nach oben

High Blood Pressure & Cardiovascular Prevention

26.04.2024 | Review article

Comparison of Acute Effects of E-cigarettes With and Without Nicotine and Tobacco Cigarettes on Hemodynamic and Endothelial Parameters: A Systematic Review and Meta-analysis

verfasst von: Shurjeel Uddin Qazi, Muhammad Huzaifa-Ul-Haq Ansari, Shamas Ghazanfar, Syed Shahryar Ghazanfar, Minaam Farooq

Erschienen in: High Blood Pressure & Cardiovascular Prevention

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Smoke from traditional cigarettes and e-cigarette aerosols have distinct chemical compositions that may impact blood pressure (BP) and heart rate (HR) differently.

Aims

This study compared the impact of nicotine-containing e-cigarettes (EC+) versus nicotine-free (EC−) on BP, HR and endothelial markers, and assessed if EC+ posed fewer risks than tobacco cigarettes (TC).

Methods

Electronic databases were searched from inception until November 2023 for studies reporting changes in systolic and diastolic BP (SBP, DBP) and HR and endothelial parameters before and after the use of EC+, EC− and TC. Data were analyzed using weighted mean differences (WMDs) and 95% confidence intervals (CIs).

Results

Fifteen studies (n = 752) were included in our meta-analysis. We demonstrate that EC+ significantly increased systolic BP (WMD = 3.41, 95% CI [0.1,6.73], p = 0.04], diastolic BP (WMD = 3.42, 95% CI [1.75, 5.09]; p < 0.01], and HR (WMD = 5.36 BPM, 95% CI [1.87, 8.85]; p < 0.01) compared to EC−. However, EC+ was observed to cause less detrimental effect on SBP (WMD = − 4.72 mmHg, 95% CI [− 6.58, − 2.86], p < 0.01), and HR (WMD = − 3.11 BPM, 95% CI [− 4.54, − 1.68]; p < 0.01) as compared to TC with no difference on DBP (WMD = − 1.14 mmHg, 95% CI [− 2.38, 0.1]; p = 0.07). EC+ also led to greater deterioration of endothelial parameters as compared to EC− but to a lesser degree as compared to TC.

Conclusion

EC+ shows greater impairment in hemodynamic and endothelial parameters than EC− but less than TC. Additional studies are needed to evaluate prolonged effects of EC use.

Graphical Abstract

Gallucci G, Tartarone A, Lerose R, Lalinga AV, Capobianco AM. Cardiovascular risk of smoking and benefits of smoking cessation. J Thorac Dis. 2020;12(7):3866–76. https://doi.org/10.21037/jtd.2020.02.47.CrossRefPubMedPubMedCentral

The Toll of Tobacco in the United States. Campaign for Tobacco-Free Kids. https://www.tobaccofreekids.org/problem/toll-us. Accessed 9 Dec 2023.

Tobacco. https://www.who.int/news-room/fact-sheets/detail/tobacco. Accessed 9 Dec 2023.

Commissioner O of the. FDA Permits Marketing of E-Cigarette Products, Marking First Authorization of Its Kind by the Agency. FDA. Published October 18, 2021. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-e-cigarette-products-marking-first-authorization-its-kind-agency. Accessed 9 Dec 2023.

Sealock T, Sharma S. Smoking Cessation. In: StatPearls. StatPearls Publishing; 2023. http://www.ncbi.nlm.nih.gov/books/NBK482442/. Accessed 9 Dec 2023.

