Abstract
Despite its negative effect on the cardiovascular system, waterpipe smoking (WPS) is currently popular worldwide, especially among youth. This study investigated the effects of moderate endurance exercise on heart function of rats exposed to WPS and its possible mechanism. The animals were randomly divided into four groups: control group (CTL), the exercise group (Ex) which trained for 8 weeks, the waterpipe tobacco smoking group (S) exposed to smoke inhalation (30 min per day, 5 days each week, for 8 weeks), and the group that did exercise training and received waterpipe tobacco smoke inhalation together (Ex + S). One day after the last session of Ex and WPS, cardiac pressures and functional indices were recorded and calculated. The levels of SIRT1, SIRT3, Klotho, Bax, and Bcl-2 in the serum and heart, the expression of phosphorylated GSK3β of heart tissue, and cardiac histopathological changes were assessed. WPS reduced systolic pressure, +dP/dt max, -dP/dt max, and heart contractility indices (P < 0.001 vs. CTL) and increased cardiac tissue lesions (P < 0.05 vs. CTL) and end diastolic pressure and Tau index (P < 0.001 vs. CTL) of the left ventricle. Exercise training normalized the left ventricular end diastolic pressure, +dP/dt max, and contractility index. Also, exercise improved the levels of SIRT1, SIRT3, Klotho, and Bcl-2 and reduced Bax level in the heart. The findings showed that WPS causes left ventricular dysfunction. Moderate exercise prevented WPS-induced heart dysfunction partly through its anti-apoptotic features and activation of the sirtuins and Klotho pathways.
Highlights
Tobacco, a product derived from the yellow and brown leaves of Nicotiana tobacum, is a plant widely cultivated in many countries around the world (Miri-Moghaddam et al, 2014)
Results show that waterpipe smoking (WPS) significantly increased cardiac troponin I (cTnI) level in the smoke inhalation group (P < 0.05 vs. control group (CTL)), and the coincidence of exercise along with smoke inhalation significantly decreased its level in comparison with the S group (P < 0.05)
There was no significant difference between concentration of cTnI in the exercise group (Ex) and CTL groups (Figure 1B)
Summary
A product derived from the yellow and brown leaves of Nicotiana tobacum, is a plant widely cultivated in many countries around the world (Miri-Moghaddam et al, 2014). According to WHO, about 2.4 billion people worldwide smoke tobacco, including cigarettes, pipes, and hookah. The prevalence of hookah smoking in the Middle East is about 6– 34% and in Iran ranges from 10.2 to 11.3% (21.4% in men and 1.4% in women) of the population, especially among adolescents (Ghasemian et al, 2015; Jawad et al, 2018). Human and animal studies indicated a significant association between hookah smoking and the prevalence of heart diseases (El-Zaatari et al, 2015; Qasim et al, 2019). An experimental study demonstrated that 8 weeks of waterpipe tobacco smoking is associated with the left ventricular systolic and diastolic dysfunction in rats (Nakhaee et al, 2019). Possible cardiac damage due to hookah smoking is attributed to inflammation, oxidative stress, and other factors that lead to disruption of energy metabolism, apoptosis, and change in gap junctions (Minicucci et al, 2016)
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