Article Text
Abstract
Objective To describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function.
Methods Participants (n=1069; 68 % female; age 45–74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education).
Results SHS exposure in childhood only was associated with reduced E/A velocity ratio (β=−0.06 (SE 0.02), p=0.008). SHS exposure in adolescence/adult only was associated with increased left ventricular ejection fraction (LVEF) (1.2 (0.6), p=0.04), left atrial volume index (1.7 (0.8), p=0.04) and decreased isovolumic relaxation time (−0.003 (0.002), p=0.03). SHS exposure in childhood and adolescence/adult was associated with worse left ventricular global longitudinal strain (LVGLS) (two-chamber) (0.8 (0.4), p= 0.049). Compared with individuals who do not live with a tobacco smoker, individuals who currently live with at least one tobacco smoker had reduced LVEF (−1.4 (0.6), p=0.02), LVGLS (average) (0.9 (0.40), p=0.03), medial E′ velocity (−0.5 (0.2), p=0.01), E/A ratio (−0.09 (0.03), p=0.003) and right ventricular fractional area change (−0.02 (0.01), p=0.01) with increased isovolumic relaxation time (0.006 (0.003), p=0.04).
Conclusions Past and current household exposure to SHS was associated with abnormalities in cardiac systolic and diastolic function. Reducing household SHS exposure may be an opportunity for cardiac dysfunction prevention to reduce the risk of future clinical heart failure.
- tobacco smoke pollution
- echocardiography
- epidemiology
- heart failure
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors All authors fulfil the International Committee of Medical Journal Editors recommendations for authorship. Conceived and designed the research: MSBP and CJR. Performed statistical analysis: KS, MSBP and CJR. Interpretation of statistical analysis: KS, MSBP and CJR. Data acquisition: RCK, KP, MD, JC, ALG, MDG abd CJR. Drafted the manuscript: MSBP and CJR. Made critical revision of the manuscript for key intellectual content: MSBP, RCK, KP, MD, JC, MMK, EJV, ALG, MDG and CJR.
Funding The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) was performed as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01- HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236) and San Diego State University (N01-HC65237). The following institutes/centres/offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke and National Institutes of Health Institution-Office of Dietary Supplements. Echo-SOL was supported by a grant from the NHLBI (R01 HL104199, Epidemiological Determinants of Cardiac Structure and Function among Hispanics: CJR as principal investigator).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Wake Forest School of Medicine.
Provenance and peer review Not commissioned; externally peer reviewed.