Quigley JM, Walsh C, Lee C, Kennelly H, McCarthy A, Kavanagh P. Efficacy and safety of electronic cigarettes as a smoking cessation intervention: a systematic review and network meta-analysis. Tob Prev Cessat. 2021;7:69. https://doi.org/10.18332/tpc/143077.CrossRefPubMedPubMedCentral

Feeney S, Rossetti V, Terrien J. E-Cigarettes—a review of the evidence—harm versus harm reduction. Tob Use Insights. 2022;15:1179173X221087524. https://doi.org/10.1177/1179173X221087524.CrossRefPubMedPubMedCentral

Besaratinia A, Tommasi S. Vaping: a growing global health concern. EClinicalMedicine. 2019;17: 100208. https://doi.org/10.1016/j.eclinm.2019.10.019.CrossRefPubMedPubMedCentral

Silverman AL, Siddique H, Kumar V, Le TH, Ng J. Vaping induced pneumonitis: a small community hospital’s case series and analysis. BMC Pulm Med. 2020;20:118. https://doi.org/10.1186/s12890-020-1158-2.CrossRefPubMedPubMedCentral

10.

Narrett JA, Khan W, Funaro MC, Moeller JJ. How do smoking, vaping, and nicotine affect people with epilepsy and seizures? A scoping review protocol. PLoS ONE. 2023;18(7): e0288120. https://doi.org/10.1371/journal.pone.0288120.CrossRefPubMedPubMedCentral

11.

Gonzalez JE, Cooke WH. Acute effects of electronic cigarettes on arterial pressure and peripheral sympathetic activity in young nonsmokers. Am J Physiol-Heart Circ Physiol. 2021;320(1):H248–55. https://doi.org/10.1152/ajpheart.00448.2020.CrossRefPubMed

12.

Esteban-Lopez M, Perry MD, Garbinski LD, Manevski M, Andre M, Ceyhan Y, Caobi A, Paul P, Lau LS, Ramelow J, Owens F, Souchak J, Ales E, El-Hage N. Health effects and known pathology associated with the use of E-cigarettes. Toxicol Rep. 2022;9:1357–68. https://doi.org/10.1016/j.toxrep.2022.06.006.CrossRefPubMedPubMedCentral

13.

Hahn J, Monakhova YB, Hengen J, Kohl-Himmelseher M, Schüssler J, Hahn H, Kuballa T, Lachenmeier DW. Electronic cigarettes: overview of chemical composition and exposure estimation. Tob Induc Dis. 2014;12(1):23. https://doi.org/10.1186/s12971-014-0023-6.CrossRefPubMedPubMedCentral

14.

Dickson K, Yeung CA. PRISMA 2020 updated guideline. Br Dent J. 2022;232(11):760–1. https://doi.org/10.1038/s41415-022-4359-7.CrossRefPubMed

15.

Santos LMD, Gomes IC, Pinho JF, Neves-Alves CM, Magalhães GS, Campagnole-Santos MJ, da Glória Rodrigues-Machado M. Predictors and reference equations for augmentation index, an arterial stiffness marker, in healthy children and adolescents. Clinics (Sao Paulo). 2021;76:e2350. https://doi.org/10.6061/clinics/2021/e2350.CrossRefPubMed

16.

Raitakari OT, Celermajer DS. Flow-mediated dilatation. Br J Clin Pharmacol. 2000;50(5):397–404. https://doi.org/10.1046/j.1365-2125.2000.00277.x.CrossRefPubMedPubMedCentral

17.

Barker TH, Stone JC, Sears K, Klugar M, Tufanaru C, Leonardi-Bee J, Aromataris E, Munn Z. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evid Synth. 2023;21(3):494–506. https://doi.org/10.11124/JBIES-22-00430.CrossRefPubMed

18.

Higgins JPT, Altman DG, Gotzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods Group, & Cochrane Statistical Methods Group. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343(Oct18 2):d5928–d5928. https://doi.org/10.1136/bmj.d5928.CrossRefPubMedPubMedCentral

19.

Moheimani RS, Bhetraratana M, Peters KM, Yang BK, Yin F, Gornbein J, Araujo JA, Middlekauff HR. sympathomimetic effects of acute e-cigarette use: role of nicotine and non-nicotine constituents. J Am Heart Assoc. 2017;6(9): e006579. https://doi.org/10.1161/JAHA.117.006579.CrossRefPubMedPubMedCentral

20.

