ACUTE EFFECT OF CIGARETTE SMOKING ON VENTRICULAR REPOLARIZATION PARAMATERS

Yıl 2005, Cilt: 9 Sayı: 1, 1 - 7, 01.01.2005

OSMAN Karakaya MUSTAFA Saglam ALI METIN Esen IRFAN Barutcu IRFAN Barutcu NIHAL Ozdemır BENGI Yaymacı OZLEM Esen BILAL Boztosun BILAL Boztosun CIHANGIR Kaymaz

Öz

Background: Acute cigarette smoking has been reported to increase heart rate and blood pressure as a consequence of sympathetic stimulation. In this study we sought to determine if single dose cigarette smoking influences ventricular repolarization paramaters in habitual smokers. Method and Results: The study population consisted of twenty-four long-term heavy smokers. A 12-lead surface ECG recorded at a paper speed of 50 ms/s was obtained from all participants before and average 15 min. after cigarette smoking. Maximum QT (QTmax), minimum QT (QTmin) intervals, QT dispersion (QTd) and corrected QT dispersion (QTcd) were calculated on each ECG record. QT and RR intervals in V2 leads (QTV2 and RRV2) were also measured before and after smoking. Hart rate and RRV2 significantly increased after smoking a cigarette (67±7 vs. 72±8 beat/min, 984±169ms vs. 875±150ms, respectively p

Anahtar Kelimeler

Cigarette smoking, ventricular repolarization, andarrhythmia.

ACUTE EFFECT OF CIGARETTE SMOKING ON VENTRICULAR REPOLARIZATION PARAMATERS

Öz

Background: Acute cigarette smoking has been reported to increase
heart rate and blood pressure as a consequence of sympathetic
stimulation. In this study we sought to determine if single dose
cigarette smoking influences ventricular repolarization paramaters
in habitual smokers.
Method and Results:The study population consisted of twenty-four
long-term heavy smokers. A 12-lead surface ECG recorded at a
paper speed of 50 ms/s was obtained from all participants before and
average 15 min. after cigarette smoking. Maximum QT (QTmax),
minimum QT (QTmin) intervals, QT dispersion (QTd) and
corrected QT dispersion (QTcd) were calculated on each ECG
record. QT and RR intervals in V2 leads (QTV2 and RRV2) were
also measured before and after smoking. Hart rate and RRV2
significantly increased after smoking a cigarette (67±7 vs. 72±8
beat/min, 984±169ms vs. 875±150ms, respectively p<0.05).
However, the other parameters including QTmax, QTmin, QTd,
QTcd and QTV2 did not alter compared to baseline values.
Concusion:Single dose cigarette smoking does not seem to be
associated with ventricular heterogeneity both in habitual smokers
although it leads to sympathetic hyperactivity.

