Effects of Endurance Exercise Training on Cardiac Dysfunction Induced by Waterpipe Tobacco Smoking

Background: There is an increasing popularity of waterpipe tobacco smoking (WTS) in youth and even in athletes worldwide. Despite the existence of evidence of the harmful effects of hookah smoke on various systems of the body, especially the cardiovascular system, its simultaneous effect with exercise training has not been well studied. We assessed the effects of WTS exposure with/without swimming exercise on blood pressure (BP), and heart histology and mechanical performance in male Wistar rats. Methods: The animals were divided into 4 groups of sedentary control (CTL), waterpipe tobacco smoking (S), mild endurance swimming exercise training (Ex), and waterpipe smoking plus exercise (S + Ex). The duration of WTS and exercise was 8 weeks. Findings: BP and heart rate (HR) did not show a significant difference among the groups. WTS increased the TNF-α level of the heart (P < 0.05 vs. CTL) and cardiac tissue lesions (P < 0.05 vs. CTL), and reduced +dP/dt max, -dp/dt max, and heart contractility indices (P < 0.01, P < 0.01, and P < 0.05, respectively, vs. CTL and Ex groups). It also increased the Tau index (P < 0.05 vs. CTL; P < 0.01 vs. Ex groups) of the left ventricle. However, the combination of exercise and WTS reduced the TNF-α level, improved the heart activity of superoxide dismutase (SOD) and catalase enzymes, and prevented the negative effects of smoking on heart function and morphology. Conclusion: Mild exercise prevents WTS-induced left ventricular systolic and diastolic dysfunction partly via improvement of antioxidants and attenuation of pro-inflammatory cytokines.