Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview

Abstract

The aim of this study was to review the most recent literature on the safety of electronic cigarettes (ECs) in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes. The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials. Daily use of ECs has implications in myocardial infarction (MI) with an odds ratio of 1.70 compared to healthy, nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62. Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions. Platelet aggregation, endothelial function, and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure. Though more studies need to be done on the topic of EC use and cardiovascular disease, the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes. ECs are toxic to human beings and their harmful effects cannot be overlooked. There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use. It will take decades to collect data for chronic EC use on long term sequelae, such as lung cancer. Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported. Due to undergoing investigations of possible harm and life threatening complications of EC use, we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies. A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage, frequency of use, and contents of EC liquid are just some of the vast complicating factors that limit the ability to effectively compare data.

Clinical impact of vaping on cardiopulmonary function and lung cancer development: an update

“…Worth reporting is a significant risk related to e-smoking-induced endothelial and platelet dysfunction observed in rat models. In conclusion, it is not possible to support the use of e-cigarettes as a safe alternative to tobacco smoking discontinuation also in the scenario of cardiovascular diseases (Vajdi and Tuktamyshov, 2020).…”

“…It has been widely demonstrated that vaping and e-smoking remain a threat to cardiovascular health (Vajdi and Tuktamyshov, 2020; Marques et al ., 2021). Although a minority of studies support e-smoking as a less dangerous alternative to tobacco cigarettes for cardiovascular health, the vast majority of published papers report some level of harm, with regard to free radical generation, diastolic functional modifications, development of atherosclerosis and incidence of myocardial infarction, in particular when focusing on long-term use.…”

“…They can use tobacco-based and non-tobacco compounds; many factors condition the delivery of nicotine and other substances to the human body, like the voltage of the power unit, the resistances, the chemical structure of the solvent and the sort of device employed. In fact, many differences have been reported between first-generation and more recent devices in terms of clinical effects on human health (Vajdi and Tuktamyshov, 2020).…”