Cigarette Smoking and Incident Heart Failure: Insights From the Jackson Heart Study.
Cigarette Smoking and Incident Heart Failure: Insights From the Jackson Heart Study.
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DOI：
10.1161/circulationaha.117.031912
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发表时间：
2018-06-12
期刊：
影响因子：
37.8
通讯作者：
Hall ME
中科院分区：
文献类型：
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作者：
Kamimura D;Cain LR;Mentz RJ;White WB;Blaha MJ;DeFilippis AP;Fox ER;Rodriguez CJ;Keith RJ;Benjamin EJ;Butler J;Bhatnagar A;Robertson RM;Winniford MD;Correa A;Hall ME
吸烟与一些与心功能障碍有关的因素有关。我们假设吸烟与左心室（LV）结构、功能和心力衰竭（HF）住院有关。我们在杰克逊心脏研究中调查了4129名非裔美国人参与者（从不吸烟者n=2884，目前吸烟者n=503，前吸烟者n=742）（平均年龄54岁，63%为女性），在基线时无心衰或冠心病（CHD）病史。本研究采用心脏磁共振成像（CMR）检查1092名受试者吸烟与左室结构和功能的关系，3325名受试者吸烟与脑钠肽（BNP）水平的关系，以及3633名数据完整的HF住院病例的关系。校正混杂因素后，与从不吸烟相比，吸烟与较高的平均左室质量指数和较低的平均左室周应变相关（均P <0.05）。吸烟状况、吸烟强度和吸烟负担与较高的平均BNP水平相关（均P <0.05）。在8.0年（7.7-8.0年）的中位随访中，有147例心衰住院。在调整传统危险因素和冠心病事件后，与不吸烟相比，当前吸烟（HR 2.82, 95%CI 1.71~4.64）、当前吸烟者吸烟强度（≥20支/天：HR 3.48, 95%CI 1.65~7.32）和曾经吸烟者吸烟负担（≥15包年：HR 2.06, 95%CI 1.29~3.3）与HF住院事件显著相关。在非裔美国人中，吸烟是左室肥大、收缩功能障碍和心衰住院的重要危险因素，即使在调整了对冠心病的影响后也是如此。
Cigarette smoking has been linked with several factors associated with cardiac dysfunction. We hypothesized that cigarette smoking is associated with left ventricular (LV) structure, function and incident heart failure (HF) hospitalization. We investigated 4129 (never smoker n=2884, current smoker n=503, and former smoker n=742) African American participants (mean age 54 years, 63% women) without a history of HF or coronary heart disease (CHD) at baseline in the Jackson Heart Study. We examined the relationship between cigarette smoking and LV structure and function using cardiac magnetic resonance imaging (CMR) among 1092 participants, cigarette smoking and brain natriuretic peptide (BNP) levels among 3325 participants and incident HF hospitalization among 3633 participants with complete data. After adjustment for confounding factors, current smoking was associated with higher mean LV mass index and lower mean LV circumferential strain (P <0.05, for all) compared with never smoking. Smoking status, intensity and burden were associated with higher mean BNP levels (all P <0.05). Over 8.0 years (7.7–8.0) median follow-up, there were 147 incident HF hospitalizations. After adjustment for traditional risk factors and incident CHD, current smoking (HR 2.82, 95%CI 1.71~4.64), smoking intensity among current smokers (≥20 cigarettes/day: HR 3.48, 95%CI 1.65~7.32) and smoking burden among ever smokers (≥15 pack-years: HR 2.06 95%CI 1.29~3.3) were significantly associated with incident HF hospitalization compared with never smoking. In African Americans, cigarette smoking is an important risk factor for LV hypertrophy, systolic dysfunction and incident HF hospitalization even after adjusting for effects on CHD.