Acute effects of cigarette smoking on left ventricular diastolic function.

Cigarette smoking increases coronary resistance in patients with coronary artery disease, causing profound disturbances in myocardial perfusion. The acute effects of smoking a single cigarette on left ventricular diastolic function were studied in 20 smokers with typical angina pectoris and angiographically documented coronary artery disease. Twenty healthy smokers served as a control group. We used simultaneous M-mode echocardiography of the mitral and aortic valves to measure isovolumic relaxation time, and pulsed Doppler echocardiography of transmitral blood flow was recorded to evaluate left ventricular filling before and immediately after smoking. In the patients with coronary artery disease, systemic blood pressure and heart rate significantly increased after smoking. The isovolumic relaxation time, the deceleration time as well as peak A velocity remained unchanged. The peak E velocity decreased by 0.06 m.s-1 (P = 0.02) and the peak E/A velocity ratio by 0.17 m.s-1 (P = 0.01). There were no significant changes in left ventricular diastolic function indexes in the controls. These results indicate that in patients with coronary artery disease, each cigarette provokes disturbances of left ventricular diastolic function.