Acute Effects of Smoking on Diastolic and Systolic Cardiac Function of Healthy Smokers according to 2D Speckle Tracking Echocardiography

Background: Smoking is a preventable cause of human death. While the chronic effects of smoking on cardiovascular health are well known, its acute effects remain obscure. Objectives: This study aimed to assess the acute effects of smoking on left ventricle (LV) diastolic and systolic cardiac function and right ventricle (RV) systolic function in healthy smokers. Methods: In this before-after (quasi-experimental) study conducted at Modarres and Shohada-e-Tajrish hospitals in Tehran, Iran, healthy smokers were asked to discontinue smoking and caffeine for half an hour. Then, they underwent echocardiography by the same echo-cardiologist at baseline and 10 minutes after smoking a single cigarette with 10 mg of nicotine. The 2D speckle tracking mode illustrated the diastolic and systolic ventricular functions. Results: Among 80 participants were 54 males (67.5%) and 26 females (32.5%). The mean age was 36.8 ± 13.6 years. The mean smoking history was 7.3 ± 7.5 pack years. Significant changes occurred after smoking in the global longitudinal strain (GLS), E/A ratio, and pulmonary artery systolic pressure (P = 0.001). No changes occurred in other factors including ejection fraction (EF), S wave velocity of septum, tricuspid annular plane systolic excursion (TAPSE), and right ventricular systolic function (SRV) (P 0.05). Conclusions: This study was carried out as a pilot for larger clinical studies to demonstrate the acute effects of smoking on heart function and cardiovascular health. Our findings indicate that smoking acutely affects both right and left ventricular parameters on echocardiography.