Abstract:
Electronic cigarette use has grown exponentially in recent years, and while their popularity has increased, the long-term effects on the heart are yet to be fully studied and understood. Originally designed as devices to assist with those trying to quit traditional combustible cigarette use, their popularity has attracted use by teens and adolescents who traditionally have not smoked combustible cigarettes. Acute effects on the heart have been shown to be similar to traditional combustible cigarettes, including increased heart rate and blood pressure. The main components of electronic cigarettes that contribute to these arrhythmic effects are found in the e-liquid that is aerosolized and inhaled, comprised of nicotine, flavourings, and a combination of vegetable glycerin (VG) and propylene glycol (PG). Nicotine can potentially induce both ventricular and atrial arrhythmogenesis, with both the atrial and ventricular effects resulting from the interactions of nicotine and the catecholamines they release via potassium channels. Atrial arrhythmogenesis, more specifically atrial fibrillation, can also occur due to structural alterations, which happens because of nicotine downregulating microRNAs 133 and 590, both post-transcriptional growth factor repressors. Liquid flavourings and the combination of PG and VG can possibly lead to arrhythmic events by exposing users to acrolein, an aldehyde that stimulates TRPA1 that in turn causes a change towards sympathetic activation and autonomic imbalance. The design of these electronic delivery devices is constantly changing; therefore, it has proven extremely difficult to study the long-term effects on the heart caused by electronic cigarettes but will be important to understand given their rising popularity. The arrhythmic effects of electronic cigarettes appear similar to traditional cigarettes as well; however, a comprehensive review has not been compiled and is the focus of this article.
摘要:
近年来,电子烟的使用呈指数级增长,虽然他们的受欢迎程度越来越高,对心脏的长期影响尚未得到充分研究和理解。最初被设计为帮助那些试图放弃传统可燃香烟使用的人的设备,它们的受欢迎程度吸引了传统上不吸烟可燃香烟的青少年使用。对心脏的急性影响已被证明类似于传统的可燃香烟,包括心率和血压升高.在雾化和吸入的电子液体中发现了导致这些心律失常作用的电子烟的主要成分,由尼古丁组成,调味品,以及植物甘油和丙二醇的组合。尼古丁可以潜在地诱发室性和房性心律失常,由于尼古丁和儿茶酚胺与钾通道的相互作用而产生心房和心室效应。心房心律失常发生,更具体地说,心房颤动,也可能由于结构改变而发生,这是因为尼古丁下调microRNAs133和590,两者都是转录后生长因子阻遏物。液体调味剂以及丙二醇和植物甘油的组合可能会通过将使用者暴露于丙烯醛而导致心律失常事件,一种刺激TRPA1的醛,进而引起交感神经激活和自主神经失衡的变化。这些电子递送设备的设计不断变化;因此,事实证明,研究电子烟对心脏的长期影响极其困难,但鉴于电子烟的受欢迎程度越来越高,理解起来很重要。电子烟的心律失常效应似乎与传统香烟相似;然而,尚未编写全面的评论,这是本文的重点。