scholarly journals Differential effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ignatios Ikonomidis ◽  
Dimitrios Vlastos ◽  
Gavriela Kostelli ◽  
Kallirhoe Kourea ◽  
Konstantinos Katogiannis ◽  
...  
Keyword(s):  
Vascular Function ◽  
Coronary Flow ◽  
Arterial Compliance ◽  
Global Longitudinal Strain ◽  
Chronic Phase ◽  
Flow Reserve ◽  
Work Index ◽  
Total Arterial Compliance ◽  
Before And After ◽  
Chronic Study

AbstractWe compared the effects of Heat-not-Burn cigarette (HNBC) to those of tobacco cigarette (Tcig), on myocardial, coronary and arterial function as well as on oxidative stress and platelet activation in 75 smokers. In the acute study, 50 smokers were randomised into smoking a single Tcig or a HNBC and after 60 min were crossed-over to the alternate smoking. For chronic phase, 50 smokers were switched to HNBC and were compared with an external group of 25 Tcig smokers before and after 1 month. Exhaled carbon monoxide (CO), pulse wave velocity (PWV), malondialdehyde (MDA) and thromboxane B2 (TxB2) were assessed in the acute and chronic study. Global longitudinal strain (GLS), myocardial work index (GWI), wasted myocardial work (GWW), coronary flow reserve (CFR), total arterial compliance (TAC) and flow-mediated dilation (FMD) were assessed in the chronic study. Acute HNBC smoking caused a smaller increase of PWV than Tcig (change 1.1 vs 0.54 m/s, p < 0.05) without change in CO and biomarkers in contrast to Tcig. Compared to Tcig, switching to HNBC for 1-month improved CO, FMD, CFR, TAC, GLS, GWW, MDA, TxB2 (differences 10.42 ppm, 4.3%, 0.98, 1.8 mL/mmHg, 2.35%, 19.72 mmHg%, 0.38 nmol/L and 45 pg/mL respectively, p < 0.05). HNBCs exert a less detrimental effect on vascular and cardiac function than tobacco cigarettes.Trial registration Registered on https://clinicaltrials.gov/ (NCT03452124, 02/03/2018).

scholarly journals Effects of heat-not-burn compared to combustible cigarettes on coronary flow, myocardial work index and vascular function

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
K Katogiannis ◽  
D Vlastos ◽  
G Kostelli ◽  
K Kourea ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Platelet Activation ◽  
Vascular Function ◽  
Coronary Flow ◽  
Arterial Compliance ◽  
Chronic Phase ◽  
Protein Carbonyls ◽  
Flow Reserve ◽  
Work Index ◽  
Chronic Study

Abstract Funding Acknowledgements Type of funding sources: None. Aim/Introduction: Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product. Purpose We compare the effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function, platelet activation and oxidative stress. Methods We compared the effects of HNBC to those of tobacco cigarette (TCig), on arterial stiffness, oxidative stress, and platelet activation, acutely and after 1 month of switching to HNBC, as well as on endothelial, myocardial, and coronary function after 1 month of switching to HNBC. In the acute study, 50 smokers were randomized into smoking a single Tcig or an HNBC and after 60 minutes were crossed over to the alternate smoking (HNBC or Tcig). For the chronic phase, 75 smokers were examined. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. Pulse wave velocity (PWV) and biomarkers [malondialdehyde (MDA), protein carbonyls (PC), and thromboxane B2 (TXB2)] were assessed in the acute and chronic study. Myocardial deformation [global longitundinal strain (GLS), myocardial work index (GWI) and wasted myocardial work (GWW)], coronary flow reserve (CFR) by Doppler echocardiography, total arterial compliance (TAC), and flow-mediated dilation (FMD) were additionally assessed in the chronic study. Results Compared to baseline, TCig smoking acutely increased exhaled CO, PWV, MDA, and TxB2 (p &lt; 0.05), while no changes were observed after HNBC. Compared to resuming Tcig smoking, switching to HNBC for 1 month improved CO (mean change: -55% vs -2.4%), FMD ( +55% vs +15%), CFR (+46% vs +4%), TAC (+9% vs -0.5%), GLS (+6% vs +1%), GWW (-19% vs +0.5%), MDA (-19% vs 1 %), and TxB2 (-12% vs 4%) (p &lt; 0.05 for all comparisons). Conclusions HNBCs exert a less detrimental effect on vascular, cardiac and platelet function than combustible tobacco.

