Key result
Acute e-cigarette and tobacco cigarette exposure reduces blood velocity ~23% and lowers venous oxygen saturation.
Why the study?
E-cigarettes contribute to endothelial dysfunction, a cause of systemic atherosclerotic disease that cannot be adequately characterized by a single physiological parameter measured at a single vascular bed.
Does acute exposure to smoking and vaping alter markers of vascular function measured by quantitative MRI?
Does acute exposure to smoking and vaping alter markers of vascular function measured by quantitative MRI?
p-value: p=<0.05
Both tobacco cigarettes and e-cigarettes (with or without nicotine) induce significant acute impairments in vascular function markers as measured by quantitative MRI.
Acute vascular impairment follows e-cig or t-cig use; leaves open long-term clinical sequelae and need for prospective outcome trials.
Background E‐cigarettes contribute to endothelial dysfunction, a known cause of systemic atherosclerotic disease that cannot be adequately characterized by a single physiological parameter measured at a single vascular bed. Purpose/Hypothesis Quantify and compare acute effects of smoking or vaping with tobacco cigarettes (t‐cigs), nicotinized e‐cigarettes (e‐cigs + ), non‐nicotinized e‐cigarettes (e‐cigs − ) on the vascular system via quantitative MRI. Study Type Prospective. Subjects Forty one smokers/vapers (mean age 29.8 ± 7.6 years), 17 non‐smokers/non‐vapers (mean age 26.5 ± 3.9 years). Field Strength/Sequence 3 T/oximetry, blood flow velocimetry. Assessment Smokers/vapers were scanned pre‐ and post‐ three challenges (ecig + , ecig, tcig). Each challenge was on a separate day. Blood flow velocity waveform in the femoral artery was measured at rest and in response to cuff occlusion, yielding parameters characterizing hyperemia (arterial peak velocity, time to peak, time of forward flow (T FF , duration of monophasic forward flow), hyperemic index, peripheral flow reserve, (PFR, peak over baseline velocity)). The dynamics of venous oxygen saturation (SvO 2 ) in the superficial femoral vein were quantified in terms of washout time of oxygen‐depleted blood, upslope (rate of resaturation), and overshoot (peak SvO 2 ). Aortic pulse wave velocity was evaluated. Cerebrovascular reactivity and cerebral metabolic rate of oxygen consumption were assessed at the superior sagittal sinus. Neurovascular compliance was assessed at the common carotid arteries. Statistical Tests Paired t ‐tests, Wilcoxon rank sum tests, linear mixed‐effects models, Bonferonni corrections. p < 0.05 indicated statistical significance. Results At the femoral vein and artery, across users, post‐challenge, the following decreased significantly: baseline SvO 2 (e‐cig + : −12%; e‐cig − : −14%; t‐cig: −9%); baseline velocity (e‐cig + : −23%; e‐cig − : −22%; t‐cig: −18%); T FF (e‐cig + : −17%; e‐cig − : −12%). The following significantly increased: upslope (e‐cig + : +22%; e‐cig − : +23%; t‐cig: +19%); overshoot (e‐cig + : +19%; e‐cig − : +23%); PFR (e‐cig − : +32%; t‐cig: +31%). Accounting for user type, the mixed model showed T FF to decrease significantly post‐challenge for all interventions: −15, −17, −23% for smokers, vapers, and dual users. Data Conclusion e‐cig + , e‐cig − , t‐cig exposure resulted in strong, significant acute effects on vascular function markers. Evidence Level 1. Stage of Technical Efficacy Stage 1.
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Nabbout et al. (2026) studied Healthy smokers/vapers and non-smokers (n=58). Tobacco cigarettes, nicotinized e-cigarettes, and non-nicotinized e-cigarettes vs. Pre-challenge baseline was evaluated on Vascular function markers (baseline SvO2, baseline velocity, time of forward flow, upslope, overshoot, peripheral flow reserve) (p=<0.05). Acute exposure to nicotinized e-cigarettes, non-nicotinized e-cigarettes, and tobacco cigarettes significantly decreased baseline venous oxygen saturation (9-14%) and blood velocity (18-23%).
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