Deficiency in nitric oxide bioactivity in epicardial coronary arteries of cigarette smokers

Division of Cardiology, Kumamoto University School of Medicine, Japan. kiyo@gpo.kumamoto-u.ac.jp

OBJECTIVES: This study sought to examine nitric oxide-mediated regulation of epicardial coronary arterial tone in cigarette smokers. BACKGROUND: Cigarette smoking is a major risk factor for coronary artery disease and is highly prevalent in patients with coronary spastic angina. Long-term exposure to cigarette smoking has been recently reported to suppress endothelium-dependent arterial relaxation in vivo humans. METHODS: Responses of epicardial coronary artery diameter to single or combined infusion of acetylcholine and NG-monomethyl-L-arginine (L-NMMA) into the left main coronary artery were examined in 11 current smokers and 17 nonsmokers using quantitative coronary angiography. RESULTS: Acetylcholine dilated one-third of the proximal segments and most of the distal segments of coronary arteries in nonsmokers, whereas it constricted most of the proximal and distal segments in smokers. L-NMMA decreased the basal diameter of coronary arteries in nonsmokers but had minimal effect on the basal diameter in smokers. L-NMMA abolished the dilator response to acetylcholine in the coronary arteries of nonsmokers but had minimal effect on the constrictor response to acetylcholine in the arteries of smokers. The dilator response to nitroglycerin was significantly increased in the coronary arteries of smokers compared with in those of nonsmokers. The constrictor response to L-NMMA at rest was significantly correlated with the dilator response to nitroglycerin and with the diameter changes to acetylcholine in both smokers and nonsmokers. CONCLUSIONS: Nitric oxide bioactivity at rest and at acetylcholine-stimulated conditions in smokers was decreased, leading to the supersensitivity of the artery to the dilator effect of nitroglycerin as well as the constrictor effect of acetylcholine in smokers. Cigarette smoking affects nitric oxide-mediated regulation of coronary artery tone.

This article has been cited by other articles:

				L. Politi, D. E. Monopoli, F. A. Sgura, R. Rossi, F. Bursi, and M. G. Modena Spontaneous Echocardiographic Wall Motion Abnormalities in Variant Angina Circulation, July 1, 2008; 118(1): e4 - e6. [Full Text] [PDF]

				J.-e. Obata and K. Kugiyama Reply. J. Am. Coll. Cardiol., March 18, 2008; 51(11): 1125 - 1125. [Full Text] [PDF]

				J R Payne, K I Eleftheriou, L E James, E Hawe, J Mann, A Stronge, P Kotwinski, M World, S E Humphries, D J Pennell, et al. Left ventricular growth response to exercise and cigarette smoking: data from LARGE Heart Heart, December 1, 2006; 92(12): 1784 - 1788. [Abstract] [Full Text] [PDF]

				X. Guo, M. J. Oldham, M. T. Kleinman, R. F. Phalen, and G. S. Kassab Effect of cigarette smoking on nitric oxide, structural, and mechanical properties of mouse arteries Am J Physiol Heart Circ Physiol, November 1, 2006; 291(5): H2354 - H2361. [Abstract] [Full Text] [PDF]

				W.-Z. Zhang, K. Venardos, J. Chin-Dusting, and D. M. Kaye Adverse Effects of Cigarette Smoke on NO Bioavailability: Role of Arginine Metabolism and Oxidative Stress Hypertension, August 1, 2006; 48(2): 278 - 285. [Abstract] [Full Text] [PDF]

				P. K. Mishra Variations in presentation and various options in management of variant angina. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 748 - 759. [Abstract] [Full Text] [PDF]

				Y. Ichigi, H. Takano, K. Umetani, K. Kawabata, J.-e. Obata, Y. Kitta, Y. Kodama, A. Mende, T. Nakamura, D. Fujioka, et al. Increased Ambulatory Pulse Pressure Is a Strong Risk Factor for Coronary Endothelial Vasomotor Dysfunction J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1461 - 1466. [Abstract] [Full Text] [PDF]

				Y. Murase, Y. Yamada, A. Hirashiki, S. Ichihara, H. Kanda, M. Watarai, F. Takatsu, T. Murohara, and M. Yokota Genetic risk and gene-environment interaction in coronary artery spasm in Japanese men and women Eur. Heart J., June 1, 2004; 25(11): 970 - 977. [Abstract] [Full Text] [PDF]

				J. A. Ambrose and R. S. Barua The pathophysiology of cigarette smoking and cardiovascular disease: An update J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1731 - 1737. [Abstract] [Full Text] [PDF]

				S.-i. Koide, K. Kugiyama, S. Sugiyama, S.-i. Nakamura, H. Fukushima, O. Honda, M. Yoshimura, and H. Ogawa Association of polymorphism in glutamate-cysteine ligase catalytic subunit gene with coronary vasomotor dysfunction and myocardial infarction J. Am. Coll. Cardiol., February 19, 2003; 41(4): 539 - 545. [Abstract] [Full Text] [PDF]

				J. P. J. Halcox, K. R. A. Nour, G. Zalos, R. Mincemoyer, M. A. Waclawiw, C. E. Rivera, G. Willie, S. Ellahham, and A. A. Quyyumi The effect of sildenafil on human vascular function, platelet activation, and myocardial ischemia J. Am. Coll. Cardiol., October 2, 2002; 40(7): 1232 - 1240. [Abstract] [Full Text] [PDF]

				R. S. Barua, J. A. Ambrose, L.-J. Eales-Reynolds, M. C. DeVoe, J. G. Zervas, and D. C. Saha Heavy and light cigarette smokers have similar dysfunction of endothelial vasoregulatory activity: An in vivo and in vitro correlation J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1758 - 1763. [Abstract] [Full Text] [PDF]