P940Effects of IQOS smoking on vascular function, coronary flow reserve, myocardial deformation and myocardial work index during one month of use

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
K Katogiannis ◽  
K Kourea ◽  
G Kostelli ◽  
D Vlastos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Flow Reserve ◽  
Vascular Function ◽  
Coronary Flow ◽  
Smoking Status ◽  
Myocardial Strain ◽  
Chronic Phase ◽  
Myocardial Deformation ◽  
Flow Reserve ◽  
Work Index

Abstract Background IQOS smoking (heat-no burn smoke product) is proposed to reduce harm compared to conventional smoking. We examined its effects on vascular function, myocardial deformation and ventricular arterial coupling. Methods Thirty-seven current smokers (mean age 48±5 years, >20 cigarettes /day) without cardiovascular disease and 20 healthy subjects with similar age sex and risk factors participated in the study. All subjects were instructed to smoke only IQOS for one month. Measurements were performed at baseline and 1 month after smoking IQOS. we measured a) the aortic PWV (PWV) and central aortic systole blood pressure (SBPc) by Complior; b) the exhaled CO level (parts per million-ppm) as a smoking status marker; and c) brachial systolic (SBP)and diastolic (DBP) blood pressure and heart rate (HR) a) flow mediated dilation (FMD) of the brachial artery b) coronary flow reserve (CFR) after adenosine infusion by Doppler echocardiography and c) global longitundinal strain (GLS) peak twisting and untwisting velocity and myocardial work index derived by pressure –myocardial strain loops by speckle tracking imaging PWV to GLS ratio was also used as a marker of ventricular arterial coupling Results At baseline exhaled CO, PWV, SBPc, FMD, PWV/GLS ratio, myocardial work index and peak untwisting velocity were higher and CFR was lower in smokers compared to controls (14.9±7 vs. 4.2±1 ppm, p<0.001, 8.7±1.4 vs 10.0±1.6 m/s, p<0.05; 118±16 vs 110±7 mmHg p<0.001, 6.9±2 vs 9.5±2% p<0.001, −0.61±0.21 vs. −0.45±0.11 m/sec%, p<0.001, 1926±284 vs 1826±300 mmHg% p=0.04, −122±36 vs −95±25 deg/sec, p=0.02, 2.5±0.9 vs. 3.1±0.8 p=0.001 respectively). In the chronic phase we observed a significant improvement of FMD, CFR, GLS, PWV/GLS, myocardial work index and peak untwisting velocity compared to baseline (12±2% vs. 6.9±2%, p=0.03; 3.2±0.6 vs. 2.5±0.9 p=0.001; −19.3±2.2% vs. −21.1±2.8%, p=0.001; −0.61±0.21 vs. −0.47±0.12 m/sec% p=0.03; 1926±284 vs 1830±343 mmHg% p=0.03, −122±36 vs −105±25 deg/sec, p=0.03, respectively) in parallel with reduction of the exhaled CO (14.9±7 vs. 6±4.9 ppm, p<0.001). HR remained unchanged throughout the study and there was a borderline reduction of central aortic systolic blood pressure (118±16 vs. 114±19 mmHg, p=0.048). Conclusions Replacement of conventional cigarettes with IQOS results in improved LV longitundinal myocardial deformation, LV untwisting and reduced LV myocardial work index possibly linked to the concomitant improvement of aortic elasticity, endothelial and coronary microcirculatory function and ventricular-arterial coupling within 1 month.

