Electronic 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 toexamine the immediate effects of electronic cigarette use on left ventricular (LV) function, compared to thewell-documented acute adverse effects of smoking.
Echocardiographic examinations were performed in 36 healthy heavy smokers (SM, age 36 ± 5 years) beforeand after smoking 1 cigarette and in 40 electronic cigarette users (ECIG, age 35 ± 5 years) before and after using thedevice 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 performanceindex 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.
Baseline measurements were similar in both groups. In SM, IVRT and IVRTc were prolonged, Em and SRe weredecreased, 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 heartrate and blood pressure.
Although acute smoking causes a delay in myocardial relaxation, electronic cigarette use has noimmediate effects. Electronic cigarettes’role in tobacco harm reduction should be studied intensively in order todetermine whether switching to electronic cigarette use may have long-term beneficial effects on smokers’health.
Current Controlled Trials ISRCTN16974547