Direct effects of smoking on the heart: silent ischemic disturbances of coronary flow

Journal Article · Thu May 01 04:00:00 EDT 1986 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0002-9149(86)90665-X· OSTI ID:5578437

Deanfield, J E; Shea, M J; Wilson, R A; Horlock, P; de Landsheere, C M; Selwyn, A P

Cigarette smoking is strongly associated with ischemic heart disease and acute coronary events. The effect of smoking a single cigarette on regional myocardial perfusion was studied in 13 chronic smokers with typical stable angina pectoris using positron emission tomography and rubidium-82 (/sup 82/Rb). Findings were compared with the effects of physical exercise. After exercise, 8 patients (61%) had angina, ST depression and abnormal regional myocardial perfusion. Uptake of /sup 82/Rb increased from 49 +/- 8 to 60 +/- 7 in remote myocardium, but decreased from 46 +/- 3 to 37 +/- 5 in an ischemic area. The remaining 5 patients (39%) had homogeneous increases in /sup 82/Rb uptake without angina or ST depression. After smoking, 6 of the 8 patients with positive exercise test responses had a decrease in /sup 82/Rb uptake, from 47 +/- 3 to 35 +/- 6 in the same segment of myocardium affected during exercise. However, in contrast to exercise, the events during smoking were largely silent. The absolute decreases in regional /sup 82/Rb uptake after smoking occurred at significantly lower levels of myocardial oxygen demand than after exercise. This suggests that an impairment of coronary blood supply is responsible. Thus, in smokers with coronary artery disease, each cigarette can cause profound silent disturbances of regional myocardial perfusion that are likely to occur frequently during daily life. Such repeated insults may represent an important mechanism linking smoking with coronary events.

• Research Organization: Royal Postgraduate Medical School, London, England
• OSTI ID: 5578437
• Journal Information: Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 13; ISSN AJCDA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
AEROSOLS
ALKALI METAL ISOTOPES
ARTERIES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BLOOD FLOW
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COLLOIDS
COMPUTERIZED TOMOGRAPHY
CORONARIES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DISPERSIONS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EXERCISE
HEART
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISCHEMIA
ISOTOPES
MINUTES LIVING RADIOISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-ODD NUCLEI
ORGANS
PATIENTS
PERFUSED ORGANS
POSITRON COMPUTED TOMOGRAPHY
RADIOISOTOPES
RESIDUES
RUBIDIUM 82
RUBIDIUM ISOTOPES
SMOKES
SOLS
TOBACCO SMOKES
TOMOGRAPHY
TOXICITY
VASCULAR DISEASES