Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Departments of Medicine F and J, Recanati Autonomic Dysfunction Center, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
Int J Environ Res Public Health. 2020 Nov 19;17(22):8571. doi: 10.3390/ijerph17228571.
It has been suggested that some of the adverse, long-term cardiovascular outcomes of smoking are mediated by impaired autonomic nervous system (ANS) activity. Yet, this association is currently inconclusive. Heart rate variability (HRV) and the deep breathing test (DBT) represent common quantitative markers of ANS activity due to their simplicity and reliability. This large cross-sectional study was designed to assess the effect of active smoking on ANS function as manifested by HRV or DBT abnormalities. Electrocardiograms were recorded at rest for 5 min and during forced metronomic breathing. HRV and DBT were calculated according to accepted standards. Participants were divided into two groups based on current smoking status. The study included 242 healthy volunteers (196 nonsmokers and 46 smokers). There were no significant differences in age, sex, and BMI between groups. Cumulative smoking exposure burden (CSEB) for the study group was 5.3 ± 1.3 pack-years. Comparative analysis of HRV and DBT parameters according to smoking status revealed no significant differences between groups. Significant ( < 0.05), yet weak or moderate correlations (r < 0.7) were found between CSEB and abnormal change in HRV parameters consistent with sympathetic overactivity and decreased parasympathetic tone. In conclusion, smoking for a relatively short period in healthy adults does not seem to lead to significant impairment in ANS function. Yet, the consequences of smoking seem to be amplified when cumulative exposure burden increases.
有人认为，吸烟对心血管的一些不良长期影响是通过损害自主神经系统 (ANS) 活动来介导的。然而，目前这种关联尚无定论。心率变异性 (HRV) 和深呼吸试验 (DBT) 由于其简单性和可靠性，代表了 ANS 活动的常见定量标志物。这项大型横断面研究旨在评估主动吸烟对 HRV 或 DBT 异常表现的 ANS 功能的影响。在休息时记录了 5 分钟的心电图，并进行了强制韵律呼吸。根据公认的标准计算了 HRV 和 DBT。根据当前的吸烟状况将参与者分为两组。该研究包括 242 名健康志愿者（196 名不吸烟者和 46 名吸烟者）。两组在年龄、性别和 BMI 方面无显著差异。研究组的累积吸烟暴露量 (CSEB) 为 5.3 ± 1.3 包年。根据吸烟状况对 HRV 和 DBT 参数进行的比较分析显示，两组之间无显著差异。CSEB 与一致提示交感神经活性亢进和副交感神经张力降低的 HRV 参数的异常变化之间存在显著（<0.05），但较弱或中度相关（r <0.7）。总之，在健康成年人中吸烟相对较短的时间似乎不会导致 ANS 功能明显受损。然而，当累积暴露量增加时，吸烟的后果似乎会加剧。
