ArticleAmerican journal of physiology. Heart and circulatory physiology2021
In vitro and in vivo cardiac toxicity of flavored electronic nicotine delivery systems.
Article in American journal of physiology. Heart and circulatory physiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Findings on e-cigarette flavors and their implications for human health: a systematic review.Frontiers in public health · 2026Pooled it
- Influence of Cooling Agents on the Arrhythmogenic and Autonomic Effects of Electronic Cigarettes in an in vivo Model.Circulation. Arrhythmia and electrophysiology · 2026Article
- Cardiovascular Consequences of E-Cigarettes: A New Challenge for Cardiologists.Journal of clinical medicine · 2026Review
- Oxidative stress mediates cardiac electrophysiological injury in inhalation exposure to flavored vaping products.Heart rhythm · 2026Article
- Influence of e-cigarettes and their constituents on cardiac rhythm and arrhythmias.American journal of physiology. Heart and circulatory physiology · 2026Review
- E-cigarettes and cardiovascular health: a review of components, mechanisms, and clinical risk.American journal of cardiovascular disease · 2026Review
- Concurrent e-cigarette or vaping product use-associated lung injury (EVALI) and myopericarditis: a rare case report and literature review.BMC pulmonary medicine · 2025Review
- Cardiac Autonomic Dysfunction and Increased Oxidative Stress in Conventional Cigarettes and E-Cigarettes: Heart Rate Variability as a Cardiovascular Predictor.Antioxidants (Basel, Switzerland) · 2025Review
- Don't go vaping my heart: e-cigarette exposure during pregnancy promotes peripartum ventricular arrhythmias and sympathetic dominance.American journal of physiology. Heart and circulatory physiology · 2025Article
- E-Cigarette and Vanillin Exposure Disrupts Cardiovascular Development in Xenopus laevis.Birth defects research · 2025Article
- Acute and Persistent Cardiovascular Effects of Menthol E-Cigarettes in Mice.Journal of the American Heart Association · 2025Article
- Non-neuronal ventricular cardiomyocyte-located nicotinergic acetylcholine receptors cause remodelling and arrhythmias.European heart journal · 2025Article
- hiPSC-CM electrophysiology: impact of temporal changes and study parameters on experimental reproducibility.American journal of physiology. Heart and circulatory physiology · 2024Article
- Forecasting vaping health risks through neural network model prediction of flavour pyrolysis reactions.Scientific reports · 2024Article
- A case report of vaping-associated sudden cardiac arrest in a young healthy patient.Annals of medicine and surgery (2012) · 2024Article
- Addressing Cardiovascular Toxicity Risk of Electronic Nicotine Delivery Systems in the Twenty-First Century: "What Are the Tools Needed for the Job?" and "Do We Have Them?"Cardiovascular toxicology · 2024Review
- Nicotine Formulation Influences the Autonomic and Arrhythmogenic Effects of Electronic Cigarettes.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Flavoring Agents in E-cigarette Liquids: A Comprehensive Analysis of Multiple Health Risks.Cureus · 2023Review
- E-cigarettes and arrhythmogenesis: a comprehensive review of pre-clinical studies and their clinical implications.Cardiovascular research · 2023Review
- Electronic Nicotine Delivery Systems and Cardiovascular/Cardiometabolic Health.Circulation research · 2023Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
The usage of flavored electronic nicotine delivery systems (ENDS) is popular, specifically in the teen and young adult age-groups. The possible cardiac toxicity of the flavoring aspect of ENDS is largely unknown. Vaping, a form of electronic nicotine delivery, uses "e-liquid" to generate "e-vapor," an aerosolized mixture of nicotine and/or flavors. We report our investigation into the cardiotoxic effects of flavored e-liquids. E-vapors containing flavoring aldehydes such as vanillin and cinnamaldehyde, as indicated by mass spectrometry, were more toxic in HL-1 cardiomyocytes than fruit-flavored e-vapor. Exposure of human induced pluripotent stem cell-derived cardiomyocytes to cinnamaldehyde or vanillin-flavored e-vapor affected the beating frequency and prolonged the field potential duration of these cells more than fruit-flavored e-vapor. In addition, vanillin aldehyde-flavored e-vapor reduced the human ether-à-go-go-related gene (hERG)-encoded potassium current in transfected human embryonic kidney cells. In mice, inhalation exposure to vanillin aldehyde-flavored e-vapor for 10 wk caused increased sympathetic predominance in heart rate variability measurements. In vivo inducible ventricular tachycardia was significantly longer, and in optical mapping, the magnitude of ventricular action potential duration alternans was significantly larger in the vanillin aldehyde-flavored e-vapor-exposed mice than in controls. We conclude that the widely popular flavored ENDS are not harm free, and they have a potential for cardiac harm. More studies are needed to further assess their cardiac safety profile and long-term health effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.