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Abnormal left ventricular global strain during exercise-test in young healthy smokers

Background. It is unknown how much precociously the cigarette smoking (CS) may compromise the integrity of the cardiovascular (CV) system. Myocardial function can be routinely assessed by conventional echocardiography, but abnormalities are only detected when somewhat a remodelling has already occur...

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Autores principales: Mandraffino, Giuseppe, Imbalzano, Egidio, Lo Gullo, Alberto, Zito, Concetta, Morace, Carmela, Cinquegrani, Maria, Savarino, Francesca, Oreto, Lilia, Giuffrida, Clemente, Carerj, Scipione, Squadrito, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105457/
https://www.ncbi.nlm.nih.gov/pubmed/32231243
http://dx.doi.org/10.1038/s41598-020-62428-7
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author Mandraffino, Giuseppe
Imbalzano, Egidio
Lo Gullo, Alberto
Zito, Concetta
Morace, Carmela
Cinquegrani, Maria
Savarino, Francesca
Oreto, Lilia
Giuffrida, Clemente
Carerj, Scipione
Squadrito, Giovanni
author_facet Mandraffino, Giuseppe
Imbalzano, Egidio
Lo Gullo, Alberto
Zito, Concetta
Morace, Carmela
Cinquegrani, Maria
Savarino, Francesca
Oreto, Lilia
Giuffrida, Clemente
Carerj, Scipione
Squadrito, Giovanni
author_sort Mandraffino, Giuseppe
collection PubMed
description Background. It is unknown how much precociously the cigarette smoking (CS) may compromise the integrity of the cardiovascular (CV) system. Myocardial function can be routinely assessed by conventional echocardiography, but abnormalities are only detected when somewhat a remodelling has already occurred. These limitations could be overcome by strain imaging. Methods. We evaluated whether young smokers with normal left ventricular (LV) geometry, wall motion and ejection fraction may present abnormalities in myocardial deformation, both at rest and during physical effort. We selected 50 young smokers with no additional CV risk factors, and 60 non-smokers to undergo a standardized exercise-test. Consistently, we evaluated the CV adaptation to exercise by both conventional echocardiography and speckle-tracking analysis (2D-STE). Results. We found no difference between smokers and controls regarding baseline characteristics; as expected, smokers presented with lower HDL-cholesterol (p < 0.005), and higher fibrinogen, C-reactive protein (CRP), and interleukin-6 (p < 0.001). Conventional echocardiography parameters were not different between groups, while we detected a different behaviour of global longitudinal strain (GLS), global circumferential strain (GCS) and twist by 2D-STE during exercise-test. Indeed, GLS, GCS and twist behaved differently during exercise test in smokers with respect to controls. We found an association between CS, inflammation and LV mechanics changes uncovered by physical effort, and regression analysis confirmed that the intensity of the exposure to cigarette smoking, together with the inflammatory status (CRP, fibrinogen and Il-6) plasma levels, drive this impairment. Conclusions. We confirm strain imaging (2D-STE) as a very useful tool to identify early changes in cardiac mechanics, as adaptation to exercise; our findings may reflect a very precocious functional abnormality in active smokers, likely long before structural damage occurs.
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spelling pubmed-71054572020-04-06 Abnormal left ventricular global strain during exercise-test in young healthy smokers Mandraffino, Giuseppe Imbalzano, Egidio Lo Gullo, Alberto Zito, Concetta Morace, Carmela Cinquegrani, Maria Savarino, Francesca Oreto, Lilia Giuffrida, Clemente Carerj, Scipione Squadrito, Giovanni Sci Rep Article Background. It is unknown how much precociously the cigarette smoking (CS) may compromise the integrity of the cardiovascular (CV) system. Myocardial function can be routinely assessed by conventional echocardiography, but abnormalities are only detected when somewhat a remodelling has already occurred. These limitations could be overcome by strain imaging. Methods. We evaluated whether young smokers with normal left ventricular (LV) geometry, wall motion and ejection fraction may present abnormalities in myocardial deformation, both at rest and during physical effort. We selected 50 young smokers with no additional CV risk factors, and 60 non-smokers to undergo a standardized exercise-test. Consistently, we evaluated the CV adaptation to exercise by both conventional echocardiography and speckle-tracking analysis (2D-STE). Results. We found no difference between smokers and controls regarding baseline characteristics; as expected, smokers presented with lower HDL-cholesterol (p < 0.005), and higher fibrinogen, C-reactive protein (CRP), and interleukin-6 (p < 0.001). Conventional echocardiography parameters were not different between groups, while we detected a different behaviour of global longitudinal strain (GLS), global circumferential strain (GCS) and twist by 2D-STE during exercise-test. Indeed, GLS, GCS and twist behaved differently during exercise test in smokers with respect to controls. We found an association between CS, inflammation and LV mechanics changes uncovered by physical effort, and regression analysis confirmed that the intensity of the exposure to cigarette smoking, together with the inflammatory status (CRP, fibrinogen and Il-6) plasma levels, drive this impairment. Conclusions. We confirm strain imaging (2D-STE) as a very useful tool to identify early changes in cardiac mechanics, as adaptation to exercise; our findings may reflect a very precocious functional abnormality in active smokers, likely long before structural damage occurs. Nature Publishing Group UK 2020-03-30 /pmc/articles/PMC7105457/ /pubmed/32231243 http://dx.doi.org/10.1038/s41598-020-62428-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Mandraffino, Giuseppe
Imbalzano, Egidio
Lo Gullo, Alberto
Zito, Concetta
Morace, Carmela
Cinquegrani, Maria
Savarino, Francesca
Oreto, Lilia
Giuffrida, Clemente
Carerj, Scipione
Squadrito, Giovanni
Abnormal left ventricular global strain during exercise-test in young healthy smokers
title Abnormal left ventricular global strain during exercise-test in young healthy smokers
title_full Abnormal left ventricular global strain during exercise-test in young healthy smokers
title_fullStr Abnormal left ventricular global strain during exercise-test in young healthy smokers
title_full_unstemmed Abnormal left ventricular global strain during exercise-test in young healthy smokers
title_short Abnormal left ventricular global strain during exercise-test in young healthy smokers
title_sort abnormal left ventricular global strain during exercise-test in young healthy smokers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105457/
https://www.ncbi.nlm.nih.gov/pubmed/32231243
http://dx.doi.org/10.1038/s41598-020-62428-7
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