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(Circulation. 1974;50:340.)
© 1974 American Heart Association, Inc.

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Effect of Cigarette Smoking and Breathing Carbon Monoxide on Cardiovascular Hemodynamics in Anginal Patients

WILBERT S. ARONOW M.D.¹; JOHN CASSIDY M.D.¹; JACK S. VANGROW M.D.¹; HAROLD MARCH M.D.¹; JOHN C. KERN M.D.¹; JOHN R. GOLDSMITH M.D.¹; MAHAVEER KHEMKA M.D.¹; JAMES PAGANO M.D.¹; MICHAEL VAWTER M.D.¹

¹ From the Cardiology Section, Medical Service, Long Beach Veterans Administration Hospital, the University of California College of Medicine, Irvine, and the California State Department of Public Health, Berkeley, California.

Smoking high-nicotine cigarettes caused a significant increase in systolic and diastolic arterial pressure, heart rate, left ventricular end-diastolic pressure, and coronary sinus, arterial, and venous CO levels, no significant change in left ventricular dp/dt, aortic systolic ejection period, and cardiac index, and a significant decrease in stroke index and coronary sinus, arterial, and venous PO₂ levels in eight anginal patients with documented coronary disease. One week later, these patients inhaled 150 ppm of carbon monoxide until their increase in coronary sinus CO was similar to that produced after smoking their third cigarette. Inhaling carbon monoxide caused a significant increase in left ventricular end-diastolic pressure and coronary sinus, arterial, and venous CO levels, no significant change in systolic and diastolic arterial pressure, heart rate, and systolic ejection period, and a significant decrease in left ventricular dp/dt, stroke index, cardiac index, and coronary sinus, arterial, and venous PO₂ levels. Nicotine caused the increased systolic and diastolic arterial pressure and heart rate after smoking. Carbon monoxide caused the negative inotropic effect which increased the left ventricular end-diastolic pressure and decreased the stroke index after smoking.

Key Words: Nicotine • Heart rate • Left ventricular contractility • Coronary heart disease • Cardiac index • Coronary sinus • Arterial pressure • Stroke index

Submitted on February 11, 1974
Accepted on March 21, 1974

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