Impact of smoking on left and right ventricular systolic function and left ventricular mass in young healthy males: A two- and three-dimensional echocardiographic study

Objective: Cigarette smoking has been associated with increased mortality, mainly due to cardiovascular diseases (CVDs).The relationship between tobacco use and CVDs is complex, and that between cigarette smoking and echocardiographic measurements of right ventricular (RV) and left ventricular (LV) structure and function has been poorly studied.This study aimed to evaluate the effect of smoking on LV and RV systolic functions and LV mass (LVM) in young healthy males using two (2D) and three-dimensional (3D) transthoracic echocardiography (TTE).Methods: Data for this observational study were collected by screening of 1013 males (smokers and non-smokers) including relatives of patients, workers, medical students and hospital clerks in Cairo University hospitals for thirty months and after history taking and clinical examination.Exclusion was done for any candidate with any comorbidities or history of any drug addiction or cannabis consumption or athletes and/or those who perform forcible sports, any candidate with poor echogenic window or any valvular lesions.Overall, 489 healthy males aged 18-35 years were grouped into smoker (123 participants) and non-smoker (366 participants) groups, then subjected to standard 2D TTE after exclusion of to evaluate dimensions and systolic function of LV and RV, then 3D TTE was used to evaluate LV volumes, systolic function and LVM.Results: Among the smoker group, the 2D TTE parameters revealed a trend towards increasing most of the values.However, only septal and posterior walls thickness (p=0.03 and p=0.01, respectively), LV myocardial performance index (p = 0.029), LVM and that indexed to body surface are (BSA) (p=0.004 and p=0.008 respectively), RV basal and mid cavity diameters (both p<0.0001),RV end-diastolic area and that indexed to BSA (both p<0.0001), and end systolic area and that indexed to BSA (p=0.016 and p=0.041, respectively) showed statistically significant higher values.The LV 3D TTE parameters also revealed similar trend in the smoker group.However, only LVM and that indexed to BSA (both p<0.0001) showed statistically significant higher values. Conclusion:In young healthy males, smoking was associated with subtle alterations in RV structure and LV structure and function.