The Left Ventricular Growth Response to Exercise and Cigarette Smoking; Data from the LARGE Heart Study

John Payne ^1*, Kyriacos Eleftheriou ¹, Laurence James ¹, Emma Hawe ¹, Jack Mann ¹, Alex Stronge ², Paul Kotwinski ¹, Michael World ³, Steve Humphries ¹, Dudley Pennell ⁴ and Hugh Montgomery ¹

¹ University College London, United Kingdom
² Army Training Regiment Lichfield, United Kingdom
³ Royal Centre for Defence Medicine, United Kingdom
⁴ Royal Brompton Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: jrp{at}tennick.com.

Accepted 14 June 2006

Abstract

Objectives: Increasing left ventricular (LV) mass is a risk factor for cardiovascular morbidity and mortality. In this study, we sought to examine the possible association of smoking with the LV growth response in men.

Methods and Results: LV mass was measured in 309 Army recruits before and after an identical 12-week physical training program. LV mass was determined using cardiovascular magnetic resonance (CMR) and increased with training (mean +SD: +3.83g ± 10.81g, P<0.0001). By univariate analysis, exercise-induced change in LV mass was positively associated with cigarette smoking (+1.69 ± 11.10g vs +4.76 ± 10.23g for [never smokers] vs [ex- and current smokers] respectively P=0.026), whereas neither age, height, diastolic and systolic blood pressure (SBP), alcohol consumption nor indices of physical activity were significantly associated with change in LV mass. Multivariate analysis showed body weight, smoking status and SBP to be independent predictors of LV mass (incremental R2=3.4%, P=0.004; R2=4.9%, P=0.024; and R2=1.7%, P=0.041 respectively).

Conclusions: Cigarette smoking and SBP are associated with exercise-induced LV growth in young men. The positive association of smoking with change in LV mass is surprising given the limited exposure of these subjects to smoking, and although these data do not prove causation, they of great interest to those trying to uncover the drivers of LV hypertrophy as well as those examining the possible ill-effects of smoking in the young.

Keywords: cardiovascular magnetic resonance, exercise, hypertrophy, left ventricle, smoking

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