Background: Chronic cigarette smoking is one of the major risk factors for coronary artery disease. However, it has additional cardiac adverse effects independent of coronary atherosclerosis. Patient and Methods: After informed consent and perm- ission from the review board of the hospital, 80 healthy subjects who were classified as smokers or non-smokers were included in the study. They were examined by standard echocardiography protocol which was followed by two-dimensional speckle tracking to assess the functions of the right ventricle. Results: The tricuspid annular plane systolic excursion (TAPSE) was significantly reduced in smokers as compared to non-smokers (P < 0.05). The tricuspid flow peak late diastolic velocity (A wave) was significantly higher in smokers (P < 0.05, and hence the E/A ratio was signif- icantly lower (P < 0.05). The tissue Doppler imaging examination of right ventricular free wall showed that the peak systolic velocity of right ventricular (RV) free wall (S’), and the peak early diastolic velocity of RV free wall (E’) were significantly lower in smokers when compared to the control group (P < 0.05 for both). The global longit- udinal strain (GLS) assessed by 2D-speckle tracking echo- cardiography was also significantly reduced in smokers (P < 0.05). Conclusion: This study demonstrates that chronic cigarette smoking causes alterations in long-axis systolic and diast- olic functions of right ventricle in healthy young subjects. These changes can be detected early with 2-D speckle tracking echocardiography.