Chaumont M, De Becker B, Zaher W, Culié A, Deprez G, Mélot C, Reyé F, Van Antwerpen P, Delporte C, Debbas N, Boudjeltia KZ, van de Borne P. Differential effects of e-cigarette on microvascular endothelial function, arterial stiffness and oxidative stress: a randomized crossover trial. Sci Rep. 2018;8(1):10378. https://doi.org/10.1038/s41598-018-28723-0.CrossRefPubMedPubMedCentral

21.

Ikonomidis I, Vlastos D, Kourea K, Kostelli G, Varoudi M, Pavlidis G, Efentakis P, Triantafyllidi H, Parissis J, Andreadou I, Iliodromitis E, Lekakis J. Electronic cigarette smoking increases arterial stiffness and oxidative stress to a lesser extent than a single conventional cigarette: an acute and chronic study. Circulation. 2018;137(3):303–6. https://doi.org/10.1161/CIRCULATIONAHA.117.029153.CrossRefPubMed

22.

Antoniewicz L, Brynedal A, Hedman L, Lundbäck M, Bosson JA. Acute effects of electronic cigarette inhalation on the vasculature and the conducting airways. Cardiovasc Toxicol. 2019;19(5):441–50. https://doi.org/10.1007/s12012-019-09516-x.CrossRefPubMedPubMedCentral

23.

Cossio R, Cerra ZA, Tanaka H. Vascular effects of a single bout of electronic cigarette use. Clin Exp Pharmacol Physiol. 2020;47(1):3–6. https://doi.org/10.1111/1440-1681.13180.CrossRefPubMed

24.

Sumartiningsih S, Lin HF, Lin JC. Cigarette smoking blunts exercise-induced heart rate response among young adult male smokers. Int J Environ Res Public Health. 2019;16(6):1032. https://doi.org/10.3390/ijerph16061032.CrossRefPubMedPubMedCentral

25.

Haptonstall KP, Choroomi Y, Moheimani R, Nguyen K, Tran E, Lakhani K, Ruedisueli I, Gornbein J, Middlekauff HR. Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people. Am J Physiol-Heart Circ Physiol. 2020;319(3):H547–56. https://doi.org/10.1152/ajpheart.00307.2020.CrossRefPubMedPubMedCentral

26.

Palamidas A, Tsikrika S, Katsaounou P, Vakali S, Gennimata SA, Kaltsakas G, Gratziou C, Koulouris N. Acute effects of short term use of e-cigarettes on airways physiology and respiratory symptoms in smokers with and without airways obstructive diseases and in healthy non smokers. Tob Prev Cessat. 2017. https://doi.org/10.18332/tpc/67799.CrossRefPubMedPubMedCentral

27.

Farsalinos K, Voudris V, Poulas K. Are metals emitted from electronic cigarettes a reason for health concern? A risk-assessment analysis of currently available literature. Int J Environ Res Public Health. 2015;12(5):5215–32. https://doi.org/10.3390/ijerph120505215.CrossRefPubMedPubMedCentral

28.

Yan XS, D’Ruiz C. Effects of using electronic cigarettes on nicotine delivery and cardiovascular function in comparison with regular cigarettes. Regul Toxicol Pharmacol. 2015;71(1):24–34. https://doi.org/10.1016/j.yrtph.2014.11.004.CrossRefPubMed

29.

Biondi-Zoccai G, Sciarretta S, Bullen C, Nocella C, Violi F, Loffredo L, Pignatelli P, Perri L, Peruzzi M, Marullo AGM, De Falco E, Chimenti I, Cammisotto V, Valenti V, Coluzzi F, Cavarretta E, Carrizzo A, Prati F, Carnevale R, Frati G. Acute effects of heat-not-burn, electronic vaping, and traditional tobacco combustion cigarettes: the Sapienza University of Rome-vascular assessment of proatherosclerotic effects of smoking (SUR-VAPES) 2 randomized trial. J Am Heart Assoc. 2019;8(6): e010455. https://doi.org/10.1161/JAHA.118.010455.CrossRefPubMedPubMedCentral

30.

