Cheraghi Mahdis, Amiri Mehrnaz, Omidi Fatemeh, Shahidi Bonjar Amir Hashem, Bakhshi Hooman, Vaezi Atefeh, Nasiri Mohammad Javad, Mirsaeidi Mehdi
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran Province, Tehran, District 1, Daneshjou Blvd, Q9XV+XG7, 19839 69411, Iran.
Department of Cardiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran Province, Tehran, District 1, Daneshjou Blvd, Q9XV+XG7, 19839 69411, Iran.
Eur Heart J Open. 2024 Dec 4;4(6):oeae098. doi: 10.1093/ehjopen/oeae098. eCollection 2024 Nov.
Electronic cigarette (EC) is widely advertised as a safe alternative to traditional cigarette (TC). We aimed to investigate the cardiovascular effect of EC with/without nicotine compared with TC. We systematically searched PubMed/MEDLINE, EMBASE, and Cochrane CENTRAL for randomized controlled trials that compared the effect of different smoking modalities on cardiovascular function up to 1 October 2024. Analysis used the weighted mean difference (WMD) with a 95% confidence interval (CI) via Comprehensive Meta-Analysis software, version 3.0. The study evaluated key cardiovascular parameters, including pulse wave velocity (PWV), augmentation index at 75 beats/min (AIx75), flow-mediated dilation (FMD), heart rate (HR), systolic blood pressure, and diastolic blood pressure. We analysed 9 trials involving 370 participants. Acute exposure to EC with nicotine (ECN) compared with nicotine-free EC (EC0) increased PWV (WMD = 0.26; 95% CI: 0.14-0.38, < 0.001), AIx75 (WMD = 4.29; 95% CI: 2.07-6.51, < 0.001), and HR (WMD = 5.06; 95% CI: 2.13-7.98, = 0.001), significantly. In contrast, comparison between ECN and TC revealed no significant differences in FMD (WMD = 0.80; 95% CI: -0.09-1.70, = 0.08). Our meta-analysis suggests that ECN acutely increases arterial stiffness more than EC0 does. Additionally, we found that the acute effect of ECN on endothelial dysfunction is not different from TC. Therefore, our study suggests that vaping cannot be considered as a safe substitute for TC. Further investigation is needed to explore the long-term cardiovascular effects of vaping and its modalities.
电子烟（EC）被广泛宣传为传统香烟（TC）的安全替代品。我们旨在研究含/不含尼古丁的电子烟与传统香烟相比对心血管的影响。我们系统检索了PubMed/MEDLINE、EMBASE和Cochrane CENTRAL，以查找截至2024年10月1日比较不同吸烟方式对心血管功能影响的随机对照试验。分析使用综合荟萃分析软件3.0，采用加权平均差（WMD）和95%置信区间（CI）。该研究评估了关键的心血管参数，包括脉搏波速度（PWV）、75次/分钟时的增强指数（AIx75）、血流介导的血管舒张（FMD）、心率（HR）、收缩压和舒张压。我们分析了9项涉及370名参与者的试验。与不含尼古丁的电子烟（EC0）相比，急性暴露于含尼古丁的电子烟（ECN）会显著增加PWV（WMD = 0.26；95%CI：0.14 - 0.38，P < 0.001）、AIx75（WMD = 4.29；95%CI：2.07 - 6.51，P < 0.001）和HR（WMD = 5.06；95%CI：2.13 - 7.98，P = 0.001）。相比之下，ECN与TC之间在FMD方面无显著差异（WMD = 0.80；95%CI： - 0.09 - 1.70，P = 0.08）。我们的荟萃分析表明，ECN比EC0更能急性增加动脉僵硬度。此外，我们发现ECN对内皮功能障碍的急性影响与TC无异。因此，我们的研究表明，吸电子烟不能被视为TC的安全替代品。需要进一步研究以探讨吸电子烟及其方式对心血管的长期影响。
