco exposure.
Objective:
Cardiovascular disease is the leading cause of death in smokers and this relationship is complicated by the multiplicity of cardiovascular effects of smoking. However, the relationship between intensity and duration of cigarette smoking and echocardiographic measures of right and left ventricular structure and function has been poorly studied.
Methods:
We examined ECHO-SOL (Echocardiographic Study of Hispanics/Latinos) participants, a subset of the Hispanic Community Health Study/Study of Latinos. Participants were administered a detailed tobacco exposure questionnaire and a comprehensive echocardiography exam. Multivariable linear regression models (adjusted for age, sex, obesity, hypertension and diabetes statuses) were performed using sampling weights. Statistical significance was defined at p<0.01.
Results:
There were 1818 ECHO-SOL participants (57.4% women, mean age 56.4 years). Among current smokers (n=304), increased duration of smoking, as measured by a younger age of smoking initiation, was significantly associated with higher mean left ventricular mass (LVM) and lower right ventricular (RV) function (lower right ventricular stroke volumes). More cigarettes smoked per day was significantly associated with higher mean LVM, worse diastolic function (higher E/e' ratio), worse LV geometry (increased relative wall thickness) and worse RV function (decreasing right ventricular stroke volume). Among current smokers, higher mean lifetime pack-years (a combined measure of smoking intensity and duration) was associated with higher LVM, worse LV geometry, worse diastolic function, greater RV dilatation and worse RV function.
Conclusions:
There is a dose-response relationship between intensity and duration of cigarette tobacco smoking with unfavourable changes of multiple measures of right-sided and left-sided cardiac structure and function.
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