Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Magnetic Resonance Imaging | Research article

Effect of short-term smoking & L-arginine on coronary endothelial function assessed by cardiac magnetic resonance cold pressor testing: a pilot study

Authors: Andreas M. Weng, Herbert Köstler, Thorsten A. Bley, Christian O. Ritter

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

The effect of smoking on coronary vasomotion has been investigated in the past with various imaging techniques in both short- and long-term smokers. Additionally, coronary vasomotion has been shown to be normalized in long-term smokers by L-Arginine acting as a substrate for NO synthase, revealing the coronary endothelium as the major site of abnormal vasomotor response. Aim of the prospective cohort study was to investigate coronary vasomotion of young healthy short-term smokers via magnetic resonance cold pressor test with and without the administration of L-Arginine and compare obtained results with the ones from nonsmokers.

Methods

Myocardial blood flow (MBF) was quantified with first-pass perfusion MRI on a 1.5 T scanner in healthy short-term smokers (N = 10, age: 25.0 ± 2.8 years, 5.0 ± 2.9 pack years) and nonsmokers (N = 10, age: 34.3 ± 13.6) both at rest and during cold pressor test (CPT). Smokers underwent an additional examination after administration of L-Arginine within a median of 7 days of the naïve examination.

Results

MBF at rest turned out to be 0.77 ± 0.30 (smokers with no L-Arginine; mean ± standard deviation), 0.66 ± 0.21 (smokers L-Arginine) and 0.84 ± 0.08 (nonsmokers). Values under CPT were 1.21 ± 0.42 (smokers no L-Arginine), 1.09 ± 0.35 (smokers L-Arginine) and 1.63 ± 0.33 (nonsmokers). In all groups, MBF was significantly increased under CPT compared to the corresponding rest examination (p < 0.05 in all cases). Additionally, MBF under CPT was significantly different between the smokers and the nonsmokers (p = 0.002). MBF at rest was significantly different between the smokers when L-Arginine was given and the nonsmokers (p = 0.035).