Kerr DMI, Brooksbank KJM, Taylor RG, Pinel K, Rios FJ, Touyz RM, Delles C. Acute effects of electronic and tobacco cigarettes on vascular and respiratory function in healthy volunteers: a cross-over study. J Hypertens. 2019;37(1):154–66. https://doi.org/10.1097/HJH.0000000000001890.CrossRefPubMed

31.

Carnevale R, Sciarretta S, Violi F, Nocella C, Loffredo L, Perri L, Peruzzi M, Marullo AG, De Falco E, Chimenti I, Valenti V, Biondi-Zoccai G, Frati G. Acute impact of tobacco vs electronic cigarette smoking on oxidative stress and vascular function. Chest. 2016;150(3):606–12. https://doi.org/10.1016/j.chest.2016.04.012.CrossRefPubMed

32.

Gernun S, Franzen K, Mallock N, Benthien J, Luch A, Mortensen K, Drömann D, Pogarell O, Rüther T, Rabenstein A. Cardiovascular functions and arterial stiffness after JUUL use. Tob Induc Dis. 2022;20(April):1–11. https://doi.org/10.18332/tid/144317.CrossRef

33.

Romagna G, Allifranchini E, Bocchietto E, Todeschi S, Esposito M, Farsalinos KE. Cytotoxicity evaluation of electronic cigarette vapor extract on cultured mammalian fibroblasts (ClearStream-LIFE): comparison with tobacco cigarette smoke extract. Inhal Toxicol. 2013;25(6):354–61. https://doi.org/10.3109/08958378.2013.793439.CrossRefPubMed

34.

Schweitzer KS, Chen SX, Law S, Van Demark M, Poirier C, Justice MJ, Hubbard WC, Kim ES, Lai X, Wang M, Kranz WD, Carroll CJ, Ray BD, Bittman R, Goodpaster J, Petrache I. Endothelial disruptive proinflammatory effects of nicotine and e-cigarette vapor exposures. Am J Physiol Lung Cell Mol Physiol. 2015;309(2):L175-187. https://doi.org/10.1152/ajplung.00411.2014.CrossRefPubMedPubMedCentral

35.

Putzhammer R, Doppler C, Jakschitz T, Heinz K, Förste J, Danzl K, Messner B, Bernhard D. Vapours of US and EU market leader electronic cigarette brands and liquids are cytotoxic for human vascular endothelial cells. PLoS ONE. 2016;11(6):e0157337. https://doi.org/10.1371/journal.pone.0157337.CrossRefPubMedPubMedCentral

36.

Anderson C, Majeste A, Hanus J, Wang S. E-cigarette aerosol exposure induces reactive oxygen species, DNA damage, and cell death in vascular endothelial cells. Toxicol Sci. 2016;154(2):332–40. https://doi.org/10.1093/toxsci/kfw166.CrossRefPubMed

37.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet Lond Engl. 2002;360(9349):1903–13. https://doi.org/10.1016/s0140-6736(02)11911-8.CrossRef

38.

Sharma A, Gupta I, Venkatesh U, Singh AK, Golamari R, Arya P. E-cigarettes and myocardial infarction: a systematic review and meta-analysis. Int J Cardiol. 2023;371:65–70. https://doi.org/10.1016/j.ijcard.2022.09.007.CrossRefPubMed

39.

García-Hermoso A, Martínez-Vizcaíno V, Gomez-Marcos MÁ, Cavero-Redondo I, Recio-Rodriguez JI, García-Ortiz L. Ideal Cardiovascular health and arterial stiffness in spanish adults—the EVIDENT study. J Stroke Cerebrovasc Dis. 2018;27(5):1386–94. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.031.CrossRefPubMed

40.

