Effects of electronic cigarette use on myocardial function

Our landmark study was performed in 2011-2012 and was presented in oral format and in a press conference during the 2012 annual congress of the European Society of Cardiology. It was one of the 30 studies, out of 4000 in total submitted to the congress, that was presented in both oral form and in press conference.

The study was designed based on the fact smoking has immediate adverse effects on myocardial function. Recently, our research group published a study about this. Therefore, the goal was to determine if similar disturbances can occur after using the electronic cigarette.

Two groups of participants were recruited. Smokers, and electronic cigarette users who had completely substituted smoking with electronic cigarettes. Interestingly, e-cigarette users had higher lifetime smoking exposure compared to current smokers (had smoked more cigarettes per day and for more years).

We asked smokers to smoke 1 cigarette, while e-cigarette users used a device (eGO battery) with liquid containing 11mg nicotine per ml for 7 minutes.

Concerning hemodynamic measurements, smoking caused an acute elevation in systolic and diastolic blood pressure, and in heart rate. In e-cigarette users, only a slight elevation in diastolic blood pressure was observed. Since hemodynamic changes depend solely on nicotine absorption, this study confirms previous observations that nicotine is absorbed at a lower rate from the e-cigarette compared to tobacco cigarette.

Concerning myocardial function, several parameters of diastolic function were adversely affected by smoking, while no parameter was changed after vaping. Diastolic function is a very sensitive measure of subclinical dysfunction. It is the phase during which the heart relaxes and blood is returning from the lungs and the peripheral veins. Almost every clinical disease involves diastolic dysfunction at an early stage.

The results of our study have shown that cardiac function is not affected by e-cigarette use, unlike the adverse effects of tobacco cigarette use. This provides the first clinical evidence about the acute cardiovascular effects of e-cigarettes

                                                                                Dr Konstantinos Farsalinos