Exclusive electronic cigarette use was associated with a lower left ventricular cardiac index compared to controls (β = -0.25; 95% CI -0.49, -0.01; P=0.042) in healthy young adults.
Cross-Sectional (n=183)
Does habitual e-cigarette use reduce left ventricular cardiac index in healthy young adults?
Habitual e-cigarette use is associated with lower left ventricular cardiac index in healthy young adults, suggesting potential long-term cardiopulmonary risks.
Effect estimate: β = -0.25 (95% CI -0.49, -0.01)
p-value: p=0.042
Abstract Rationale Electronic cigarettes (EC) are marketed as a safe alternative to cigarettes, yet the cardiopulmonary risks of EC use are understudied. Prior studies have shown that acute exposure to EC aerosols was associated with short-term increases in heart rate and blood pressure, increased arterial stiffness, and vascular endothelial changes; however, the effects of habitual EC use on cardiac structure and function remain uncertain. We aimed to investigate the association of habitual EC use with cardiac magnetic resonance imaging (MRI) measures of cardiac function in healthy young adults. Methods The VapeScan Study recruited young adults aged 18-50 years without a history of cardiovascular or chronic obstructive pulmonary disease from the New York City area. Participants were recruited into one of four groups based on self-reported EC and cigarette use: no EC/cigarette use (controls), current EC/no cigarette use (exclusive EC use), current EC/former cigarette use, or current dual EC/cigarette use (dual use). Questionnaires, anthropometry, and gadolinium-enhanced cardiopulmonary MRI were performed. Semiautomated Circle (cvi42) software was used to measure left ventricular volumes and heart rate from which body-surface-area-adjusted left ventricular cardiac index (LVCI) was calculated. Associations with EC/cigarette use were tested by linear regression, with adjustment for age, sex, and systolic blood pressure. Results Among 183 participants (mean age 29 years, 46% male), there were 52 controls, 49 with exclusive EC use, 37 with current EC/former cigarette use, and 45 with dual use (mean 4 cigarettes/day). Among participants with EC use, the mean (SD) EC puffs-per-day was 99 (142). The mean (SD) LVCI was 3.33 L/min/m² (0.61). Compared to controls, LVCI was lower with exclusive EC use (β = -0.25, 95% CI -0.49, -0.01; P-value = 0.042) and dual use (β = -0.29, 95% CI -0.53, -0.05; P-value = 0.017); a similar trend was observed for current EC/former cigarette use (β = -0.17, 95% CI -0.42, 0.09; P-value = 0.195). Results were comparable with additional adjustment for cannabis use. No significant associations with EC use were observed for heart rate or ventricular volumes. Conclusion EC use was associated with lower LVCI in healthy young adults without clinical cardiopulmonary disease. Physiologic mechanisms underlying the association between EC use and LVCI warrant further investigation. E-liquid nicotine exposure may lead to long-term sympathetic overactivation and increased systemic vascular resistance which can impair cardiac function over time. The contributions of EC use to long-term cardiopulmonary risk are an important concern. This abstract is funded by: R01HL155576, R01ES029967
Ravi et al. (Fri,) conducted a cross-sectional in Electronic cigarette use (n=183). Electronic cigarette (EC) use vs. No EC/cigarette use (controls) was evaluated on Left ventricular cardiac index (LVCI) (β = -0.25, 95% CI -0.49, -0.01, p=0.042). Exclusive electronic cigarette use was associated with a lower left ventricular cardiac index compared to controls (β = -0.25; 95% CI -0.49, -0.01; P=0.042) in healthy young adults.