Abstract
The objective of our study was to determine the relationship between exposure to environmental tobacco smoke (ETS) and the value of the aortic valve calcification score (AVCS) in people suffering from arterial hypertension (AH). 107 non-smokers with AH (mean age 67.16 ± 8.48 years) were qualified for the study. The degree of exposure to ETS was assessed using the Second-hand Smoke Exposure Scale (SHSES) questionnaire. Study group was divided depending on ETS exposure: A—no exposure, B—low, C—medium and D—high. AVCS was measured based on the aortic valve plane multiplanar reconstruction from the non-contrast phase of the cardiac computed tomography. The Agatston algorithm was used, in which calcifications were considered changes with a density exceeding 130 HU. The mean AVCS value in the study group of patients was 213.59 ± 304.86. The AVCS was significantly lower in subgroup A than in subgroups C and D. In subgroup A, the lack of aortic valve calcification (AVCS = 0) was observed significantly more frequently than in subgroups C and D. There was a positive correlation between the number of SHSES points and the AVCS value (r = 0.37, p < 0.05). Based on the ROC curve, the SHSES value was determined as the optimal cut-off point for the prediction of AVCS = 0, amounting to 3 points. The accuracy of SHSES < 3 as the predictor of AVCS = 0 was set at 62.18%. Hypertensive patients have an unfavourable relationship between the amount of exposure to ETS, determined on the SHSES scale, and the AVCS value.
Highlights
There are over 1.3 billion people smoking tobacco and over 8 million of them die every year due to tobacco smoke [1, 2]
Our study showed that in patients with arterial hypertension (AH) there is a significant correlation between Environmental tobacco smoke (ETS) exposure expressed using Second-hand Smoke Exposure Scale (SHSES) and aortic valve calcification (AVC)
There is a dysfunction of endothelium due to mechanical stress related to valves
Summary
There are over 1.3 billion people smoking tobacco and over 8 million of them die every year due to tobacco smoke [1, 2]. A study conducted on over 9,000 children in which in utero exposure to tobacco smoke was considered has shown that the exposed have greater odds to hypertension, especially increase of systolic blood pressure. Increased risk of hypertension due to ETS exposure was found in girls, especially in those whose father was smoking tobacco [9]. ETS besides increasing odds to arterial hypertension (AH) increase risk for other cardiovascular diseases (CVD) to passive smokers with already diagnosed hypertension [18]. Tobacco smoke contain high concentration of nicotine which activates sympathetic neurotransmission and induces oxidative stress in vascular endothelium. These events lead to endothelial disfunction and atherosclerosis lesions [22, 23]
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