Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
Pulmonary and Critical Care Section, VA San Diego Healthcare System, La Jolla, CA, USA.
J Physiol. 2020 Nov;598(22):5039-5062. doi: 10.1113/JP279754. Epub 2020 Oct 12.
E-cigarette aerosols are exceedingly different from conventional tobacco smoke, containing dozens of chemicals not found in cigarette smoke. It is highly likely that chronic use of e-cigarettes will induce pathological changes in both the heart and lungs. Here we review human and animal studies published to date and summarize the cardiopulmonary physiological changes caused by vaping. In terms of cardiac physiology, acute exposure to e-cigarette aerosols in human subjects led to increased blood pressure and heart rate, similar to traditional cigarettes. Chronic exposure to e-cigarette aerosols using animal models caused increased arterial stiffness, vascular endothelial changes, increased angiogenesis, cardiorenal fibrosis and increased atherosclerotic plaque formation. Pulmonary physiology is also affected by e-cigarette aerosol inhalation, with increased airway reactivity, airway obstruction, inflammation and emphysema. Research thus far demonstrates that the heart and lung undergo numerous changes in response to e-cigarette use, and disease development will depend on how those changes combine with both environmental and genetic factors. E-cigarettes have been advertised as a healthy alternative to cigarette smoking, and users are under the impression that vaping of e-cigarettes is harmless, but these claims that e-cigarettes are safer and healthier are not based on evidence. Data from both humans and animal models are consistent in demonstrating that vaping of e-cigarettes causes health effects both similar to and disparate from those of cigarette smoking. Further work is needed to define the long-term cardiopulmonary effects of e-cigarette use in humans.
电子烟气溶胶与传统烟草烟雾有很大的不同，其中含有数十种在香烟烟雾中未发现的化学物质。长期使用电子烟极有可能导致心肺发生病理变化。在此，我们回顾了迄今为止发表的人类和动物研究，并总结了电子烟引起的心肺生理学变化。在心脏生理学方面，人体对电子烟气溶胶的急性暴露会导致血压和心率升高，与传统香烟相似。使用动物模型进行慢性暴露于电子烟气溶胶会导致动脉僵硬、血管内皮变化、血管生成增加、心肾纤维化和动脉粥样硬化斑块形成增加。肺部生理学也受到电子烟气溶胶吸入的影响，导致气道反应性增加、气道阻塞、炎症和肺气肿。迄今为止的研究表明，心肺对电子烟的使用会发生多种变化，疾病的发展将取决于这些变化如何与环境和遗传因素相结合。电子烟被宣传为吸烟的健康替代品，使用者认为电子烟的吸入是无害的，但电子烟更安全、更健康的说法并没有事实依据。来自人类和动物模型的数据一致表明，电子烟的吸入会导致与吸烟相似和不同的健康影响。需要进一步的工作来确定人类长期使用电子烟对心肺的影响。
