EFFECT OF ACUTE AND LONG-TERM SMOKING ON MYOCARDIAL BLOOD-FLOW AND FLOW RESERVE

被引:110
作者
CZERNIN, J [1 ]
SUN, K [1 ]
BRUNKEN, R [1 ]
BOTTCHER, M [1 ]
PHELPS, M [1 ]
SCHELBERT, H [1 ]
机构
[1] UNIV CALIF LOS ANGELES, STRUCT BIOL & MOLEC MED LAB, LOS ANGELES, CA USA
关键词
MYOCARDIUM; BLOOD FLOW; SMOKING; TOMOGRAPHY;
D O I
10.1161/01.CIR.91.12.2891
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Cigarette smoking is a major preventable risk factor for coronary artery disease and sudden cardiac death. However, the effect of acute and long-term cigarette smoking on coronary vasodilatory capacity and myocardial flow reserve has not been quantified in humans. Methods and Results To examine the effect of short-term and long-term smoking, myocardial blood flow was quantified at rest and during dipyridamole-induced hyperemia (0.56 mg/kg) in 12 smokers (10 males and 2 females; mean age, 27 +/- 4 years) under baseline conditions (reflecting the effect of longterm smoking) and during short-term cigarette smoking with N-13 ammonia, positron emission tomography, and a two-compartment model. Twelve sex- and age-matched nonsmokers served as control subjects. Smoking significantly increased the rate-pressure product at rest from 7525 +/- 1290 to 9160 +/- 1125 (P<.001 versus baseline), which was paralleled by a proportional increase in myocardial blood flow at rest (0.70 +/- 0.17 versus 0.88 +/- 0.17 mL . g(-1).(-1); P<.05 versus baseline). In contrast, hyperemic blood flow declined from 2.23 +/- 0.35 at baseline (P=NS versus control) to 1.98 +/- 0.32 mL . g(-1). min(-1) during smoking (P<.01 versus baseline). Accordingly, the myocardial flow reserve declined from 3.36 +/- 0.83 in smokers at baseline to only 2.28 +/- 0.28 during smoking (P<.0001 versus baseline). Thus, myocardial blood flow and flow reserve were similar in young, long-term smokers and young, healthy nonsmokers. Conclusions Short-term smoking increases the coronary vasomotor tone during dipyridamole-induced hyperemia and markedly reduces the myocardial flow reserve. In contrast, long-term smoking does not attenuate the coronary vasodilatory capacity in young individuals with a relatively short smoking history. It might be speculated that the short-term reduction in the coronary vasodilatory capacity during smoking could lower the ischemic threshold in smokers with coronary artery disease and contribute to the increased risk for sudden cardiac death.
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收藏
页码:2891 / 2897
页数:7
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