Acute effects of using an electronic nicotine-delivery device (electronic cigarette) on myocardial function: comparison with the effects of regular cigarettes

Abstract

BackgroundElectronic cigarettes have been developed and marketed in recent years as smoking substitutes. However, no studies have evaluated their effects on the cardiovascular system. The purpose of this study was to examine the immediate effects of electronic cigarette use on left ventricular (LV) function, compared to the well-documented acute adverse effects of smoking.MethodsEchocardiographic examinations were performed in 36 healthy heavy smokers (SM, age 36 ± 5 years) before and after smoking 1 cigarette and in 40 electronic cigarette users (ECIG, age 35 ± 5 years) before and after using the device with “medium-strength” nicotine concentration (11 mg/ml) for 7 minutes. Mitral flow diastolic velocities (E, A), their ratio (E/A), deceleration time (DT), isovolumetric relaxation time (IVRT) and corrected-to-heart rate IVRT (IVRTc) were measured. Mitral annulus systolic (Sm), and diastolic (Em, Am) velocities were estimated. Myocardial performance index was calculated from Doppler flow (MPI) and tissue Doppler (MPIt). Longitudinal deformation measurements of global strain (GS), systolic (SRs) and diastolic (SRe, SRa) strain rate were also performed.ResultsBaseline measurements were similar in both groups. In SM, IVRT and IVRTc were prolonged, Em and SRe were decreased, and both MPI and MPIt were elevated after smoking. In ECIG, no differences were observed after device use. Comparing after-use measurements, ECIG had higher Em (P = 0.032) and SRe (P = 0.022), and lower IVRTc (P = 0.011), MPI (P = 0.001) and MPIt (P = 0.019). The observed differences were significant even after adjusting for changes in heart rate and blood pressure.ConclusionsAlthough acute smoking causes a delay in myocardial relaxation, electronic cigarette use has no immediate effects. Electronic cigarettes’ role in tobacco harm reduction should be studied intensively in order to determine whether switching to electronic cigarette use may have long-term beneficial effects on smokers’ health.Trial registrationCurrent Controlled Trials ISRCTN16974547

Short‐Term E‐Cigarette Exposure Increases the Risk of Thrombogenesis and Enhances Platelet Function in Mice

“…Furthermore, some of these studies were contradictory, with some reporting no cardiovascular harm,11, 12 whereas others found e‐cigarettes to be harmful 13, 14. In support of the latter notion, several studies have shown that e‐cigarettes are associated with an increase in blood pressure, aortic stiffness, endothelial dysfunction, and oxidative stress 6, 13, 14, 15.…”

Hormonal contraception among electronic cigarette users and cardiovascular risk: a systematic review

“…Of these, 13 articles met inclusion criteria for this review [49][50][51][52][53][54][55][56][57][58][59][60][61]. One article reported on the clinical outcomes of interest (two cases of MI) [49].…”

“…One article reported on the clinical outcomes of interest (two cases of MI) [49]. Eleven articles measured heart rate and BP after EC exposure [50][51][52][53][54][55][56][57][58][59][60]. In 5 of these articles, investigators followed participants for at least 1 week [49,[57][58][59][60], but in 7 articles, authors only reported acute outcomes (changes over b 5 h of exposure) [50][51][52][53][54][55][56].…”

“…We identified seven studies in which investigators observed individuals using ECs in laboratory settings for short time periods (≤ 5 h of observation per session) [50][51][52][53][54][55][56] (Table 2). Participants attended one [50,54] to six [53] sessions.…”

“…Participants attended one [50,54] to six [53] sessions. Each of these studies reported only acute results (e.g., changes to heart rate or BP after short periods of EC use).…”