Conclusion

Short-term smokers showed a reduced response to cold both with and without the administration of L-Arginine. However, absolute MBF values under CPT were lower compared to nonsmokers independently of L-Arginine administration.
Literature
1.
go back to reference Campisi R, Czernin J, Schöder H, et al.: Effects of long-term smoking on myocardial blood flow, coronary vasomotion, and vasodilator capacity. Circulation 1998:119–125. Campisi R, Czernin J, Schöder H, et al.: Effects of long-term smoking on myocardial blood flow, coronary vasomotion, and vasodilator capacity. Circulation 1998:119–125.
2.
go back to reference Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, et al. Cigarette smoking exposure and heart failure risk in older adults : the health, aging, and body composition study. Am Heart J. 2012;164:236–42.CrossRef Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, et al. Cigarette smoking exposure and heart failure risk in older adults : the health, aging, and body composition study. Am Heart J. 2012;164:236–42.CrossRef
3.
go back to reference Ahmed AA, Patel K, Nyaku MA, et al. Risk of heart failure and death after prolonged smoking cessation role of amount and duration of prior smoking. Circ Hear Fail. 2015;8:694–701.CrossRef Ahmed AA, Patel K, Nyaku MA, et al. Risk of heart failure and death after prolonged smoking cessation role of amount and duration of prior smoking. Circ Hear Fail. 2015;8:694–701.CrossRef
4.
go back to reference Kamimura D, Cain L, Mentz R, et al.: Cigarette smoking and incident heart failure. 2018:2572–2582. Kamimura D, Cain L, Mentz R, et al.: Cigarette smoking and incident heart failure. 2018:2572–2582.
5.
go back to reference Zeiher AM, Schächinger V, Minners J. Long-term cigarette smoking impairs endothelium-dependent coronary arterial vasodilator function. Circulation. 1995;92:1094–100.CrossRef Zeiher AM, Schächinger V, Minners J. Long-term cigarette smoking impairs endothelium-dependent coronary arterial vasodilator function. Circulation. 1995;92:1094–100.CrossRef
6.
go back to reference Selwyn AP, Kinlay S, Creager M, Libby P, Ganz P. Cell dysfunction in atherosclerosis and the ischemic manifestations of coronary artery disease. Am J Cardiol. 1997;79:17–23.CrossRef Selwyn AP, Kinlay S, Creager M, Libby P, Ganz P. Cell dysfunction in atherosclerosis and the ischemic manifestations of coronary artery disease. Am J Cardiol. 1997;79:17–23.CrossRef
7.
go back to reference Sanz J, Fayad ZA. Imaging of atherosclerotic cardiovascular disease. Nature. 2008;451(February):953–7.CrossRef Sanz J, Fayad ZA. Imaging of atherosclerotic cardiovascular disease. Nature. 2008;451(February):953–7.CrossRef
8.
go back to reference Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction testing and clinical relevance. Circulation. 2007;115:1285–95.CrossRef Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction testing and clinical relevance. Circulation. 2007;115:1285–95.CrossRef
9.
go back to reference Schindler TH, Zhang X, Prior JO, et al. Assessment of intra- and interobserver reproducibility of rest and cold pressor test-stimulated myocardial blood flow with 13N-ammonia and PET. Eur J Nucl Med Mol Imaging. 2007;34:1178–88.CrossRef Schindler TH, Zhang X, Prior JO, et al. Assessment of intra- and interobserver reproducibility of rest and cold pressor test-stimulated myocardial blood flow with 13N-ammonia and PET. Eur J Nucl Med Mol Imaging. 2007;34:1178–88.CrossRef
10.
go back to reference Iwado Y, Yoshinaga K, Furuyama H, et al. Decreased endothelium-dependent coronary vasomotion in healthy young smokers. Eur J Nucl Med. 2002;29:984–90.CrossRef Iwado Y, Yoshinaga K, Furuyama H, et al. Decreased endothelium-dependent coronary vasomotion in healthy young smokers. Eur J Nucl Med. 2002;29:984–90.CrossRef
11.
go back to reference Schindler TH, Facta AD, Prior JO, et al. PET-measured heterogeneity in longitudinal myocardial blood flow in response to sympathetic and pharmacologic stress as a non-invasive probe of epicardial vasomotor dysfunction. Eur J Nucl Med Mol Imaging. 2006;33:1140–9.CrossRef Schindler TH, Facta AD, Prior JO, et al. PET-measured heterogeneity in longitudinal myocardial blood flow in response to sympathetic and pharmacologic stress as a non-invasive probe of epicardial vasomotor dysfunction. Eur J Nucl Med Mol Imaging. 2006;33:1140–9.CrossRef
12.
