ECG and Echocardiographic Findings in Adults with Chronic Pulmonary Disorders Who Use Electronic Cigarettes: A Meta-Analysis
Abstract
Background: Electronic-cigarette use is increasingly common among adults who currently smoke or have smoked combustible cigarettes, including people living with chronic obstructive pulmonary disease, asthma, bronchiectasis, interstitial lung disease, and chronic hypoxemic respiratory disorders. These patients often already have autonomic dysfunction, systemic inflammation, pulmonary vascular stress, right ventricular strain, myocardial ischemia, or other cardiovascular disease. Because electronic-cigarette aerosol can contain nicotine, ultrafine particles, carbonyl compounds, metals, and flavour-related chemicals, there are several plausible pathways through which vaping could affect cardiac rhythm and myocardial function. Yet the extent to which findings from existing human studies apply to adults with established chronic lung disease remains uncertain.
Objective: To critically evaluate human evidence on electrocardiographic, autonomic and echocardiographic findings associated with electronic-cigarette use, determine its applicability to adults with chronic pulmonary disorders, and identify clinically important evidence gaps.
Methods: A focused literature search of PubMed/MEDLINE was conducted from database inception through January, 2026. Search concepts included electronic cigarettes, vaping, electronic nicotine delivery systems, electrocardiography, QT interval, Tpeak–Tend interval, ventricular repolarization, arrhythmia, heart-rate variability, echocardiography,…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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