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Abstract：
BACKGROUND: In assessing the effects of smoking cessation on endothelial function, low-flow-mediated constriction (L-FMC) may provide complementary information to flow-mediated dilation (FMD). However, the value of flow-mediated total dilation (FMTD), an index that incorporates L-FMC into FMD, remains underreported. We aimed to evaluate the effect of smoking cessation on endothelial function, as assessed by FMD and FMTD, and clarify its associated clinical factors.
METHODS: We enrolled 118 consecutive current smokers without previous coronary artery disease (72.9% were men; age: 59 ± 11 years) who underwent smoking cessation treatment. The clinical variables %FMD, %L-FMC, and %FMTD were examined before and 20 weeks after treatment initiation. A multivariate linear regression model was used to investigate the effects of smoking cessation on %FMD and %FMTD and the interaction between smoking cessation and baseline clinical variables.
RESULTS: After 20 weeks, 85 smokers (69.4% were men; age: 59 ± 12 years) ceased smoking (abstainers), whereas 33 smokers (81.8% were men; age: 58 ± 11 years) did not (continued smokers). The estimated group differences (abstainers - continued smokers) in changes in the %FMD and %FMTD were 0.77% (95% confidence interval [CI], -0.22-1.77%; p = 0.129) and 1.17% (95% CI, 0.16-2.18%; p = 0.024), respectively. Smoking cessation-associated improvement in %FMTD was greater in women than in men (5.41% [95% CI, 3.15-7.67%] versus 0.24% [95% CI, -0.81-1.28%]; p-value for interaction, < 0.001). Additionally, a greater %FMTD improvement was observed in patients who smoked fewer cigarettes per day (p-value for interaction, 0.042) and those who had a smaller resting baseline lumen diameter (Dbase) (p-value for interaction, 0.023).
CONCLUSIONS: Smoking cessation was associated with an improvement in %FMTD. Sex, cigarettes smoked per day, and Dbase significantly affected this improvement. The FMTD may help in risk stratification after smoking cessation.
METHODS: We enrolled 118 consecutive current smokers without previous coronary artery disease (72.9% were men; age: 59 ± 11 years) who underwent smoking cessation treatment. The clinical variables %FMD, %L-FMC, and %FMTD were examined before and 20 weeks after treatment initiation. A multivariate linear regression model was used to investigate the effects of smoking cessation on %FMD and %FMTD and the interaction between smoking cessation and baseline clinical variables.
RESULTS: After 20 weeks, 85 smokers (69.4% were men; age: 59 ± 12 years) ceased smoking (abstainers), whereas 33 smokers (81.8% were men; age: 58 ± 11 years) did not (continued smokers). The estimated group differences (abstainers - continued smokers) in changes in the %FMD and %FMTD were 0.77% (95% confidence interval [CI], -0.22-1.77%; p = 0.129) and 1.17% (95% CI, 0.16-2.18%; p = 0.024), respectively. Smoking cessation-associated improvement in %FMTD was greater in women than in men (5.41% [95% CI, 3.15-7.67%] versus 0.24% [95% CI, -0.81-1.28%]; p-value for interaction, < 0.001). Additionally, a greater %FMTD improvement was observed in patients who smoked fewer cigarettes per day (p-value for interaction, 0.042) and those who had a smaller resting baseline lumen diameter (Dbase) (p-value for interaction, 0.023).
CONCLUSIONS: Smoking cessation was associated with an improvement in %FMTD. Sex, cigarettes smoked per day, and Dbase significantly affected this improvement. The FMTD may help in risk stratification after smoking cessation.
摘要：
背景：在评估戒烟对内皮功能的影响时，低流量介导的收缩（L-FMC）可能为流量介导的扩张（FMD）提供补充信息。然而,流量介导的总扩张(FMTD)的值，将L-FMC纳入FMD的索引，仍然被低估了。我们旨在评估戒烟对内皮功能的影响，根据FMD和FMTD的评估，并阐明其相关临床因素。
方法：我们招募了118名连续吸烟者，这些吸烟者没有既往冠状动脉疾病（72.9%为男性；年龄：59±11岁），他们接受了戒烟治疗。临床变量%FMD，%L-FMC,在治疗开始前和治疗后20周检查%FMTD。使用多元线性回归模型来研究戒烟对％FMD和％FMTD的影响以及戒烟与基线临床变量之间的相互作用。
结果：20周后，85名吸烟者（69.4％为男性；年龄：59±12岁）停止吸烟（戒酒者），而33名吸烟者(81.8%为男性;年龄:58±11岁)没有(持续吸烟者)。%FMD和%FMTD变化的估计组差异(戒烟者-持续吸烟者)为0.77%(95%置信区间[CI],-0.22-1.77%；p=0.129)和1.17%(95%CI，0.16-2.18%；p=0.024)，分别。与戒烟相关的%FMTD改善在女性中大于男性(5.41%[95%CI,3.15-7.67%]vs.0.24%[95%CI,-0.81-1.28%];p值用于互动,<0.001)。此外,在每天吸烟较少的患者中观察到更大的%FMTD改善(相互作用的p值，0.042）和那些具有较小的静息基线管腔直径（Dbase）（相互作用的p值，0.023).
结论：戒烟与%FMTD的改善相关。性,每天吸烟，和Dbase显著影响了这一改进。FMTD可能有助于戒烟后的风险分层。
方法：我们招募了118名连续吸烟者，这些吸烟者没有既往冠状动脉疾病（72.9%为男性；年龄：59±11岁），他们接受了戒烟治疗。临床变量%FMD，%L-FMC,在治疗开始前和治疗后20周检查%FMTD。使用多元线性回归模型来研究戒烟对％FMD和％FMTD的影响以及戒烟与基线临床变量之间的相互作用。
结果：20周后，85名吸烟者（69.4％为男性；年龄：59±12岁）停止吸烟（戒酒者），而33名吸烟者(81.8%为男性;年龄:58±11岁)没有(持续吸烟者)。%FMD和%FMTD变化的估计组差异(戒烟者-持续吸烟者)为0.77%(95%置信区间[CI],-0.22-1.77%；p=0.129)和1.17%(95%CI，0.16-2.18%；p=0.024)，分别。与戒烟相关的%FMTD改善在女性中大于男性(5.41%[95%CI,3.15-7.67%]vs.0.24%[95%CI,-0.81-1.28%];p值用于互动,<0.001)。此外,在每天吸烟较少的患者中观察到更大的%FMTD改善(相互作用的p值，0.042）和那些具有较小的静息基线管腔直径（Dbase）（相互作用的p值，0.023).
结论：戒烟与%FMTD的改善相关。性,每天吸烟，和Dbase显著影响了这一改进。FMTD可能有助于戒烟后的风险分层。