Differential effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function, platelet activation and oxidative stress

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Ikonomidis ◽  
D Vlastos ◽  
G Kostelli ◽  
K Kourea ◽  
K Katogiannis ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Platelet Activation ◽  
Vascular Function ◽  
Coronary Flow ◽  
Arterial Compliance ◽  
Public Institution ◽  
Protein Carbonyls ◽  
Funding Source ◽  
Flow Reserve ◽  
Chronic Study

Abstract   Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product. Methods We compared the effects of HNBC to those of tobacco cigarette (TCig), on arterial stiffness, oxidative stress, and platelet activation, acutely and after 1 month of switching to HNBC, as well as on endothelial, myocardial, and coronary function after 1 month of switching to HNBC. In the acute study, 50 smokers were randomised into smoking a single Tcig or an HNBC and after 60 minutes were crossed over to the alternate smoking (HNBC or Tcig). For the chronic phase, 75 smokers were examined. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. Pulse wave velocity (PWV) and biomarkers [malondialdehyde (MDA), protein carbonyls (PC), and thromboxane B2 (TXB2)] were assessed in the acute and chronic study. Myocardial deformation [global longitundinal strain (GLS), myocardial work index (GWI) and wasted myocardial work (GWW)], coronary flow reserve (CFR) by echocardiography, total arterial compliance (TAC), and flow-mediated dilation (FMD) were additionally assessed in the chronic study. Results Compared to baseline, TCig smoking acutely increased exhaled CO, PWV, MDA, and TxB2 (p&lt;0.05), while no changes were observed after HNBC. Compared to resuming Tcig smoking, switching to HNBC for 1 month improved CO (mean change: −55% vs −2.4%), FMD (+55% vs +15%), CFR (+46% vs +4%), TAC (+9% vs −0.5%), GLS (+6% vs +1%), GWW (−19% vs +0.5%), MDA (−19% vs 1%), and TxB2 (−12% vs 4%) (p&lt;0.05 for all comparisons). Conclusions HNBCs exert a less detrimental effect on vascular, cardiac and platelet function than tobacco Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Hellenic Association of Lipidiology, Atherosclerosis and Vascular disease

Preservation of coronary flow reserve in stunned myocardium

1989 ◽  
Vol 256 (5) ◽  
pp. H1303-H1310
Author(s):  
R. W. Jeremy ◽  
L. Stahl ◽  
M. Gillinov ◽  
M. Litt ◽  
T. R. Aversano ◽  
...  
Keyword(s):  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Coronary Occlusion ◽  
Myocardial Dysfunction ◽  
Reactive Hyperemia ◽  
Stunned Myocardium ◽  
Flow Reserve ◽  
Before And After ◽  
Adenosine Antagonist ◽  
Hyperemic Flow

Microvascular obstruction and persistent focal ischemia have been suggested as a possible cause of myocardial dysfunction (stunning) after brief coronary occlusion. Microvascular occlusion should result in a reduction in maximal coronary flow reserve, although resting transmural coronary flow may be maintained by release of local vasodilators, such as adenosine. To test the microvascular occlusion hypothesis, coronary flow reserve was measured in 14 anesthetized dogs, before and after myocardial stunning produced by 10 min of ischemia. Intracoronary adenosine infusion (5,900 microM/min) increased coronary flow to the same degree in normal [195 +/- 20 (SE) ml/min] and stunned (212 +/- 23 ml/min) myocardium. Peak hyperemic flow after 100 s of coronary occlusion was also similar in normal (205 +/- 25 ml/min) and stunned (218 +/- 23 ml/min) myocardium. The adenosine antagonist 8-phenyltheophylline (5 mg/kg) reduced the flow response to exogenous adenosine, but neither resting coronary flow nor peak hyperemic flow in stunned myocardium was altered. In stunned myocardium, myocardial shortening at rest (0.2 +/- 2.0%) increased during reactive hyperemia (to 13.8 +/- 2.5%, P less than 0.01), but shortening promptly returned to basal levels after each hyperemia. These findings indicate that fixed microvascular occlusion is unlikely to be an important factor in the pathogenesis of stunned myocardium and that local adenosine release does not appear to have a compensatory role in coronary vasoregulation in stunned myocardium.

