ENDS use in young adults was associated with reduced right ventricular peak long-axis longitudinal strain (-16.84 vs -19.46; p=0.024) and lower pulmonary artery flow compared to healthy controls.
Observational (n=27)
Does Electronic Nicotine Delivery Systems (ENDS) use alter cardiac strain and pulmonary arterial flow in asymptomatic young adults?
Cardiac MRI reveals early subclinical reductions in pulmonary artery flow and right ventricular function in asymptomatic young adult ENDS users, suggesting impaired pulmonary circulation.
Absolute Event Rate: -16.84% vs -19.46%
p-value: p=0.024
Abstract Rationale Electronic Nicotine Delivery Systems (ENDS) use is increasingly prevalent, especially among young adults. There is limited quantitative information regarding the effects of ENDS on cardiovascular and pulmonary function in otherwise healthy subjects. We hypothesize that ENDS use will impact cardiac function, with early changes most likely to affect right heart function and pulmonary circulation. Here, we evaluate quantitative metrics of cardiac strain and arterial flow using cardiac magnetic resonance imaging (MRI) in a cohort of ENDS users, and compare them to age-matched healthy controls. Methods ENDS users and controls underwent pulmonary function testing (PFT) and time-resolved 3D phase-contrast MRI protocol with three-directional velocity encoding (4DFlow), with cardiac triggering. Arterial flow was measured using circular regions of interest drawn on the pulmonary artery (PA) using Tempus Pixel Cardio (Arterys Inc., Chicago, USA). Right and left ventricular (RV, LV) boundaries were manually segmented and automatically tracked using the Strain Analysis Module (MedViso AB, Lund, Sweden). Summary metrics included mean flow in the PA, and peak global (i.e. average across ventricle wall segments) short and long axis strain for both LV and RV across the cardiac cycle. Flow is typically normalized using body surface area, but here we use forced vital capacity (FVC) as an anatomical surrogate for lung size. Results Nineteen ENDS users (11F/8M) and eight age-matched controls (6F/2M) were assessed. Demographics, PFT, and Cardiac MRI summary results are presented in Table 1. Peak long-axis longitudinal strain was significantly lower in the RV for ENDS users (-16.84 ± 2.60 vs. -19.46 ± 2.29 in controls, p = 0.024). Note that by convention, longitudinal strain uses end-systolic length as reference and is therefore reported as negative. There were no significant differences in LV strain or circumferential strain in either ventricle. PA flow was significantly reduced in ENDS users, (64.40 ± 10.50 vs. 74.48 ± 8.87 mL/s/L in controls, p = 0.042) normalized to FVC. Conclusions Cardiac MRI detects reduction in PA flow and RV function in asymptomatic ENDS users suggesting early evidence of impaired pulmonary circulation. In conjunction with prior work demonstrating a reduction in pulmonary vascular volume, these findings support the hypothesis that cardiovascular dynamics are altered in ENDS users, potentially driven by vascular remodeling in the lungs. These subclinical markers may indicate early-stage disease and help identify mechanism of functional decline. This abstract is funded by: NIH/NHLBI R01HL 169765, NIH NCATS S10OD026960, NIH NCATS S10OD025025, NIH CTSA UM1TR004403, NIH R25TR004393
Spain et al. (Fri,) conducted a observational in Electronic Nicotine Delivery Systems (ENDS) use (n=27). Electronic Nicotine Delivery Systems (ENDS) use vs. Age-matched healthy controls was evaluated on Peak long-axis longitudinal strain in the right ventricle (p=0.024). ENDS use in young adults was associated with reduced right ventricular peak long-axis longitudinal strain (-16.84 vs -19.46; p=0.024) and lower pulmonary artery flow compared to healthy controls.