Abstract
BackgroundChronic heavy cigarette smoking can affect the right ventriclular function. The standard echocardiography may not show early right ventricular functional changes, and a more sensitive measure is needed. The aim of this work was to evaluate the subtle subclinical effects of chronic heavy cigarette smoking on the right ventricular function. The study included 55 healthy asymptomatic chronic heavy cigarette smokers (smoking history of at least 5 pack-years and a daily cigarette consumption of at least 1 pack) and 35 healthy non-smoking control subjects. Patients underwent a full clinical assessment and a conventional as well as a 2D-speckle tracking transthoracic echocardiography of the right ventricle and data was compared between the 2 groups.ResultsThe mean age was 32.9 ± 7.2 years in smokers and 30.9 ± 7.9 years in non-smokers (p = 0.227). The 2 groups showed comparable conventional right ventricular systolic and diastolic functions. Smokers showed a significantly lower (less negative) right ventricular global longitudinal strain (− 19.0 ± 3.2% vs. − 24.5 ± 3.5%, p < 0.001). Patients with a higher daily cigarette consumption showed a poorer right ventricular global longitudinal strain (p = 0.014).ConclusionChronic heavy cigarette smoking can adversely affect the right ventricular function, a finding that can be easily missed by conventional echocardiography and can be better detected by the right ventricular speckle tracking.
Highlights
Chronic heavy cigarette smoking can affect the right ventriclular function
The present study aims to find out whether chronic cigarette smoking, in otherwise healthy individuals, can cause subtle dysfunction of the right ventricle by applying a 2D speckle tracking echocardiography (2D-STE) as well as other conventional echocardiographic methods of assessment of the right ventricular function
The relatively new technique of Speckle Tracking Echocardiography has revealed that chronic heavy smokers who develop chronic obstructive pulmonary disease (COPD) show echocardiographic evidence of right ventricular dysfunction appearing even before the occurrence of pulmonary hypertension and cor pulmonale
Summary
Chronic heavy cigarette smoking can affect the right ventriclular function. The aim of this work was to evaluate the subtle subclinical effects of chronic heavy cigarette smoking on the right ventricular function. More than one billion people, about one quarter of adults worldwide, smoke tobacco [1]. Tobacco is currently the greatest preventable cause of death in the world, killing up to half the people who smoke it, which is more than 7 million people worldwide annually [2]. Prevalence of cigarette smoking was 46.4% among males and 0.2% among females in the Global Adult Tobacco Survey (GATS) Egypt Country Report 2009 [1]. Kaplan et al reviewed the possible mechanisms by which cigarette smoke can directly affect the myocardium thereby causing smoking cardiomyopathy, and concluded that oxidative stress, inflammation, metabolic impairment, and cell death were the possible factors responsible for cardiac remodeling after chronic cigarette exposure [4]
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