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

There is an increasing popularity of waterpipe tobacco smoking (WTS) in youth and even inathletes worldwide. Despite the existence of evidence of the harmful effects of hookah smoke on varioussystems of the body, especially the cardiovascular system, its simultaneous effect with exercise training hasnot been well studied. We assessed the effects of WTS exposure with/without swimming exercise on bloodpressure (BP), and heart histology and mechanical performance in male Wistar rats. 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). Theduration of WTS and exercise was 8 weeks. BP and heart rate (HR) did not show a significant difference among the groups. WTS increased theTNF-α level of the heart (P < 0.05 vs. CTL) and cardiac tissue lesions (P < 0.05 vs. CTL), and reduced +dP/dtmax, -dp/dt max, and heart contractility indices (P < 0.01, P < 0.01, and P < 0.05, respectively, vs. CTL andEx 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 ofsuperoxide dismutase (SOD) and catalase enzymes, and prevented the negative effects of smoking on heartfunction and morphology. Mild exercise prevents WTS-induced left ventricular systolic and diastolic dysfunction partly viaimprovement of antioxidants and attenuation of pro-inflammatory cytokines.