Department of Medical Education and General Practice, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku, Osaka, 545-8585, Japan.
Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Cardiovasc Ultrasound. 2024 Aug 14;22(1):11. doi: 10.1186/s12947-024-00329-9.
In assessing the effects of smoking cessation on endothelial function, low-flow-mediated constriction (L-FMC) may provide complementary information to flow-mediated dilation (FMD). However, the value of flow-mediated total dilation (FMTD), an index that incorporates L-FMC into FMD, remains underreported. We aimed to evaluate the effect of smoking cessation on endothelial function, as assessed by FMD and FMTD, and clarify its associated clinical factors.
We enrolled 118 consecutive current smokers without previous coronary artery disease (72.9% were men; age: 59 ± 11 years) who underwent smoking cessation treatment. The clinical variables %FMD, %L-FMC, and %FMTD were examined before and 20 weeks after treatment initiation. A multivariate linear regression model was used to investigate the effects of smoking cessation on %FMD and %FMTD and the interaction between smoking cessation and baseline clinical variables.
After 20 weeks, 85 smokers (69.4% were men; age: 59 ± 12 years) ceased smoking (abstainers), whereas 33 smokers (81.8% were men; age: 58 ± 11 years) did not (continued smokers). The estimated group differences (abstainers - continued smokers) in changes in the %FMD and %FMTD were 0.77% (95% confidence interval [CI], -0.22-1.77%; p = 0.129) and 1.17% (95% CI, 0.16-2.18%; p = 0.024), respectively. Smoking cessation-associated improvement in %FMTD was greater in women than in men (5.41% [95% CI, 3.15-7.67%] versus 0.24% [95% CI, -0.81-1.28%]; p-value for interaction, < 0.001). Additionally, a greater %FMTD improvement was observed in patients who smoked fewer cigarettes per day (p-value for interaction, 0.042) and those who had a smaller resting baseline lumen diameter (D) (p-value for interaction, 0.023).
Smoking cessation was associated with an improvement in %FMTD. Sex, cigarettes smoked per day, and D significantly affected this improvement. The FMTD may help in risk stratification after smoking cessation.
在评估戒烟对内皮功能的影响时，低流介导的收缩（L-FMC）可能为血流介导的扩张（FMD）提供补充信息。然而，将 L-FMC 纳入 FMD 的血流介导的总扩张（FMTD）的价值仍未得到充分报道。我们旨在评估戒烟对内皮功能的影响，通过 FMD 和 FMTD 进行评估，并阐明其相关的临床因素。
我们纳入了 118 例连续的当前吸烟者，这些吸烟者没有先前的冠心病（72.9%为男性；年龄：59±11 岁），他们接受了戒烟治疗。在治疗开始前和 20 周后，我们检查了临床变量 %FMD、%L-FMC 和 %FMTD。使用多元线性回归模型来研究戒烟对 %FMD 和 %FMTD 的影响，以及戒烟与基线临床变量之间的相互作用。
20 周后，85 名吸烟者（69.4%为男性；年龄：59±12 岁）戒烟成功（戒烟者），而 33 名吸烟者（81.8%为男性；年龄：58±11 岁）没有戒烟（继续吸烟者）。%FMD 和 %FMTD 的组间差异（戒烟者 - 继续吸烟者）估计分别为 0.77%（95%置信区间，-0.22-1.77%；p=0.129）和 1.17%（95%置信区间，0.16-2.18%；p=0.024）。戒烟与 %FMTD 改善相关的变化在女性中大于男性（5.41%[95%置信区间，3.15-7.67%]与 0.24%[95%置信区间，-0.81-1.28%]；p 值交互作用，<0.001）。此外，每天吸烟量较少的患者（p 值交互作用，0.042）和基线静息腔径（D）较小的患者（p 值交互作用，0.023）的 %FMTD 改善更为明显。
戒烟与 %FMTD 的改善相关。性别、每天吸烟量和 D 显著影响了这种改善。FMTD 可能有助于戒烟后的风险分层。
