Abstract
BackgroundCigarette smoking harms nearly every organ, including the heart and lungs. A comprehensive assessment of both cardiac and respiratory function is necessary for evaluating the direct effects of tobacco on the heart. However, few previous studies examining the effects of cigarette smoking on cardiac function included an assessment of lung function. This cross-sectional study investigated the influence of cigarette smoking on cardiac function, independent of respiratory function.MethodsWe retrospectively reviewed the medical records of 184 consecutive cases that underwent both spirometry and transthoracic echocardiography around the same time (within 1 month) in one hospital from April 2019 to March 2020. Participants were classified into three groups based on lifetime smoking exposure (pack-years): non-smoker (n = 49), low exposure (1–20 pack-years, n = 40), and high exposure (≥ 20 pack years, n = 95). Multiple linear regression analysis was used to assess the relationship among cigarette smoking, and cardiac and respiratory functions. The relationship between selected dependent variables and lifetime pack-years was assessed in two models with multiple linear regression analysis. Model 1 was adjusted for age and male sex; and Model 2 was adjusted for Model 1 plus forced expiratory volume percentage in 1 s and forced vital capacity percentage.ResultsCompared with the non-smokers, the participants with high smoking exposure had lower left ventricular (LV) systolic function and larger LV size. Multiple linear regression analysis revealed a negative association of cumulative lifetime pack-years with LV and right ventricular (RV) systolic functions, even after adjustment for age, sex, and spirometric parameters (forced expiratory volume percentage in 1 s and forced vital capacity percentage). Meanwhile, there was no significant association of smoking exposure with LV diastolic function (E/e′ and E/A) and RV diastolic function (e′t and e′t/a′t).ConclusionsCumulative smoking exposure was associated with a negative effect on biventricular systolic function in patients with relatively preserved cardiac function, independent of respiratory function.
Highlights
IntroductionA comprehensive assessment of both cardiac and respiratory function is necessary for evaluating the direct effects of tobacco on the heart
Cigarette smoking harms nearly every organ, including the heart and lungs
Measured and derived variables were determined as follows: left ventricular mass (LVM) was calculated from left ventricular (LV) chamber size and wall thickness dimensions; 2-dimentional left ventricular ejection fraction (LVEF) was computed from LV end-diastolic and end-systolic volumes which were calculated according to the bi-plane disk summation method in apical four- and two-chamber views; pulsed-wave Doppler was performed with the sample volume placed at the level of the mitral leaflet tips to obtain peak early (E) and late (A) diastolic transmitral inflow velocities and E-wave deceleration time; and tissue Doppler was performed to acquire mitral early (e′) and late (a′) diastolic annular velocities on the lateral side of the wall
Summary
A comprehensive assessment of both cardiac and respiratory function is necessary for evaluating the direct effects of tobacco on the heart. Few previous studies examining the effects of cigarette smoking on cardiac function included an assessment of lung function This cross-sectional study investigated the influence of cigarette smoking on cardiac function, independent of respiratory function. A comprehensive assessment of both cardiac and respiratory function is important for investigating the direct effects of tobacco use on the heart. We investigated the crosssectional association between cigarette smoking and cardiac function independent of respiratory function in individuals who underwent simultaneous echocardiography and spirometry
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