Abstract: 1375
Acute effects of using an electronic nicotine-delivery device (e-cigarette) on myocardial function: comparison with the effects of regular cigarettes

K. Farsalinos1, D. Tsiapras1, S. Kyrzopoulos1, M. Savvopoulou1, E. Avramidou1, D. Vasilopoulou1, V. Voudris1, 1Onassis Cardiac Surgery Center, 2nd Department of Cardiology - Athens - Greece,

European Heart Journal ( 2012 ) 33 ( Abstract Supplement ), 203

Purpose: The addictive properties and devastating consequences of cigarette smoke on human health, including cardiac function, are well known. In recent years the electronic cigarette (e-cigarette), a battery-powered nicotine delivery device, has been marketed as a safer habit. Despite the global debate about its' use, no studies have examined the device's consequences on cardiac function. The purpose of our study was to evaluate the acute effects of using the e-cigarette on left ventricular myocardial function and to compare them with the effects of regular cigarettes.

Methods: Participants were 42 healthy volunteers (age 25-45 years): ex-smokers who were using the e-cigarette (group eCIG, n=22), and regular cigarette smokers (group SM, n=20). A complete echocardiographic exam was performed in both groups after 3-hours abstinence from alcohol, coffee and e-cigarette use or smoking (eCIG-1 and SM-1 respectively). A repeat echocardiogram was performed in eCIG subjects after using an e-cigarette with nicotine concentration of 11mg/ml for 7 minutes (eCIG-2). In smokers, the repeat echocardiogram was done after smoking one cigarette (SM-2). Transmitral Doppler flow parameters (MV-E and MV-A wave, E/A ratio and deceleration time-DT) and averaged (lateral, septal, anterior and inferior) tissue Doppler mitral annulus velocities (systolic: Sm, early diastolic: Em, late diastolic: Am) were measured. The isovolumic relaxation time (IVRT) and myocardial performance index (MPI) of the left ventricle were also measured.

Results: The two groups had similar characteristics, baseline echocardiographic and haemodynamic parameters. Subjects in the eCIG group had quit smoking for 93±65 days and were using an e-cigarette for 95±64 days; however, they had significantly higher total smoking exposure, with a Brinkman index (number of daily cigarettes x smoking years) of 533±270 compared to 369±150 in SM (p = 0.019). Using the e-cigarette for 7 minutes lead to no significant alterations in any echocardiographic parameters, except for a slight rise in MV-A wave (p = 0.047). On the contrary, a significant decrease in Em velocity (p = 0.005) and Em/Am ratio (p = 0.001), and an increase in IVRT (p = 0.032) and MPI (p=0.01) were found in SM-2 compared to baseline.

Conclusions: Although regular smoking leads to an acute impairment of left ventricular function, the use of e-cigarette for inhaling nicotine-containing liquid exerts no acute adverse effects on cardiac function. Further research is urgently needed since the use of e-cigarettes is continuously rising and it could be a potentially useful method for smoking cessation.