Effects of Endurance Exercise Training on Cardiac Dysfunction Induced by Waterpipe Tobacco Smoking

Document Type : Original Article


1 Department of Exercise Physiology, School of Sport Sciences, Urmia University, Urmia, Iran

2 Neuroscience Research Center, Institute of Neuropharmacology AND Cardiovascular Research Center, , Kerman University of Medical Sciences, Kerman, Iran

3 Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences AND Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

4 Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran

5 Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran


Background: There is an increasing popularity of waterpipe tobacco smoking (WTS) in youth and even in
athletes worldwide. Despite the existence of evidence of the harmful effects of hookah smoke on various
systems of the body, especially the cardiovascular system, its simultaneous effect with exercise training has
not been well studied. We assessed the effects of WTS exposure with/without swimming exercise on blood
pressure (BP), and heart histology and mechanical performance in male Wistar rats.
Methods: The animals were divided into 4 groups of sedentary control (CTL), waterpipe tobacco smoking (S),
mild endurance swimming exercise training (Ex), and waterpipe smoking plus exercise (S + Ex). The
duration of WTS and exercise was 8 weeks.
Findings: BP and heart rate (HR) did not show a significant difference among the groups. WTS increased the
TNF-α level of the heart (P < 0.05 vs. CTL) and cardiac tissue lesions (P < 0.05 vs. CTL), and reduced +dP/dt
max, -dp/dt max, and heart contractility indices (P < 0.01, P < 0.01, and P < 0.05, respectively, vs. CTL and
Ex groups). It also increased the Tau index (P < 0.05 vs. CTL; P < 0.01 vs. Ex groups) of the left ventricle.
However, the combination of exercise and WTS reduced the TNF-α level, improved the heart activity of
superoxide dismutase (SOD) and catalase enzymes, and prevented the negative effects of smoking on heart
function and morphology.
Conclusion: Mild exercise prevents WTS-induced left ventricular systolic and diastolic dysfunction partly via
improvement of antioxidants and attenuation of pro-inflammatory cytokines.


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