scholarly journals P1402 The behavior of regional longitudinal strain depends on the coronary reserve in a simultaneous analysis during Dipyridamol Stress Echocardiography Test

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Arbucci ◽  
D Lowenstein Haber ◽  
P Merlo ◽  
G Zambrana ◽  
G Rousse ◽  
...  
Keyword(s):  
Coronary Flow Reserve ◽  
Predictive Value ◽  
Coronary Flow ◽  
Longitudinal Strain ◽  
Wall Motion ◽  
Visual Analysis ◽  
Global Longitudinal Strain ◽  
Contractile Reserve ◽  
Flow Reserve ◽  
Wall Motion Abnormalities

Abstract Background.The diagnostic and prognostic utility of coronary flow reserve(CFR) during dipyridamole Stress echo(EchoDipi) has been recognized when the contractile response is positive and even in absence of wall motion abnormalities. Less studied is the behavior of regional longitudinal strain(RLS) and global(GLS) in relation of CFR in the territory of the left anterior descending artery(LADA). Objectives Compare the behavior of the Apical LS and GLS with the value of the CFR in the LADA and as a secondary objective to compare these responses with a simultaneous visual analysis of the motility during EchoDipi. Materials and methods 179 patients (p) were included (age 68.7 ± 7 years). Of them, 113p(65%) were men. At the peak of the effect of Dipi(0.84mg/kg in 4m) the CFR was measured in the distal region of the LADA(Normal Value≥2). The subjects were divided into 2 groups(G): G1: p with CFR of the LAD≥2 and G2 p with LADA CFR &lt; 2. ApRLS was defined as the average of the 4 apical segments, in 4, 3 and 2 apical views, considering any increase in the percentage of deformation as normal. The LGS and wall motility of the 17 segments were evaluated; p with LBBB or wall motion abnormalities were excluded. Results Of 179 p, 113p(63.12%) were included in G1 and 66p(36.87%) in G2. G1 were older(65.9 ± 10.27 vs 72.2 ± 9.31,p &lt; 0.02), without significant differences in other clinical characteristics. No differences in the values of LGS and the Ap RLS at rest between G1 and G2 (GLS: G1: -19.8 ± 4.8 vs G2: -20.27 ± 2.6 p = NS; Ap RLS G1: -25.41 ± 4.75 vs G2: -26.73 ± 7.6 p = NS). During EchoDipi GLS and Ap RLS increased in the pts of G1 with a significant worsening in the G2 (SLG: G1: -22.98 ± 4.31 vs G2: -17.82 ± 2.70, p &lt; 0.0001; Ap SLR G1: -28.43 ± 5.6 vs. G2: -22.78 ± 7.41, p &lt; 0.0001). We observed that in 96.7% of p G1 the ApRLS increased strain with the stress meanwhile 95.31% of the G2 decrease(p &lt; 0.0001). Negative predictive value (NPV) :95.6%(CI = 87.8-98.5%), positive predictive value (PPV) =96.8%(CI = 89.0-99.1%).Specificity(E): 97%(CI = 89.9-99.2%),Sensibility(S): 95.2%(CI = 86.9-98.4%). Area Under the ROC curve(AUC)=0.92. The behavior of the GLS showed that 82.8% of the pts of the G1 during EchoDipi increased their Strain values in contrast with 78.8% p of the G2 decrease p &lt; 0.01).NPV 78.8%(CI = 67.5-86.9%),PPV:90.8%(CI = 83.9-94.9%),E:83.9% (CI = 72.8-91.0%),S:87.6%(CI = 80.3-92.5%).AUC ROC= 0.84. The analysis of wall motility showed that 96.46%(109p) of G1 had preserved wall motility, 1 p showed contractility abnormalities and decreased ApRLS. Of the G2, 36p showed conserved contractility during the stress. Conclusions.There was a close correlation between LADA coronary flow reserve and the contractile reserve evaluated by regional longitudinal strain of the 4 apical segments, which was superior to the use of global longitudinal strain. The Apical Strain showed a better correlation with the LADA coronary flow reserve than with the visual analysis of wall motion.