Mohammadi L, Han DD, Xu F, Huang A, Derakhshandeh R, Rao P, Whitlatch A, Cheng J, Keith RJ, Hamburg NM, Ganz P, Hellman J, Schick SF, Springer ML. Chronic E-cigarette use impairs endothelial function on the physiological and cellular levels. Arterioscler Thromb Vasc Biol. 2022;42(11):1333–50. https://doi.org/10.1161/ATVBAHA.121.317749.CrossRefPubMedPubMedCentral

41.

Kelesidis T, Zhang Y, Tran E, Sosa G, Middlekauff HR. Expression of key inflammatory proteins is increased in immune cells from tobacco cigarette smokers but not electronic cigarette vapers: implications for atherosclerosis. J Am Heart Assoc. 2021;10(1): e019324. https://doi.org/10.1161/JAHA.120.019324.CrossRefPubMed

42.

Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension. 1999;33(5):1111–7. https://doi.org/10.1161/01.HYP.33.5.1111.CrossRefPubMed

43.

London GM, Blacher J, Pannier B, Guérin AP, Marchais SJ, Safar ME. Arterial wave reflections and survival in end-stage renal failure. Hypertension. 2001;38(3):434–8. https://doi.org/10.1161/01.HYP.38.3.434.CrossRefPubMed

44.

Grana RA, Ling PM. “Smoking revolution” a content analysis of electronic cigarette retail websites. Am J Prev Med. 2014;46(4):395–403. https://doi.org/10.1016/j.amepre.2013.12.010.CrossRefPubMedPubMedCentral

45.

Metzen D, M’Pembele R, Zako S, Mourikis P, Helten C, Zikeli D, Ahlbrecht S, Ignatov D, Ayhan A, Huhn R, Zeus T, Levkau B, Petzold T, Kelm M, Dannenberg L, Polzin A. Platelet reactivity is higher in e-cigarette vaping as compared to traditional smoking. Int J Cardiol. 2021;343:146–8. https://doi.org/10.1016/j.ijcard.2021.09.005.CrossRefPubMed

46.

Hom S, Chen L, Wang T, Ghebrehiwet B, Yin W, Rubenstein DA. Platelet activation, adhesion, inflammation, and aggregation potential are altered in the presence of electronic cigarette extracts of variable nicotine concentrations. Platelets. 2016;27(7):694–702. https://doi.org/10.3109/09537104.2016.1158403.CrossRefPubMed

47.

Sifat AE, Vaidya B, Kaisar MA, Cucullo L, Abbruscato TJ. Nicotine and electronic cigarette (E-Cig) exposure decreases brain glucose utilization in ischemic stroke. J Neurochem. 2018;147(2):204–21. https://doi.org/10.1111/jnc.14561.CrossRefPubMedPubMedCentral

48.

Skotsimara G, Antonopoulos AS, Oikonomou E, Siasos G, Ioakeimidis N, Tsalamandris S, Charalambous G, Galiatsatos N, Vlachopoulos C, Tousoulis D. Cardiovascular effects of electronic cigarettes: a systematic review and meta-analysis. Eur J Prev Cardiol. 2019;26(11):1219–28. https://doi.org/10.1177/2047487319832975.CrossRefPubMed

49.

de Andrade M, Hastings G, Angus K. Promotion of electronic cigarettes: tobacco marketing reinvented? BMJ. 2013;347: f7473. https://doi.org/10.1136/bmj.f7473.CrossRefPubMed

50.

Yao T, Jiang N, Grana R, Ling PM, Glantz SA. A content analysis of electronic cigarette manufacturer websites in China. Tob Control. 2016;25(2):188–94. https://doi.org/10.1136/tobaccocontrol-2014-051840.CrossRefPubMed

51.

Myers Smith K, Phillips-Waller A, Pesola F, McRobbie H, Przulj D, Orzol M, Hajek P. E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomized controlled trial. Addiction. 2022;117(1):224–33. https://doi.org/10.1111/add.15628.CrossRefPubMed

52.