				R. S. Barua, J. A. Ambrose, L.-J. Eales-Reynolds, M. C. DeVoe, J. G. Zervas, and D. C. Saha Dysfunctional Endothelial Nitric Oxide Biosynthesis in Healthy Smokers With Impaired Endothelium-Dependent Vasodilatation Circulation, October 16, 2001; 104(16): 1905 - 1910. [Abstract] [Full Text] [PDF]

				K. Kugiyama, Y. Miyao, T. Sakamoto, H. Kawano, H. Soejima, S. Miyamoto, M. Yoshimura, H. Ogawa, S. Sugiyama, and H. Yasue Glutathione attenuates coronary constriction to acetylcholine in patients with coronary spastic angina Am J Physiol Heart Circ Physiol, January 1, 2001; 280(1): H264 - H271. [Abstract] [Full Text] [PDF]

				W. D. Clouse, H. Yamaguchi, M. R. Phillips, R. D. Hurt, L. A. Fitzpatrick, T. P. Moyer, C. Rowland, H. V. Schaff, and V. M. Miller Effects of transdermal nicotine treatment on structure and function of coronary artery bypass grafts J Appl Physiol, September 1, 2000; 89(3): 1213 - 1223. [Abstract] [Full Text] [PDF]

				N. Hirai, H. Kawano, O. Hirashima, T. Motoyama, Y. Moriyama, T. Sakamoto, K. Kugiyama, H. Ogawa, K. Nakao, and H. Yasue Insulin resistance and endothelial dysfunction in smokers: effects of vitamin C Am J Physiol Heart Circ Physiol, September 1, 2000; 279(3): H1172 - H1178. [Abstract] [Full Text] [PDF]

				Y. Miyao, K. Kugiyama, H. Kawano, T. Motoyama, H. Ogawa, M. Yoshimura, T. Sakamoto, and H. Yasue Diffuse intimal thickening of coronary arteries in patients with coronary spastic angina J. Am. Coll. Cardiol., August 1, 2000; 36(2): 432 - 437. [Abstract] [Full Text] [PDF]

				B. Szekacs, W. Dachman, and Z. Vajo Alterations of Venous Drug Reactivity in Humans: Acquired and Genetic Factors Angiology, May 1, 2000; 51(5): 361 - 366. [Abstract] [PDF]

				M. Nakayama, H. Yasue, M. Yoshimura, Y. Shimasaki, K. Kugiyama, H. Ogawa, T. Motoyama, Y. Saito, Y. Ogawa, Y. Miyamoto, et al. T-786->C Mutation in the 5'-Flanking Region of the Endothelial Nitric Oxide Synthase Gene Is Associated With Coronary Spasm Circulation, June 8, 1999; 99(22): 2864 - 2870. [Abstract] [Full Text] [PDF]

				M. Hamada, Y. Kazatani, K. Matsuzaki, E. Murakami, Y. Shigematsu, K. Hiwada, and K. Kodama Clinical Characteristics in Japanese Patients with Coexistent Hypertrophic Cardiomyopathy and Coronary Vasospasm Angiology, September 1, 1998; 49(9): 849 - 855. [Abstract] [PDF]

				H. Moreno Jr., S. Chalon, A. Urae, O. Tangphao, A. K. Abiose, B. B. Hoffman, and T. F. Blaschke Endothelial dysfunction in human hand veins is rapidly reversible after smoking cessation Am J Physiol Heart Circ Physiol, September 1, 1998; 275(3): H1040 - H1045. [Abstract] [Full Text] [PDF]

				R. Campisi, J. Czernin, H. Schoder, J. W. Sayre, F. D. Marengo, M. E. Phelps, and H. R. Schelbert Effects of Long-term Smoking on Myocardial Blood Flow, Coronary Vasomotion, and Vasodilator Capacity Circulation, July 14, 1998; 98(2): 119 - 125. [Abstract] [Full Text] [PDF]

				K. Kugiyama, T. Motoyama, O. Hirashima, M. Ohgushi, H. Soejima, K. Misumi, H. Kawano, Y. Miyao, M. Yoshimura, H. Ogawa, et al. Vitamin C attenuates abnormal vasomotor reactivity in spasm coronary arteries in patients with coronary spastic angina J. Am. Coll. Cardiol., July 1, 1998; 32(1): 103 - 109. [Abstract] [Full Text] [PDF]

				K. Kugiyama, H. Doi, T. Motoyama, H. Soejima, K. Misumi, H. Kawano, O. Nakagawa, M. Yoshimura, H. Ogawa, T. Matsumura, et al. Association of Remnant Lipoprotein Levels With Impairment of Endothelium-Dependent Vasomotor Function in Human Coronary Arteries Circulation, June 30, 1998; 97(25): 2519 - 2526. [Abstract] [Full Text] [PDF]

				K. Kugiyama, M. Ohgushi, T. Motoyama, O. Hirashima, H. Soejima, K. Misumi, M. Yoshimura, H. Ogawa, S. Sugiyama, and H. Yasue Intracoronary Infusion of Reduced Glutathione Improves Endothelial Vasomotor Response to Acetylcholine in Human Coronary Circulation Circulation, June 16, 1998; 97(23): 2299 - 2301. [Abstract] [Full Text] [PDF]

				T. Motoyama, H. Kawano, K. Kugiyama, O. Hirashima, M. Ohgushi, M. Yoshimura, H. Ogawa, and H. Yasue Endothelium-dependent vasodilation in the brachial artery is impaired in smokers: effect of vitamin C Am J Physiol Heart Circ Physiol, October 1, 1997; 273(4): H1644 - H1650. [Abstract] [Full Text] [PDF]