Smoking and Cardiac Structure and Function in the Elderly: The ARIC Study (Atherosclerosis Risk in Communities).
Smoking and Cardiac Structure and Function in the Elderly: The ARIC Study (Atherosclerosis Risk in Communities).
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DOI：
10.1161/circimaging.116.004950
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Solomon SD
中科院分区：
文献类型：
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作者：
Nadruz W Jr;Claggett B;Gonçalves A;Querejeta-Roca G;Fernandes-Silva MM;Shah AM;Cheng S;Tanaka H;Heiss G;Kitzman DW;Solomon SD
吸烟与冠心病无关的心力衰竭事件风险较高相关，但烟草使用对普通人群心脏结构和功能的影响尚不确定。本研究在一个大型老年队列中评估了吸烟与超声心动图测量之间的关系。我们研究了4，580名无明显冠状动脉疾病、心力衰竭和严重瓣膜疾病的参与者，这些参与者来自社区动脉粥样硬化风险（ARIC）研究的第五次访视，并接受了经胸超声心动图检查。参与者根据自我报告的吸烟习惯分为3类：从不吸烟（43.2%），以前吸烟（50.5%）和现在吸烟（6.3%）。包年和吸烟年也进行了估计。与从不吸烟者相比，目前吸烟者的左心室（LV）质量指数（80.4±1.1g/m2 vs. 76.7±0.4g/m2; p<0.001），LV质量/体积比（1.93±0.03g/mL vs. 1.83±0.03g/mL; p<0.001），LV肥大的发生率较高（15% vs. 9%; p=0.008），舒张功能更差，反映为校正潜在混杂因素后E/E′比值更高（11.7±0.2 vs. 10.9±0.1; p<0.001）。相反，前吸烟者与从不吸烟者相比，表现出相似的超声心动图特征。此外，在多变量分析后，估计的吸烟包年数和吸烟年数（累积香烟暴露的测量）与当前吸烟者的左室质量指数、左室质量/体积比和舒张功能差（E/E′比较高）相关（所有p<0.01）。在无明显冠状动脉疾病和心力衰竭的老年社区人群中，主动吸烟和累积香烟暴露与LV结构和功能的细微变化相关。
Cigarette smoking has been associated with higher risk of incident heart failure independent of coronary artery disease, but the impact of tobacco use on cardiac structure and function in the general population is uncertain. This study evaluated the relationship between smoking and echocardiographic measures in a large elderly cohort. We studied 4,580 participants free of overt coronary artery disease, heart failure and significant valvular disease from the fifth visit of the Atherosclerosis Risk in Communities (ARIC) Study who underwent transthoracic echocardiography. Participants were classified into 3 categories based on self-reported smoking habits: never (43.2%), former (50.5%) and current smokers (6.3%). Pack-years and years of smoking were also estimated. Compared to never smokers, current smokers had greater left ventricular (LV) mass index (80.4±1.1g/m2vs. 76.7±0.4g/m2; p<0.001), LV mass/volume ratio (1.93±0.03g/mL vs. 1.83±0.03g/mL; p<0.001), higher prevalence of LV hypertrophy (15% vs. 9%; p=0.008), and worse diastolic function, as reflected by higher E/E′ ratio (11.7±0.2 vs. 10.9±0.1; p<0.001), after adjusting for potential confounding factors. In contrast, former smokers showed similar echocardiographic features when compared to never smokers. Furthermore, estimated pack-years and years of smoking, measures of cumulative cigarette exposure, were associated with greater LV mass index, LV mass/volume ratio, and worse diastolic function (higher E/E′ ratio) in current smokers after multivariable analysis (all p<0.01). Active smoking and cumulative cigarette exposure were associated with subtle alterations in LV structure and function in an elderly community-based population free of overt coronary artery disease and heart failure.