Soneji S, Barrington-Trimis JL, Wills TA, Leventhal AM, Unger JB, Gibson LA, Yang J, Primack BA, Andrews JA, Miech RA, Spindle TR, Dick DM, Eissenberg T, Hornik RC, Dang R, Sargent JD. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis. JAMA Pediatr. 2017;171(8):788. https://doi.org/10.1001/jamapediatrics.2017.1488.CrossRefPubMedPubMedCentral

53.

Siddiqi TJ, Rashid AM, Siddiqi AK, Anwer A, Usman MS, Sakhi H, Bhatnagar A, Hamburg NM, Hirsch GA, Rodriguez CJ, Blaha MJ, DeFilippis AP, Benjamin EJ, Hall ME. Association of electronic cigarette exposure on cardiovascular health: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;48(9): 101748. https://doi.org/10.1016/j.cpcardiol.2023.101748.CrossRefPubMed

54.

Larue F, Tasbih T, Ribeiro Paula AB, Lavoie KL, Dolan E, Bacon SL. Immediate physiological effects of acute electronic cigarette use in humans: a systematic review and meta-analysis. Respir Med. 2021;190:106684. https://doi.org/10.1016/j.rmed.2021.106684.CrossRefPubMed

55.

Fetterman JL, Keith RJ, Palmisano JN, McGlasson KL, Weisbrod RM, Majid S, Bastin R, Stathos MM, Stokes AC, Robertson RM, Bhatnagar A, Hamburg NM. Alterations in vascular function associated with the use of combustible and electronic cigarettes. J Am Heart Assoc. 2020;9(9): e014570. https://doi.org/10.1161/JAHA.119.014570.CrossRefPubMedPubMedCentral

56.

Hwang J, Sundar IK, Yao H, Sellix MT, Rahman I. Circadian clock function is disrupted by environmental tobacco/cigarette smoke, leading to lung inflammation and injury via a SIRT1-BMAL1 pathway. FASEB J. 2014;28(1):176–94. https://doi.org/10.1096/fj.13-232629.CrossRefPubMedPubMedCentral

57.

Khan MS, Khan SU, Khan SU, Suleman M, Shan Ahmad RU, Khan MU, Tayyeb JZ, Crovella S, Harlina PW, Saeed S. Cardiovascular diseases crossroads: cGAS-STING signaling and disease progression. Curr Probl Cardiol. 2024;49(2): 102189. https://doi.org/10.1016/j.cpcardiol.2023.102189.CrossRefPubMed

58.

Tomiyama H, Yamashina A. Non-invasive vascular function tests: their pathophysiological background and clinical application. Circ J. 2010;74(1):24–33. https://doi.org/10.1253/circj.cj-09-0534.CrossRefPubMed

Titel: Comparison of Acute Effects of E-cigarettes With and Without Nicotine and Tobacco Cigarettes on Hemodynamic and Endothelial Parameters: A Systematic Review and Meta-analysis
verfasst von: Shurjeel Uddin Qazi
Muhammad Huzaifa-Ul-Haq Ansari
Shamas Ghazanfar
Syed Shahryar Ghazanfar
Minaam Farooq
Publikationsdatum: 26.04.2024
Verlag: Springer International Publishing
Erschienen in: High Blood Pressure & Cardiovascular Prevention
Print ISSN: 1120-9879
Elektronische ISSN: 1179-1985
DOI: https://doi.org/10.1007/s40292-024-00643-3

Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Comparison of Acute Effects of E-cigarettes With and Without Nicotine and Tobacco Cigarettes on Hemodynamic and Endothelial Parameters: A Systematic Review and Meta-analysis

Abstract

Introduction

Aims

Methods

Results

Conclusion

Graphical Abstract

Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Kardiologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Introduction

Aims

Methods

Results

Conclusion

Graphical Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Kardiologie