Evidence map›Paper›PMID 27625349›Full record

Observational studyCirculation. Cardiovascular imaging2016

Smoking and Cardiac Structure and Function in the Elderly: The ARIC Study (Atherosclerosis Risk in Communities).

Wilson Nadruz, Brian Claggett, Alexandra Gonçalves, Gabriela Querejeta-Roca, Miguel M Fernandes-Silva, Amil M Shah, Susan Cheng, Hirofumi Tanaka, Gerardo Heiss, Dalane W Kitzman and 1 more

Open access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Cardiovascular imaging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 63 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Smoking behavior changes and risk of cardiovascular diseases after cancer diagnosis: a nationwide cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Preventing new-onset heart failure: Intervening at stage A.American journal of preventive cardiology · 2023
    Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 3 countries.

Wilson NadruzFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Brian ClaggettFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Alexandra GonçalvesFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Gabriela Querejeta-RocaFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Miguel M Fernandes-SilvaFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Amil M ShahFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Susan ChengFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Hirofumi TanakaFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Gerardo HeissFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Dalane W KitzmanFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
Scott D SolomonFrom the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.). ssolomon@rics.bwh.harvard.edu.
The University of Texas at Austin · USUniversidade Estadual de Campinas (UNICAMP) · BRWake Forest University · USUniversidade do Porto · PTUniversity of North Carolina at Chapel Hill · US

Funding

Myocardial and Arterial Aging: Spectrum, Correlates, and PrognosisR00HL107642 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI CHENG, SUSAN · 2014 to 2016
$747k
Systolic & diastolic dysfunction in heart failure and preserved ejection fractionK08HL116792 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SHAH, AMIL M · 2013 to 2017
$735k
NHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100005GNHLBI NIH HHS HHSN268201100005INHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100007INHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100008INHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100009INHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100011INHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS K08 HL116792NHLBI NIH HHS R00 HL107642
6 · The paper itself

Abstract

backgroundCigarette smoking has been associated with higher risk of incident heart failure independent of coronary artery disease, but the impact of tobacco use on cardiac structure and function in the general population is uncertain. This study evaluated the relationship between smoking and echocardiographic measures in a large elderly cohort. METHODS AND

resultsWe studied 4580 participants free of overt coronary artery disease, heart failure, and significant valvular disease from the fifth visit of the ARIC study (Atherosclerosis Risk in Communities) who underwent transthoracic echocardiography. Participants were classified into 3 categories based on self-reported smoking habits: never (43.2%), former (50.5%), and current smokers (6.3%). Pack-years and years of smoking were also estimated. Compared with never smokers, current smokers had greater left ventricular (LV) mass index (80.4±1.1 versus 76.7±0.4 g/m(2); P<0.001), LV mass/volume ratio (1.93±0.03 versus 1.83±0.03 g/mL; P<0.001), higher prevalence of LV hypertrophy (15% versus 9%; P=0.008), and worse diastolic function, as reflected by higher E/E' ratio (11.7±0.2 versus 10.9±0.1; P<0.001), after adjusting for potential confounding factors. In contrast, former smokers showed similar echocardiographic features when compared with never smokers. Furthermore, estimated pack-years and years of smoking, measures of cumulative cigarette exposure, were associated with greater LV mass index, LV mass/volume ratio, and worse diastolic function (higher E/E' ratio) in current smokers after multivariable analysis (all P<0.01).

conclusionsActive smoking and cumulative cigarette exposure were associated with subtle alterations in LV structure and function in an elderly, community-based population free of overt coronary artery disease and heart failure.

Indexed as

AgingAgedAged, 80 and overAge FactorsAtherosclerosisChi-Square DistributionCross-Sectional StudiesDiastoleEchocardiographyFemaleHumansHypertrophy, Left VentricularLinear ModelsMaleMiddle AgedMultivariate Analysisatherosclerosisechocardiographyepidemiological studiesheart failuresmoking

Identifiers

PMID27625349
PMCPMC5193104
OpenAlexW2523190994

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.