go back to reference Campisi R, Czernin J, Scho H, Sayre JW, Schelbert HR. L-arginine normalizes coronary vasomotion in long-term smokers. Circulation. 1999;99:491–7.CrossRef Campisi R, Czernin J, Scho H, Sayre JW, Schelbert HR. L-arginine normalizes coronary vasomotion in long-term smokers. Circulation. 1999;99:491–7.CrossRef
13.
go back to reference Ochi N, Yoshinaga K, Ito YM, et al.: Comprehensive assessment of impaired peripheral and coronary artery endothelial functions in smokers using brachial artery ultrasound and oxygen-15-labeled water PET. J Cardiol 2016. Ochi N, Yoshinaga K, Ito YM, et al.: Comprehensive assessment of impaired peripheral and coronary artery endothelial functions in smokers using brachial artery ultrasound and oxygen-15-labeled water PET. J Cardiol 2016.
14.
go back to reference Cicala S, Pellegrino T, Storto G, et al. Noninvasive quantification of coronary endothelial function by SPECT imaging in children with a history of Kawasaki disease. Eur J Nucl Med Mol Imaging. 2010;37:2249–55.CrossRef Cicala S, Pellegrino T, Storto G, et al. Noninvasive quantification of coronary endothelial function by SPECT imaging in children with a history of Kawasaki disease. Eur J Nucl Med Mol Imaging. 2010;37:2249–55.CrossRef
15.
go back to reference Ritter CO, Kowalski M, Weng AM, Beer M, Hahn D, Köstler H. Quantitative myocardial perfusion imaging with a MR cold pressor test. Magn Reson Med. 2012;67:246–50.CrossRef Ritter CO, Kowalski M, Weng AM, Beer M, Hahn D, Köstler H. Quantitative myocardial perfusion imaging with a MR cold pressor test. Magn Reson Med. 2012;67:246–50.CrossRef
16.
go back to reference Weng AM, Wilimsky S, Bender G, Hahner S, Köstler H, Ritter CO: Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes. J Magn Reson Imaging 2018:1595–1601. Weng AM, Wilimsky S, Bender G, Hahner S, Köstler H, Ritter CO: Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes. J Magn Reson Imaging 2018:1595–1601.
17.
go back to reference Ichikawa Y, Kitagawa K, Kato S, et al.: Altered coronary endothelial function in young smokers detected by magnetic resonance assessment of myocardial blood flow during the cold pressor test. Int J Cardiovasc Imaging 2014. Ichikawa Y, Kitagawa K, Kato S, et al.: Altered coronary endothelial function in young smokers detected by magnetic resonance assessment of myocardial blood flow during the cold pressor test. Int J Cardiovasc Imaging 2014.
18.
go back to reference Kato S, Kitagawa K, Yoon YE, et al.: Detection of diminished response to cold pressor test in smokers: assessment using phase-contrast cine magnetic resonance imaging of the coronary sinus. Magn Reson Imaging 2014. Kato S, Kitagawa K, Yoon YE, et al.: Detection of diminished response to cold pressor test in smokers: assessment using phase-contrast cine magnetic resonance imaging of the coronary sinus. Magn Reson Imaging 2014.
19.
go back to reference Fairbairn TA, Motwani M, Mather AN, et al. Cardiac MR imaging to measure myocardial blood flow response to the cold pressor test in healthy smokers and nonsmokers. Radiology. 2014;270:82–90.CrossRef Fairbairn TA, Motwani M, Mather AN, et al. Cardiac MR imaging to measure myocardial blood flow response to the cold pressor test in healthy smokers and nonsmokers. Radiology. 2014;270:82–90.CrossRef
20.
go back to reference Köstler H, Sandstede JW, Lipke C. Auto-Sense perfusion imaging of the whole human heart. J Magn Reson Imaging. 2003;708:702–8.CrossRef Köstler H, Sandstede JW, Lipke C. Auto-Sense perfusion imaging of the whole human heart. J Magn Reson Imaging. 2003;708:702–8.CrossRef
21.
go back to reference Ritter CO, Wilke A, Wichmann T, Beer M, Hahn D, Köstler H. Comparison of intravascular and extracellular contrast media for absolute quantification of myocardial rest-perfusion using high-resolution MRI. J Magn Reson Imaging. 2011;33:1047–51.CrossRef Ritter CO, Wilke A, Wichmann T, Beer M, Hahn D, Köstler H. Comparison of intravascular and extracellular contrast media for absolute quantification of myocardial rest-perfusion using high-resolution MRI. J Magn Reson Imaging. 2011;33:1047–51.CrossRef
22.
go back to reference Stäb D, Wech T, Breuer FA, et al. High resolution myocardial first-pass perfusion imaging with extended anatomic coverage. J Magn Reson Imaging. 2014;39:1575–87.CrossRef Stäb D, Wech T, Breuer FA, et al. High resolution myocardial first-pass perfusion imaging with extended anatomic coverage. J Magn Reson Imaging. 2014;39:1575–87.CrossRef
23.
