Acute use of an electronic cigarette for 7 minutes had no immediate adverse effects on left ventricular relaxation, whereas smoking one tobacco cigarette significantly prolonged corrected isovolumetric relaxation time (p=0.011).
Observational (n=76)
Single-blind (echocardiographer blinded to protocol)
No
Does acute electronic cigarette use prevent the immediate adverse effects on myocardial relaxation and diastolic function compared to smoking regular tobacco cigarettes in healthy subjects?
Acute use of electronic cigarettes does not cause the immediate impairment in myocardial relaxation and diastolic function that is observed after smoking regular tobacco cigarettes.
Absolute Event Rate: -1.2% vs 10.4%
p-value: p=0.011
BACKGROUND: 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 to examine the immediate effects of electronic cigarette use on left ventricular (LV) function, compared to the well-documented acute adverse effects of smoking. METHODS: Echocardiographic 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. RESULTS: Baseline 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. CONCLUSIONS: Although 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 REGISTRATION: Current Controlled Trials ISRCTN16974547.
Farsalinos et al. (Mon,) conducted a observational in Healthy heavy smokers and electronic cigarette users (n=76). Electronic cigarette use (11 mg/ml nicotine) vs. Tobacco cigarette smoking (1 cigarette) was evaluated on Change in corrected isovolumetric relaxation time (IVRTc) in milliseconds (p=0.011). Acute use of an electronic cigarette for 7 minutes had no immediate adverse effects on left ventricular relaxation, whereas smoking one tobacco cigarette significantly prolonged corrected isovolumetric relaxation time (p=0.011).