Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Effects of Active Smoking on Heart Rate Variability, Heart Rate & Various Other Cardiac Risk Events in Chronic Smokers


Affiliations
1 Assistant Professor, Department of Internal Medicine
2 Assistant Professor, Department of Physiology
3 Senior Resident, Department of Pathology
4 Junior Resident, Department of Internal Medicine, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
     

   Subscribe/Renew Journal


Background: Smoking increases the risk of vasospasm and arrhythmias, and may decrease heart rate variability (HRV). Shown to increase the risk for cardiovascular diseases and autonomic dysfunction specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk however, no study has till now has evaluated the time onset of these electrophysiological changes following smoking.

Method: Male smokers with atypical chest pain were screened with TMT. A total of 31 patients in whom TMT was either negative or mildly positive, underwent a 24-hour holter monitoring and were asked to note down the time of smoking.

Results: Heart rate increased significantly during smoking and came back to normal after 30 minutes. Smoking is also associated with an increased risk of ectopics (mean of 5.28 prior to smoking to 9.81 per hour during smoking to 11.29 during the next hour after smoking p 0.001). 3 patients had significant ST-T changes after smoking that lasted for half to two hours. HRV index is significantly decreased in smokers but spectral parameters- SDNN, RMSSD and SDANN remained normal.

Conclusion: Smoking increases heart rate and ectopic significantly. Ischemic ST-T changes were also detected during smoking. Spectral parameters of HRV analysis of smoker remained with normal limits but more important geometrical parameter -HRV index showed significant abnormality.


Keywords

HRV Heart Rate Variability, TMT Treadmill Test
Subscription Login to verify subscription
User
Notifications
Font Size


  • Harrsion principle of medicine, 17 th edition, page 2076
  • ezzati M, Henley SJ, role of smoking in global and regional cardiovascular mortality. circulation 112:489,2002
  • al-delaimy wk,manson JE,smoking and risl of hemorrhagic stroke in men. Stroke 34:1151,2003
  • barua RS, et al,reactive oxyfgen species are involved in smoking induced dysfunction of nitric oxide biosynthesis and upregulation of endothelial nitric oxide synthase, an in bitro demonstration in human coronary rtery endothelial ccells. Circulation 107,:2342;2007
  • Bazzano LA,HE j,relationship between cigarette smoking and novel risk factors for cardiovascular disease in united states, Ann Intern Med 138:891,2003
  • Akishima S, Matsushita S, Sato F, et al. Cigarettesmoke- induced vasoconstriction of peripheral arteries: evaluation by synchrotron radiation micro angiography. Circ J 2007;71(3):418-22.
  • Caralis DG, Deligonul U, Kern MJ, Cohen JD. Smoking is a risk factor for coronary spasm in young women. Circulation 1992;85(3):905-9.
  • Cigarette-Smoke-Induced Vasoconstriction of Peripheral Arteries Evaluation by Synchrotron Radiation Microangiography Shinji Akishima, MD; Shonosuke Matsushita, MD; Fujio Sato, MD; Kazuyuki Hyodo, PhD; Tomohiro Imazuru, MD; Yoshiharu Enomoto, MD; Mio Noma, MD; Yuji Hiramatsu, MD Osamu Shigeta, MD; Yuzuru Sakakibara, MD
  • Lauer MS, Pashkow FJ, Larson MG, Levy D. Association of cigarette smoking with chronotropic incompetence and prognosis in the Framingham Heart Study. Circulation 1997;96(3):897-903.
  • Srivastava R, Blackstone EH, Lauer MS. Association of smoking with abnormal exercise heart rate responses and long-term prognosis in a healthy, population-based cohort. Am J Med. 2000;109(1):20-6.
  • Heart rate variability as a prognostic tool in cardiology. A problem from a theoretical point of view 1994;90;1078-1082 Noordergraaf M Moser, M Lehofer, A Sedminek, M Lux, HG Zapotoczky, T Kenner .
  • silent ischemia,cardiovascular medicine, 3rd edition, spinger link, james wallerson.
  • Silent ischemia: a clinical update. G A Valle and L Lemberg Chest 1990;97;186-191 Smoking, Carbon Monoxide, and Coronary Heart Disease WILBERT S. ARONOW Circulation 1973;48;1169- 1172
  • heart rate variability in cardiology, brtisl Lek Listy, BMJ,2002:103(10):368-377
  • Lahiri et al. Assessment of Autonomic Function May 6, JACC Vol. 51, No. 18, 2008:1725–33
  • Rahimi K, Thomas A, Adam M, et al. Implications of exercise test modality on modern prognostic markers in patients with known or suspected coronary artery disease: treadmill versus bicycle. Eur J Cardiovasc Prev Rehabil. 2006 Feb;13(1):45-50.
  • Acute Exposure to Environmental Tobacco Smoke and Heart Rate Variability C. Arden Pope, III,1 Delbert J. Eatough, Diane R. Gold, Yanbo Pang,1 Karen R. Nielsen, Prema Nath, Richard L. Verrier, and Richard E. Kanner, Environ Health Perspect 109:711–716 (2001)
  • Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation93:1043–1065 (1996).
  • Dekker J, Crow R, Folsom A, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC study. Circulation 2000;102: 1239–44.
  • de Bruyne M, Kors J, Hoes A, et al. Both decreased and increased heart rate variability on the standard 10-second electrocardiogram predict cardiac mortality in the elderly: the Rotterdam Study. Am J Epidemiol 1999;150:1282– 8.
  • Stein PK, Rottman JN, Kleiger RE. Effect of 21 mg transdermal nicotine patches and smoking cessation on heart rate variability. Am J Cardiol 77:701–705 (1996).

Abstract Views: 611

PDF Views: 0




  • Effects of Active Smoking on Heart Rate Variability, Heart Rate & Various Other Cardiac Risk Events in Chronic Smokers

Abstract Views: 611  |  PDF Views: 0

Authors

Pranay Swarnkar
Assistant Professor, Department of Internal Medicine
Narendra Kumar
Assistant Professor, Department of Physiology
Kamya Verma
Senior Resident, Department of Pathology
Sunny Goel
Junior Resident, Department of Internal Medicine, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh

Abstract


Background: Smoking increases the risk of vasospasm and arrhythmias, and may decrease heart rate variability (HRV). Shown to increase the risk for cardiovascular diseases and autonomic dysfunction specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk however, no study has till now has evaluated the time onset of these electrophysiological changes following smoking.

Method: Male smokers with atypical chest pain were screened with TMT. A total of 31 patients in whom TMT was either negative or mildly positive, underwent a 24-hour holter monitoring and were asked to note down the time of smoking.

Results: Heart rate increased significantly during smoking and came back to normal after 30 minutes. Smoking is also associated with an increased risk of ectopics (mean of 5.28 prior to smoking to 9.81 per hour during smoking to 11.29 during the next hour after smoking p 0.001). 3 patients had significant ST-T changes after smoking that lasted for half to two hours. HRV index is significantly decreased in smokers but spectral parameters- SDNN, RMSSD and SDANN remained normal.

Conclusion: Smoking increases heart rate and ectopic significantly. Ischemic ST-T changes were also detected during smoking. Spectral parameters of HRV analysis of smoker remained with normal limits but more important geometrical parameter -HRV index showed significant abnormality.


Keywords


HRV Heart Rate Variability, TMT Treadmill Test

References