Abstract 14447: Dose Response Effect of Cigarette Smoking on Cardiac Function and Heart Failure in the Multi-Ethnic Study of Atherosclerosis

Abstract

Background: Pack years of cigarette consumption (PYCC) reflects the accumulated lifetime exposure to smoking and is associated with pulmonary function. However, the association with cardiac function or incident congestive heart failure (CHF) has not been established. We hypothesized that PYCC had a significant relationship with left ventricle (LV) long axis strain (LAS), a sensitive marker of LV function, and with incident heart failure events in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods: At baseline,PYCC was registered in 6790 asymptomatic MESA participants (53% men). Moreover, LAS was assessed from conventional cine cardiac MR images in a randomly selected cohort (n=1656, 53% men). All participants were followed for a median of 7.0 years. We tested the association between PYCC and LAS using linear regression, and the association between PYCC and incident CHF using Cox regression analysis after adjustment for Framingham risk score for heart failure events (age, gender, BMI, heart rate, systolic blood pressure or hypertension, diabetes and LV mass indexed to body surface area).

Results: A total of 172 HF events were observed. PYCC was significantly associated with reduced LAS even after adjustment (Table 1). LAS was significantly higher in never smokers compared to smokers (11.9 ± 2.4 vs 11.3 ± 2.7, p=0.003). PYCC was significantly associated with incident heart failure events, before and after adjustment (Table 2). Differentiation between current and previous smokers did not significantly affect the results.

Conclusion: Left ventricle systolic function is associated with pack years of cigarette consumption. Moreover, the risk for incident congestive heart failure increases with increasing cigarette consumption.