Acute effects of cigarette smoking on the cardiac diastolic functions

AbstractBackgroundSmoking is an independent risk factor for coronary heart diseases and it increases all causes of cardiovascular morbidity and mortality.Aim of the workTo assess the acute effect of cigarette smoking on ventricular diastolic functions (LV and RV) in healthy, young, and slim smokers.MethodsThirty volunteers who had recently commenced smoking (less than one year) and who smoked 1–2 cigarettes per day, underwent ECG, 2D and M-mode echocardiography, standard Doppler echocardiography, pulsed TDI (tissue Doppler imaging) on septal and lateral side of mitral annulus and lateral tricuspid annulus. Vp values were measured. The investigator asked them to hold smoking for at least two days after which echocardiographic examination was conducted before smoking one cigarette and the second examination conducted immediately after smoking one cigarette containing at least 0.4mg of nicotine.ResultsDoppler findings over the mitral valve showed the E wave was significantly reduced from 82.7±10.4 to 74.6±10.4 after smoking; the A wave increased; the E/A ratio was reduced from 1.5±0.3 to 1.2±0.2; the E′ septal significantly decreased (15.3±2.4 vs. 11.2±1.1) after smoking, and the E/E′ ratio increased from 5.5±1.1 to 6.7±1.1. Doppler findings over the tricuspid valve showed the E wave was reduced from 60.6±9.7 to 52.7±9.6; the A wave increased from 42.2±6.5 to 50.1±6.6; and the E/A ratio decreased (1.45±0.25 vs. 1.06±0.19). The E′ significantly decreased from 14.1±1.8 to 10.9±2.4, while the A′ increased (10.2±2.4 vs. 12.7±3.6) after smoking; and the IVRT of the RV was significantly prolonged from 62.9±7.5 to 68.7±7.9 after smoking. The Vp was markedly reduced from 67.8±8 to 55.2±3.5 after smoking. These findings reflected on the LV filling pressure (LVFvp) which increased from 9.8±1.4 to 10.5±1.3 after smoking. All changes were statistically significant at P<0.001.ConclusionsOur study reveals that cigarette smoking can result in significant acute alteration in the diastolic functions of both ventricles

Effect of Airborne Particulate Matter on Cardiovascular Diseases

Context: Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially cardiovascular diseases. Although numerous epidemiological studies have been published worldwide in developing countries on risks associated with exposure to PM, such studies are still scarce in developing countries such as Saudi Arabia. Objective: To examine the association between the concentration of airborne particulate matter (PM) and hospital admissions resulting from cardiovascular diseases (CVD) in the Eastern Region of Saudi Arabia, specifically in the cities of Dammam and Khobar. Methodology: The daily concentrations of PM10 and PM2.5 were obtained from 10 monitoring stations distributed around the two hospitals. There was an examination of the discharge data of patients diagnosed with cardiac arrhythmias, acute myocardial infarction, and heart failure as their primary diagnoses. The data were obtained from two big governmental hospitals in the Eastern Region. The primary cause of hospital admission of 259 patients was identified as acute cardiac condition. Results: For PM10 and PM2.5, the 24 h mean was calculated as 101.2 and 37.1 µg/m3, respectively; such means are considered higher than the Air Quality Guidelines (AQGs). We found evidence of an increased risk of cardiovascular events for long-term exposure to PM2.5–10 concentrations, and a correlation with the IHD hospital admission within 6 days of the peak PM10 or PM2.5 concentration. In addition, the increased PM2.5 concentration also had a correlation with hospital admissions; however, analysis shows an increase in mortality at lag1, lag2, and lag3 prior to hospital admission. Conclusions: Hospital admissions for several cardiovascular diseases acutely increase in response to higher ambient PM concentrations. It is recommended that residents need to use personal protection, especially those residents with cardiovascular disease, while the government needs to strengthen the governance of air pollution in areas with lighter air pollution

Morning blood pressure surge as a predictor of outcome in patients with essential hypertension

Objective: To determine the usefulness of monitoring morning blood pressure surge (MBPS) to predict cardiovascular events in patients with essential hypertension. Materials and Methods: A total of 81 patients (43 males and 38 females) with a mean age of 55.9 ± 9.8 years with essential hypertension were included in the study. Twenty-four hour ambulatory blood pressure (BP) monitoring was carried out to record MBPS. All patients were followed up for 36 months for cardiovascular events. Results: Mean MBPS was 26.23 ± 10.17 mmHg. Nineteen patients (23%) who experienced a cardiovascular event during the follow-up period had higher MBPS than patients who did not experience a cardiovascular event (P < 0.0001). MBPS was positively correlated with interventricular septum thickness (r = +0.38 and P = 0.000), left atrial size (r = +0.39 and P = 0.000), 24-h mean systolic BP (r = +0.36 and P = 0.001) and total cholesterol level (r = +0.23 and P = 0.003). MBPS was negatively correlated with high-density lipoprotein-cholesterol (r = −0.37 and P = 0.001). Conclusion: MBPS can be used as a biomarker for a cardiovascular disease event in hypertensive patients