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Long-term smoking causes more advanced coronary endothelial dysfunction in middle-aged smokers compared to young smokers

  • Original Article
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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Smoking cessation has been shown to normalize the coronary endothelial dysfunction in healthy young smokers. However, its effect has not been explored in middle-aged smokers with a longer history of smoking. Therefore, we compared the effects of smoking cessation on coronary vasomotor response between both young and middle-aged smokers and identified the predictor for its improvement.

Methods

This study investigated 14 young healthy smokers (age 25.2 ± 2.3 years), 13 middle-aged smokers (age 42.0 ± 6.5 years) and 10 non-smokers. Myocardial blood flow (MBF) was measured by using 15O-water positron emission tomography (PET).

Results

At baseline, the ratio of MBF during the cold pressor test (CPT) to that at rest (MBFCPT/rest), the index of coronary endothelial function, was significantly decreased in both young and middle-aged smokers compared to non-smokers (1.24 ± 0.20 and 1.10 ± 0.39 vs 1.53 ± 0.18, p < 0.05 and p < 0.001, respectively). The ratio of MBF during adenosine triphosphate infusion to that at rest was significantly decreased in middle-aged smokers compared to young smokers and non-smokers (3.34 ± 1.52 vs 4.43 ± 0.92 and 4.69 ± 1.25, p < 0.05, respectively). MBFCPT/rest at 1 month after smoking cessation significantly increased in young smokers, but not in middle-aged smokers. By multivariate analysis, baseline serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) was an independent predictor for the changes in MBFCPT/rest after smoking cessation (β = –0.45, p < 0.05).

Conclusion

Coronary endothelial dysfunction was reversible by short-term smoking cessation in young smokers, but not in middle-aged smokers, which was associated with serum MDA-LDL levels. Long-term smoking exposure could lead to more advanced coronary endothelial dysfunction and atherosclerosis possibly via oxidative stress.

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Abbreviations

ATP:

Adenosine triphosphate

BP:

Blood pressure

CPT:

Cold pressor test

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

MBF:

Myocardial blood flow

MBFATP/rest :

Ratio of myocardial blood flow during adenosine triphosphate infusion to that at rest

MBFCPT/rest :

Ratio of myocardial blood flow during the cold pressor test to that at rest

MDA:

Malondialdehyde

PET:

Positron emission tomography

RPP:

Rate-pressure product

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Acknowledgement

This study was supported in part by the Grants-in-Aid for Young Scientists (20790871) from the Ministry of Education, Culture, Sports, Science and Technology, Japan (MN), in part by The Mochida Memorial Foundation for Medical and Pharmaceutical Research, Japan (MN), and in part by the Smoking Research Foundation, Japan (NT).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Masanao Naya, Daisuke Goto & Hiroyuki Tsutsui

  2. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Koichi Morita, Osamu Manabe, Kenji Hirata & Nagara Tamaki

  3. Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Keiichiro Yoshinaga

  4. Department of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Chietsugu Katoh

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  1. Masanao Naya
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  2. Koichi Morita
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  4. Osamu Manabe
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  9. Hiroyuki Tsutsui
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Correspondence to Masanao Naya.

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Naya, M., Morita, K., Yoshinaga, K. et al. Long-term smoking causes more advanced coronary endothelial dysfunction in middle-aged smokers compared to young smokers. Eur J Nucl Med Mol Imaging 38, 491–498 (2011). https://doi.org/10.1007/s00259-010-1647-2

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  • DOI: https://doi.org/10.1007/s00259-010-1647-2

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