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Global and regional wall motion and contractility of the left ventricle following cigarette smoking
Insights
Acute cigarette smoking does not impair heart contractility in healthy individuals. However, it significantly depresses myocardial function in patients with coronary artery disease, affecting both ischemic and non-ischemic areas.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Cigarette smoking is a major risk factor for cardiovascular disease.
- Understanding the acute effects of smoking on cardiac function is crucial for patient management.
Purpose of the Study:
- To investigate the acute hemodynamic and contractile effects of cigarette smoking.
- To compare these effects across different patient groups: normal cardiac function, compensated hypertensive hypertrophy, and various cardiac diseases including coronary artery disease.
Main Methods:
- Analysis of hemodynamic and contractile effects in 35 patients.
- Stratification of patients into groups based on cardiac and coronary function.
- Assessment of global and regional left ventricular myocardial function.
Main Results:
- In patients with normal cardiac function and compensated hypertensive hypertrophy, cigarette smoking showed no contractile depressant effects, with some cases showing moderate increases in contractility.
- In patients with cardiac disease (dilatative cardiomyopathy, advanced coronary artery disease, decompensated hypertensive heart disease), cigarette smoking led to depression in overall and regional left ventricular myocardial contraction.
- In coronary artery disease patients, marked depression of regional contraction occurred in dysfunctional zones and also in non-ischemic zones.
Conclusions:
- Acute cigarette smoking does not negatively impact cardiac contractility in individuals with normal cardiac function or compensated hypertensive hypertrophy.
- In patients with coronary artery disease, cigarette smoking induces significant negative inotropic effects, impacting both ischemic and non-ischemic myocardial regions.
Abstract:
The hemodynamic and contractile effects of acute cigarette smoking were analyzed in 35 patients with normal cardiac and coronary function as well as with cardiac failure and with coronary artery disease. In normal patients (normal ventricular function, normal coronary arteriogram) cigarette smoking exhibited no contractile depressant effects. Moderate increase in global and in regional wall motion and contractility was found. Likewise, in patients with compensated hypertensive hypertrophy (normal ventriculogram, significant left ventricular hypertrophy, normal coronary arteriogram) cigarette smoking increased global and regional contraction function. In cardiac disease patients (dilatative cardiomyopathy, advanced coronary artery disease, decompensated hypertensive heart disease) cigarette smoking was associated with depression in the overall and regional contraction behavior of the left ventricular myocardium. In patients with coronary artery disease, cigarette smoking was accompanied by marked depression of the regional contraction pattern in hypokinetic, akinetic, and dyskinetic zones. Moreover, contractile depression also occurred in the non-ischemic zones, without pre-existing coronary artery stenoses. In conclusion, acute cigarette smoking may not cause contractile depressant effects in normal patients and patients with compensated hypertensive hypertrophy. However, in coronary patients, significant negative inotropic effects are present not only in the ischemic zones, but also in the non-ischemic myocardium.