go back to reference Otazo R, Kim D, Axel L, Sodickson DK. Combination of compressed sensing and parallel imaging for highly accelerated first-pass cardiac perfusion MRI. Magn Reson Med. 2010;64:767–76.CrossRef Otazo R, Kim D, Axel L, Sodickson DK. Combination of compressed sensing and parallel imaging for highly accelerated first-pass cardiac perfusion MRI. Magn Reson Med. 2010;64:767–76.CrossRef
24.
go back to reference Knott KD, Camaioni C, Ramasamy A, et al.: Quantitative myocardial perfusion in coronary artery disease: a perfusion mapping study. J Magn Reson Imaging 2019. Knott KD, Camaioni C, Ramasamy A, et al.: Quantitative myocardial perfusion in coronary artery disease: a perfusion mapping study. J Magn Reson Imaging 2019.
25.
go back to reference Nakajima T, Oriuchi N, Tsushima Y, Funabasama S, Aoki J, Endo K. Noninvasive determination of regional myocardial perfusion with first-pass magnetic resonance (MR) imaging. Acad Radiol. 2004;11:802–8.CrossRef Nakajima T, Oriuchi N, Tsushima Y, Funabasama S, Aoki J, Endo K. Noninvasive determination of regional myocardial perfusion with first-pass magnetic resonance (MR) imaging. Acad Radiol. 2004;11:802–8.CrossRef
26.
go back to reference Weng AM, Ritter CO, Beer M, Hahn D, Köstler H. Quantitative pixelwise myocardial perfusion maps from first-pass perfusion MRI. Br J Radiol. 2014;87:20130727.CrossRef Weng AM, Ritter CO, Beer M, Hahn D, Köstler H. Quantitative pixelwise myocardial perfusion maps from first-pass perfusion MRI. Br J Radiol. 2014;87:20130727.CrossRef
27.
go back to reference Vogel-claussen J, Skrok J, Shehata ML, et al. Right and left ventricular myocardial perfusion reserves correlate with right ventricular function and pulmonary hemodynamics in patients with pulmonary arterial hypertension. Radiology. 2011;258:119–27.CrossRef Vogel-claussen J, Skrok J, Shehata ML, et al. Right and left ventricular myocardial perfusion reserves correlate with right ventricular function and pulmonary hemodynamics in patients with pulmonary arterial hypertension. Radiology. 2011;258:119–27.CrossRef
28.
go back to reference Unlu M, Anik Y, Demirci A, Ural D, Kahraman G, Komsuoglu B. Cardiac MRI in ischemic heart disease with severe coronary artery stenosis. Acad Radiol. 2006;13:1387–93.CrossRef Unlu M, Anik Y, Demirci A, Ural D, Kahraman G, Komsuoglu B. Cardiac MRI in ischemic heart disease with severe coronary artery stenosis. Acad Radiol. 2006;13:1387–93.CrossRef
29.
go back to reference Ma H, Zhang Y, Chen J, Yang J. Whole left ventricular coverage versus conventional 3-slice myocardial perfusion magnetic resonance imaging for the detection of suspected coronary artery disease. Acad Radiol. 2019;26:519–25.CrossRef Ma H, Zhang Y, Chen J, Yang J. Whole left ventricular coverage versus conventional 3-slice myocardial perfusion magnetic resonance imaging for the detection of suspected coronary artery disease. Acad Radiol. 2019;26:519–25.CrossRef
30.
go back to reference Cullen JH, Horsfield MA, Reek CR, Cherryman GR, Barnett DB, Samani NJ. A myocardial perfusion reserve index in humans using first-pass contrast-enhanced magnetic resonance imaging. J Am Coll Cardiol. 1999;33:1386–94.CrossRef Cullen JH, Horsfield MA, Reek CR, Cherryman GR, Barnett DB, Samani NJ. A myocardial perfusion reserve index in humans using first-pass contrast-enhanced magnetic resonance imaging. J Am Coll Cardiol. 1999;33:1386–94.CrossRef
31.
go back to reference Pack NA, DiBella EVR. Comparison of myocardial perfusion estimates from dynamic contrast-enhanced magnetic resonance imaging with four quantitative analysis methods. Magn Reson Med. 2010;64:125–37.CrossRef Pack NA, DiBella EVR. Comparison of myocardial perfusion estimates from dynamic contrast-enhanced magnetic resonance imaging with four quantitative analysis methods. Magn Reson Med. 2010;64:125–37.CrossRef
32.
go back to reference Fritz-Hansen T, Hove JD, Kofoed KF, Kelbaek H, Larsson HBW. Quantification of MRI measured myocardial perfusion reserve in healthy humans: a comparison with positron emission tomography. J Magn Reson Imaging. 2008;27:818–24.CrossRef Fritz-Hansen T, Hove JD, Kofoed KF, Kelbaek H, Larsson HBW. Quantification of MRI measured myocardial perfusion reserve in healthy humans: a comparison with positron emission tomography. J Magn Reson Imaging. 2008;27:818–24.CrossRef
33.
go back to reference Morris SM. Arginine metabolism in vascular biology and disease. Vasc Med. 2005;10:83–7.CrossRef Morris SM. Arginine metabolism in vascular biology and disease. Vasc Med. 2005;10:83–7.CrossRef
