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Endothelial function
Light cigarette smoking impairs coronary microvascular functions as severely as smoking regular cigarettes
  1. Hakan Gullu1,
  2. Mustafa Caliskan1,
  3. Ozgur Ciftci1,
  4. Dogan Erdogan1,
  5. Semra Topcu1,
  6. Erkan Yildirim2,
  7. Aylin Yildirir1,
  8. Haldun Muderrisoglu1
  1. 1
    Baskent University, Faculty of Medicine, Cardiology Department, Ankara, Turkey
  2. 2
    Baskent University, Faculty of Medicine, Radiology Department, Ankara, Turkey
  1. Dr H Gullu, Baskent University, Konya Teaching and Medical Research Centre, Cardiology Department, Hoca Cihan Mah, Saray Cad, No 1, 42080, Selcuklu, Konya, Turkey; gulluhakan{at}


Background: Smoking is the most prevalent and most preventable risk factor for cardiovascular diseases. Smoking low-tar, low-nicotine cigarettes (light cigarettes) would be expected to be less hazardous than smoking regular cigarettes owing to the lower nicotine and tar yield.

Objective: To compare the chronic and acute effects of light cigarette and regular cigarette smoking on coronary flow velocity reserve (CFVR).

Methods: 20 regular cigarette smokers (mean (SD) age 24.8 (5.0)), 20 light cigarette smokers (mean age 25.6 (6.4)), and 22 non-smoker healthy volunteers (mean age 25.1 (4.2)) were included. First, each subject underwent echocardiographic examination, including CFVR measurement, after a 12 hour fasting and smokeless period. Two days later, each subject smoked two of their normal cigarettes in a closed room within 15 minutes. Finally, within 20–30 minutes, each subject underwent an echocardiographic examination, including CFVR measurement.

Results: Mean (SD) CFVR values were similar in light cigarette and regular cigarette smokers and significantly lower than in the controls (2.68 (0.50), 2.65 (0.61), 3.11 (0.53), p = 0.013). Before and after smoking a paired t test showed that smoking two light cigarettes acutely decreased the CFVR from 2.68 (0.50) to 2.05 (0.43) (p = 0.001), and smoking of two regular cigarettes acutely decreased CFVR from 2.65 (0.61) to 2.18 (0.48) (p = 0.001).

Conclusion: Smoking low-tar, low-nicotine cigarettes impairs the CFVR as severely as smoking regular cigarettes. CFVR values are similar in light cigarette and regular cigarette smokers and significantly lower than in controls.

  • light cigarettes
  • coronary flow reserve
  • echocardiography

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  • Abbreviations:
    coronary flow velocity reserve
    diastolic peak flow velocity
    left anterior descending artery