scholarly journals Στεφανιαία εφεδρεία ροής και διαστολική απόδοση της αριστερής κοιλίας σε ασθενείς με χρόνια νεφρική νόσο

2020 ◽  
Author(s):  
Λάμπρος Λάκκας
Keyword(s):  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Coronary Flow ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Healthy Controls ◽  
Ventricular Diastolic Function ◽  
Flow Reserve ◽  
Echocardiographic Evaluation ◽  
Before And After

lntroduction-Aim of the studv: Chronic kidney disease (CKD) is related to higher risk for cardiovasular related morbidity and mortality. lt seems that this risk is higher even in the presence of early abnormal indices related to functionality of the left ventricle orland abnormal coronary flow reserve (CFR). Aim of this study was a) to investigate diastolic dysfunction and CFR after dipyridamole infusion in CKD patients, b) to inspect changes in diastolic dysfunction of the left ventricle after dipyridamole infusion in these patients and c) to compare the aforementioned indices between CKD patients and healthy controls, as also between patients with CKD and patients with a hisotry of renal transplantation Tx. Materials and methods: This study included 60 CKD patients from the outpatient CKD clinic of University Hospital of loannina, 30 healthy controls and 50 patients with Tx history. All patients and healthy controls were evaluated thoroughly (clinical examination, lab exams and echocardiographic evaluation). The echocardiographic evaluation included transthoracic echocardiogram, dipyridamole infusion for coronary flow reserve (CFR) evaluation in the left anterior descending coronary artery and at the end of the this stress test, a new transthoracic echocardiogram.ln a subgroup of Tx patients, the whole evaluation was repeated after 3 years. Results: Mean CFR value [t standard deviation (SD)] for CKD patients was 2.98 (t0.83).Deformation related echocardiographic indices urere normal [mean values (t) SD: GLS -20.5 (t3.1)o/o, τWlsT s.07(t4.41)", UNTW|Sτ -69.2(t30)"/sec]' Patients with advanced CKD (GFR<3omllminl1'73m2), had bigger left ventricle mass (p<0.037), without any other differences comparing to other patients as far as echocardiographic indices related to systolic and diastoliο left ventricular function were concerned. CKD patients had lower CFR comparing to healthy controls. There \rvere no differences of statistical importance between these two populations, in left ventricular functional indices. After dipyridamole infusion, there was a significant improvement (p<0.05) in all left venticular functionality related echoοardiographic indices in both populations.Tx patients had bigger left atrial volume (p=0.014), lower CFR mean value (p=0.007) and better left ventricular diastolic function shown by UΝTW|SΤ (p=0.035) comparing to CKD patients. There ιΛ/ere no differenοes in echocardiographic indices'changes before and after dipyridamole infusion. ln Tx patients that were re-evaluated after 3 years (N=45), a deterioration was shown in most of echocardiographic indices [increase in left ventricuΙat mass (ρ=0.009), decrease in left ventricular ejection fraction (p=0.001), increase in E/e'(p=0.002), deterioration in TW|ST (p=0.002) and UNTW|ST (p=9.935μ. Conclusion: Patients with CKD have lower CFR values comparing to healthy controls and higher than patients with a history of Tx. Tx patients had better left ventricular diastolic function than CKD patients. There \Λrere no significant differrences in various echocardiographiο indices before and after dipyridamole infusion, in all subgroups of patients in this study. Larger-scale studies are mandatory to clarify the clinical importance of various echocardiographic indices in different CKD stages.

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