34.
go back to reference Michel T. R is for arginine : metabolism of arginine takes off again, in new directions. Circulation. 2013;125:1400–4.CrossRef Michel T. R is for arginine : metabolism of arginine takes off again, in new directions. Circulation. 2013;125:1400–4.CrossRef
35.
go back to reference Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet. 1991;338:1546–50.CrossRef Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet. 1991;338:1546–50.CrossRef
36.
go back to reference Köstler H, Ritter CO, Lipp M, Beer M, Hahn D, Sandstede J. Prebolus quantitative MR heart perfusion imaging. Magn Reson Med. 2004;52:296–9.CrossRef Köstler H, Ritter CO, Lipp M, Beer M, Hahn D, Sandstede J. Prebolus quantitative MR heart perfusion imaging. Magn Reson Med. 2004;52:296–9.CrossRef
37.
go back to reference Weng AM, Ritter CO, Lotz J, Beer MJ, Hahn D, Köstler H. Automatic postprocessing for the assessment of quantitative human myocardial perfusion using MRI. Eur Radiol. 2010;20:1356–65.CrossRef Weng AM, Ritter CO, Lotz J, Beer MJ, Hahn D, Köstler H. Automatic postprocessing for the assessment of quantitative human myocardial perfusion using MRI. Eur Radiol. 2010;20:1356–65.CrossRef
38.
go back to reference Köstler H, Ritter C, Lipp M, Beer M, Hahn D, Sandstede J. Comparison of different contrast agents and doses for quantitative MR myocardial perfusion imaging. J Magn Reson Imaging. 2008;28:382–9.CrossRef Köstler H, Ritter C, Lipp M, Beer M, Hahn D, Sandstede J. Comparison of different contrast agents and doses for quantitative MR myocardial perfusion imaging. J Magn Reson Imaging. 2008;28:382–9.CrossRef
39.
go back to reference Weng AM, Wilimsky S, Bender G, Hahner S, Köstler H, Ritter CO. Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes. J Magn Reson Imaging. 2018;48:1595–601.CrossRef Weng AM, Wilimsky S, Bender G, Hahner S, Köstler H, Ritter CO. Magnetic resonance cold pressor test to investigate potential endothelial dysfunction in patients suffering from type 1 diabetes. J Magn Reson Imaging. 2018;48:1595–601.CrossRef
40.
go back to reference Köstler H, Ritter CO, Reiss-Zimmermann M, Beer M, Hahn D, Sandstede J. Correction for partial volume errors in MR heart perfusion imaging. Magn Reson Med. 2004;51:848–52.CrossRef Köstler H, Ritter CO, Reiss-Zimmermann M, Beer M, Hahn D, Sandstede J. Correction for partial volume errors in MR heart perfusion imaging. Magn Reson Med. 2004;51:848–52.CrossRef
41.
go back to reference Weng AM, Ritter CO, Lotz J, Beer M, Hahn D, Köstler H. Automatic postprocessing for the assessment of quantitative human myocardial perfusion using MRI. Eur Radiol. 2010;20:1356–65.CrossRef Weng AM, Ritter CO, Lotz J, Beer M, Hahn D, Köstler H. Automatic postprocessing for the assessment of quantitative human myocardial perfusion using MRI. Eur Radiol. 2010;20:1356–65.CrossRef
42.
go back to reference Wang Y, Passic M. Preliminary quantitative myocardial perfusion in response to cold pressor test in normals. J Cardiovasc Magn Res. 2013;15(Suppl 1):2013. Wang Y, Passic M. Preliminary quantitative myocardial perfusion in response to cold pressor test in normals. J Cardiovasc Magn Res. 2013;15(Suppl 1):2013.
43.
go back to reference Prior JO, Schindler TH, Facta AD, et al. Determinants of myocardial blood flow response to cold pressor testing and pharmacologic vasodilation in healthy humans. Eur J Nucl Med Mol Imaging. 2007;34:20–7.CrossRef Prior JO, Schindler TH, Facta AD, et al. Determinants of myocardial blood flow response to cold pressor testing and pharmacologic vasodilation in healthy humans. Eur J Nucl Med Mol Imaging. 2007;34:20–7.CrossRef
44.
go back to reference Williams MC, Mirsadraee S, Dweck MR, et al. Computed tomography myocardial perfusion vs 15O-water positron emission tomography and fractional flow reserve. Eur Radiol. 2017;27:1114–24.CrossRef Williams MC, Mirsadraee S, Dweck MR, et al. Computed tomography myocardial perfusion vs 15O-water positron emission tomography and fractional flow reserve. Eur Radiol. 2017;27:1114–24.CrossRef
Metadata
Title
Effect of short-term smoking & L-arginine on coronary endothelial function assessed by cardiac magnetic resonance cold pressor testing: a pilot study
Authors
Andreas M. Weng
Herbert Köstler
Thorsten A. Bley
Christian O. Ritter
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02050-1

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue