Myocardial contrast echocardiography will be used to measure regional myocardial perfusion .

young hookah smokers will be randomized to have coronary endothelial function assessed before and after inhaling Carbon Monoxide or room air from a Douglas bag.

Test coronary endothelial function before after hookah smokers smoke charcoal-heated hookah and before and after age-matched cigarette smokers smoke 2 cigarettes. In the same subjects, we will test for acute smoking-induced changes in LV wall strain by speckle tracking. Finally, in a subset of subjects we will repeat the MCE and speckle tracking studies after pretreatment with either i.v. vitamin C or one dose of oral tadalafil.

Smoking

Endothelial Dysfunction

The Myocardial Blood Flow (MBF) will be measured at rest and during the last minute of a 3-minute bout of handgrip at 30% Maximal voluntary contraction. This sequence will be performed before and after 12 young hookah smokers are randomized to smoke the same popular Starbuzz tobacco product heated with either charcoal for 30 min each.

Charcoal hookah

The Myocardial Blood Flow (MBF) will be measured at rest and during the last minute of a 3-minute bout of handgrip at 30% Maximal voluntary contraction. This sequence will be performed before and after 12 young hookah smokers are randomized to smoke the same popular Starbuzz tobacco product heated with electrically (Global First "e-coal," ) for 30 min each.

E-coal hookah

The Myocardial Blood Flow (MBF) will be measured at rest and during the last minute of a 3-minute bout of handgrip at 30% Maximal voluntary contraction. This sequence will be performed before and after 12 young cigarette smokers smoke 2 cigarettes down to the stub over 30 min (to simulate real-world use).

Cigarette

A subset (n=8) of the young hookah smokers will return on a later day and will be randomized to have coronary endothelial function assessed before and after inhaling 0.3 CO gas from a Douglas bag.

Carbon Monoxide inhalation

A subset 8 of the young hookah smokers will return on a later day and will be randomized to have coronary endothelial function assessed before and after inhaling room air from a Douglas bag.

Room Air inhalation

in a subset of 6 subjects the study team will repeat the Myocardial Contrast Echocardiography and speckle tracking studies after pretreatment with either i.v. vitamin C .

vitamin C

in a subset of 6 subjects the study team will repeat the Myocardial Contrast Echocardiography and speckle tracking studies after pretreatment with one dose of oral tadalafil.

tadalafil

Cedars-Sinai Medical Center

Hookah Smoking, Carbon Monoxide, and Coronary Endothelial Function

the change in Myocardial Blood Flow between Baseline and post intervention.

Florian Rader

Staff Physician I

National Institutes of Health (NIH)

National Institute on Drug Abuse (NIDA)

In healthy young adults 18-39 years of age, The Investigator will determine if intermittent inhalation a 0.1% CO, from a 1-liter bag once every minute for 30-40 minutes, at a level that approaches the CO boost with hookah smoking, augments endothelial function, thus implicating CO as the major endothelial vasodilator substance in hookah smoke.

In healthy young adults 18-39 years of age, The investigator will determine if intermittent inhalation of 0.1% CO, from a 1-Liter bag once every minute for 30-40 min at a level that approaches the CO boost with hookah smoking, augments endothelial function.

Carbon Monoxide

Effects of Carbon Monoxide Breathing on Blood Vessel Function

assessment of endothelial function measured by brachial artery flow-mediated dilation after 30-40 minutes of carbon monoxide adminstration

charcoal/hypoxia

Hookah Smoking, Carbon Monoxide, and Coronary Endothelial Function

Effects of Carbon Monoxide Breathing on Blood Vessel Function

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