RESUMEN
This study included 165 COPD heavy smoker patients with a mean age of 59.9 +/- 8.9 year referred for echo Doppler and cardiac assessment. They were divided according to their type of smoked material into three groups; cigarette smoker group, meassel water-pipe smoker group and cigarette and water-pipe smoker group. The aim of the study was to assess the prevalence of echo Doppler abnormalities in those patients looking for any specific pattern induced by meassel. The results have shown that the common effects of the whole smoker groups when compared to the non-smoker group were as follows: Severe reduction in FEV 1/FVC%, arterial pO2 reduction, left ventricular diastolic dysfunction, right ventricular diastolic dysfunction, impaired index of global right ventricular function, decreased pulmonary acceleration time and right ventricular enlargement. However, water-pipe smoker group if compared to cigarette smoker group showed more aggressive pulmonary obstruction, more degree of pulmonary hypertension, more right ventricular enlargement and more deterioration of right ventricular global function index. In conclusion, the hazards of heavy water-pipe meassel smoking on echo Doppler, FEV1/FVC% and arterial blood gases indices are not only similar to those of heavy cigarette smoking but also it cause more respiratory obstruction, more pulmonary hypertension and more deleterious effect on right ventricular size and global function