Abstract 12610: Effect of Smoking Reduction on Endothelial Glucocalyx and Arterial Wave Reflection During Medically-aided Smoking Cessation Program
The integrity of endothelial glucocalyx plays a vital role in vascular permeability and inlammation.Smoking cessation is related with improved vascular function.Pharmacotherapy is a standard component of evidence based smoking cessation treatment.This study investigated the effects medically-aided smoking cessation on glucocalyx thickness and arterial elasticity.
Methods: We examined 119 smokers (58% males,age:51±10y )without cardiovascular disease treated with transdermal nicotine patches(60%) and/or varenicline (40%) before, at 4 and 12 weeks after treatment during validated smoking cessation program.We measured a )exhaled carbon monoxide(CO, ppm), self-reported number of cigarretes/day b)carotid-femoral pulse wave velocity(PWVc m/sec) and augmentation index(AI %)c)perfused boundary region (PBR)of the sublingual arterial microvessels (ranged from 5-25 microns) using Sideview Darkfield imaging.The PBR in microvessels is the cell-poor layer which results from the phase separation between the flowing red blood cells (RBC)and plasma.The PBR includes the most luminal part of glycocalyx that does allow cell penetration.Increased PBR is considered an accurate index of reduced endothelial glucocalyx thickness because of a deeper RBC penetration in the glucocalyx.Twenty non-smokers served as controls
Results: At baseline smokers had higher PBR,PWVc and AI than non-smokers (2.05±0.17vs.1.77±0.14,10±2 vs.8.5±2,33±18vs.15±10,p≤0.05).At 12 weeks of follow-up there was a reduction of CO,number of smoked cigarettes (32±18 vs.10±13 and 31±8 vs.6±9,) and a parallel reduction of PBR (2.05±0.17 vs.1.93±0.24),and AI (33±18vs.15±1 )(p≤0.05).These differences in vascular markers were not evident after 4 weeks of f/u. At 12 weeks a decreasing CO was related with improved PBR,PWV and AI (r=0.88,r=0.53,r=0.47,p≤0.05) while an improved PBR was related with reduced AI (r=0.47,p≤0.05)
Conclusion: Endothelial glucocalyx thickness is reduced in smokers compared to non-smokers.Medically-aided smoking reduction contributes to restoration of glucocalyx thickness and reduction of abnormal arterial wave reflections. Improvement of Endothelial glucocalyx is linked with improved arterial elasticity during smoking cessation.
- © 2013 by American Heart Association, Inc.