Thread by @gargtushark

What are the short-term effects of #vaping and #tobacco #smoke on lung ventilation and perfusion?

Inspired from a recent study in @radiology_rsna by Nyilas, Bauman et al. pubs.rsna.org/doi/10.1148/ra…

#tweetorial thread 👇

BACKGROUND:

Randomized control trials suggest that #vaping
can effectively support #smoking cessation.

What is the effect of #vaping on airway inflammation and airway resistance?

Answer: It has been shown that after 5 minutes of vaping the airway inflammation and airway resistance increases⬆️

physoc.onlinelibrary.wiley.com/doi/10.1113/JP…

sciencedirect.com/science/articl…

Which tests are more sensitive in detecting local lung perfusion and ventilation changes?

Answer: Noninvasive MRI techniques have a higher sensitivity in detecting local lung perfusion and ventilation impairment. Especially, functional MRI of the lungs can show early changes in ventilation and perfusion not detectable with traditional LFTs

AIM OF THE STUDY:

To investigate the short-term ventilation and perfusion changes after vaping and tobacco smoke exposure.

HYPOTHESIS:

Vaping and tobacco smoking variably affect lung perfusion and ventilation in comparison to a healthy
control group.

STUDY DESIGN AND POPULATION:

➡️ Prospective observational study
➡️ People who smoke, vape, quit smoking recently and have never smoked

STUDY VISIT:

The participants underwent nitrogen multiple-breath washout, spirometry, and functional MRI.

RESULTS:

44 adult participants enrolled 🧵

➡️ Healthy participants = 10
➡️ People who smoked before = 9
➡️ People who vape = 13
➡️ People who smoke = 12

What happens to the lung perfusion in participants who smoke?

Answer:

⬇️ The lung perfusion reduced after exposure in people who smoke (8.6-9.1% vs. baseline, p=0.03) and was found to be correlated with lung clearance index (r=0.65, p=0.02)

What happens to the lung perfusion in people who vape?

⬆️The lung perfusion increased after exposure in people who vape (9-9.7% vs. baseline, p=0.01).

↔️ No ventilation changes found in all participants
↔️ No perfusion changes found in healthy control and former smokers

TAKEAWAY:

MRI showed a decrease in lung perfusion after exposure to tobacco smoke and an increase in lung perfusion after vaping.

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