A link between cigarette smoking and heart failure?

in #science6 years ago

In the Circulation journal dated April 16, 2018, reports indicate researchers have linked cigarette smoking to left ventricular hypertrophy and heart failure in blacks.

by @vanessahampton

It is no longer news that excessive cigarette smoking is responsible for a range of cardiac dysfunctions including cancer. What wasn’t clear was how the cigarette smoking-induced the congestive heart failure.

The left ventricle powers the main arm of the systemic circulation by pumping blood through a greater distance than the right ventricle and with a higher force of contraction as it also has to work against gravity. For this reason, the left ventricle is considerably more muscular than the other heart chambers. An excessive increase in the musculature of the left ventricle is called left ventricular hypertrophy. With this increase, the left ventricular preload or the force it has to work against is increased. This causes the left ventricle to do more work than usual.

1024px-Heart_left_ventricular_hypertrophy_sa.jpgSource:
By Patrick J. Lynch CC BY 2.5

Hypertrophy of the left ventricles

If this continues, the left ventricle will gradually weaken and lose its ability to pump blood through the systemic circulation and the coronary blood vessels. Decreased blood supply to the coronary vessel will lead to ischemia that would only serve to weaken the heart further. Eventually, congestive heart failure will occur.

Any pathophysiology that increases the work of the left ventricle is susceptible to left ventricular hypertrophy and congestive heart failure. Some of these conditions include excessively high blood pressure, hypertrophic cardiomyopathy and aortic valve stenosis.

The Jackson Heart Study is an investigative research website with the goal of finding out how the pattern of cardiovascular diseases and genetic factors affect African Americans. In this study, 2884 black participants who had never smoked, 503 smokers and 742 former smokers with an average age of 54 years took part. By using cardiac magnetic resonance imaging, they were able to establish a link between cigarette smoking and left ventricular hypertrophy.

References

Cigarette smoking and incident heart failure: insights from the Jackson Heart study
Left Ventricular hypertrophy

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