Anahtar Kelimeler

Cigarette smoking, ventricular repolarization, and arrhythmia

Kaynakça

• Jonas MA, Oates JA, Ockene JK, Hennekens CH. Statement on smoking and cardiovascular disease for health care professionals. Circulati- on 1992;86:1664-1669.
• Kawarada O, Yokoi Y, Morioka N, Nakata S, Higashiue S, Mori T, et al. Carotid stenosis and peripheral artery disease in Japanese patients with coronary artery disease undergoing coro- nary artery bypass grafting. Circ J ;67:1003-1006.
• Hallstrom AP, Cobb LA, Ray R. Smoking as a risk factor for recurrence of sudden cardiac arrest. N Eng J Med 1986;314:271-275.
• Willet WC, Green A, Stampfer MJ, Speizer FE, Colditz GA, Rosner B, et al. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Eng J Med 1987;317:1303-1309.
• Narkiewicz K, van de Borne PJ, Hausberg M, Hausberg M, Cooley RL, Winniford MD, et al. Cigarette smoking increases sympathetic outflow in humans. Circulation 1998;98:528
• Barutcu I , Esen AM, Degirmenci B, Acar M, Kaya D, Turkmen M, Melek M, Onrat E, Esen OB, Kirma C. Acute smoking-induced alterati- ons in the common carotid artery. A Transcrani- al Dopper study. Circ J 2004;68:1127-1131.
• Esen AM, Barutcu I, Acar M, Degirmenci B, Kaya D, Turkmen M, Melek M, Onrat E, Esen OB, Kirma C. Effect of smoking on endothelial function and wall thickness of brachial artery. Circ J 2004;68:1123-1126.
• Hill P, Wynder EL. Smoking and cardiovas- cular disease: effect of nicotine on the serum epinephrine and corticoids. Am Heart J ;87:491-496. Cryer PE, Haymond MW, Santiago JV, Shah SD. Norepinephrine release and adrenergic me- diation of smoking-associated hemodynamic and metabolic events. N Eng J Med ;296:573-577. Algra A, Tijssen JG, Roelandt JR, Pool J, Lubsen J. QTc prolongation measured by stan- dard 12-lead electrocardiography is an indepen- dent risk factor for sudden death due to cardiac arrest. Circulation 1991;83:1888-18194.
• Glancy JM, Garratt CJ, Woods KL, de Bo- no DP. QT dispersion and mortality after myo- cardial infarction. Lancet 1995;345:945-948.
• Cappato R, Alboni P, Pedroni P, Gilli G, An- tonioi GE. Sympathetic and vagal influences on rate dependent changes of QT interval in he- althy subjects. Am J Cardiol 1991;68:1188
• Ewing DJ, Neilson JMM. QT interval length and diabetic autonomic neuropathy. Di- abetic Med 1990;7:23-26.
• Loo SS, Mathias CJ, Sutton MJ. QT inter- val and dispersion in primary autonomic failu- re. Heart 1996;75:498-501.
• Glickstein JS, Axelrod FB, Friedman D. Electrocardiographic repolarization abnormali- ties in familial dysautonomia: an indicator of cardiac autonomic dysfunction. Clin Auton Res ;9:109-112. Ishida S, Nakagava M, Fujino T, Yonemoc- hi H, Saikawa T, Ito Met al: Circadien variation of QT interval dispersion:correlation with heart rate variability. J Electrocardiol 1997;30;205
• Ioannidis PJ, Aravanis C, Lekos D, Vasili- kos CG. Ventricular repolarization during smo- king. Cardiology 1973;58:139-149.
• Alexopoulos D, Christodoulou J, Toulgari- dis T, Sitafidis G, Manias O, Hahalis G, et al. Repolarization abnormalities with prolonged hyperventilation in apparently healthy subjects: incidence, mechanisms and affecting factors. Eur Heart J 1996;17:1432-1437.
• Fauchier L, Maison-Blanche P, Forhan A, D’Hour A, Lepinay P, Tichet J, et al. Associati- on between heart rate-corrected QT interval and coronary risk factors in 2,894 healthy subjects (DESIRE study). Am J Cardiol 2000;86:557
• Romero Mestre JC, Licea Puig M, Faget Cepero O, Perich Amador P, Marquez-Guillen A. Studies of cardiovascular autonomic functi- on and duration of QTc interval in smokers. Rev Esp Cardiol 1996;49:259-263.
• Karjalainen J, Reunanen A, Ristola P, Viita- salo M. QT interval as a cardiac risk factor in middle aged population. Heart 1997;77:543- de Bruyne MC, Hoes AW, Kors JA, Hofman
• A, van bemmel JH, Grobbe DE. QTc dispersion predicts cardiac mortality in the elderly: The Rotterdam Study. Circulation 1998;97:467
• Dilaveris P, Pantazis A, Gialafos E, Tripos- kiadis F, Gialafos J. The effect of cigarette smo- king on the heterogeneity of ventricular repola- rization. Am Heart J 2001;142:833-837.
• Ahnve S. Correction of QT interval for he- art rate: Review of different formulas and the use of Bazzet’s formula in myocardial infarcti- on. Am Heart J 1985;109:568-574.
• Cowan JC, Yusoff K, Moore M, Amos PA, Gold AE, Bourke JP, et al. Importance of lead selection in QT interval measurement. Am J Cardiol 1988;61:83-87.
• Benowitz NL, Gourlay SG. Cardiovascular toxicity of nicotine: implications for nicotine replacement therapy. J Am Coll Cardiol ;29:1422-1431.
• Wang H, Shi H, Wang Z. Nicotine depres- ses the functions of multiple cardiac potassium channels. Life Sci 1999;65:143-149.
• Stefanidis R, Tsiamis E, Vlachopoulus C, Stratos C, Toutouzas K, Pitsavos C, et al. Unfa- vorable effect of smoking on the elastic proper- ties of the human aorta. Circulation ;95:31-38. Puddu PE, Jouve R, Mariotti S, Giampaoli S, Lanti M, Reale A, et al. Evaluation of 10 QT prediction formulas in 881 middle-aged men from the seven countries study: emphasis on the cubic root Frederica’s equation. J Electrocardi- ol 1988;21:219-229.
• Sagie A, Larson MG, Goldberg RJ, Beng- tson JR, Levy D. An improved method for ad- justing the QT interval for heart rate (the Fra- mingham Heart Study). Am J Cardiol ;70:797-801.