Smartphone App Predicts Cardiovascular Damage from Vaping

PASADENA, Calif., Jan. 28, 2025 /PRNewswire/ -- Huntington Medical Research Institutes (HMRI), a pioneer in scientific research with a track record of groundbreaking discoveries, provides crucial insights into predicting the long-term risk for cardiovascular damage from e-cigarettes (ECs), particularly those containing nicotine. ECs have gained popularity among youth and are used as a potential aid to quit traditional cigarette smoking. However, their impact on cardiovascular health has been poorly understood — until now.

In this study, "Adverse Cardiovascular Effects on Nicotine Delivered by Chronic Electronic Cigarettes or Standard Cigarettes Captured by Cardiovascular Intrinsic Frequencies," researchers applied an innovative blood flow dynamics method using intrinsic frequency to measure blood vessel dilatation and determine the impact of nicotine exposure from electronic cigarette vapor. Findings showed nicotine-containing vapes negatively impacted vascular function and left ventricle-arterial coupling ­— key indicators of cardiovascular health, contributing to accelerated aging of the vascular system.

Rashid Alavi, PhD, James G. Boswell Postdoctoral Fellow at the California Institute of Technology (Caltech) and HMRI, led this study, recently published in the Journal of the American Heart Association (JAHA). He began this research during his doctoral studies in mechanical/cardiovascular engineering in the lab of Niema Pahlevan, PhD, the Gordon S. Marshall Early Career Chair in Engineering at the University of Southern California (USC), and Fellow of the American Heart Association (FAHA), in collaboration with the Keck School of Medicine of USC, HMRI, and the University of California Irvine.

"The intrinsic frequency method, which is a new fluid dynamics-based analysis technique, is very sensitive at detecting abnormalities in the cardiovascular system, even more than some standard hemodynamic measures," said one of Alavi's faculty mentors, Robert Kloner, MD, PhD, chief scientific officer at HMRI, and professor of medicine at the Keck School of Medicine at USC. "It is exciting that this technique can be applied to cell phone applications to assess the heart's function and help reduce risk for cardiovascular disease among e-cigarette users."

This pioneering approach, validated on preclinical models, has significant potential for human applications, offering a simple yet powerful, non-invasive tool to detect cardiovascular risks early on. For human applications, the smartphone captures images of the neck skin. Then, the algorithm extracts vessel wall dilation from skin vibrations recorded on the images. The dilation of vessel waveforms mirrors pressure waveforms in large arteries, such as the carotid artery.

Traditional methods to detect cardiovascular risk rely on more invasive and complex tests such as invasive cardiac catheterization that includes radiation exposure, or other imaging techniques such as cardiac MRI, CT scanning, or echocardiography. These tests can be relatively expensive and usually involve a visit to a hospital or medical clinic.  The carotid waveform measurement can eventually be made from the comfort of one's home and will have minimal cost, and no risks, such as radiation exposure.

This novel technique developed by Alavi and his collaborators requires only carotid waveform (neck pulse) measurements, making it faster, noninvasive, and more affordable to detect early cardiovascular changes, whether in clinical settings or using smartphone-based technologies. Researchers also evaluated vapor from traditional cigarettes and found it significantly impairs left ventricle contractile function. In addition to damage from vaping, the novel neck pulse waveform analysis will help users detect risks from traditional smoking.

As vaping becomes increasingly common, especially among younger populations, these findings emphasize the need for greater awareness of the potential health risks associated with nicotine exposure through electronic cigarettes. "People have this idea that e-cigarettes are much better than traditional cigarettes, so they quit traditional smoking and try e-cigarettes with nicotine. However, e-cigarettes with nicotine have many adverse effects, so they need to be carefully considered," said Pahlevan.

"The goal of this study was to raise awareness about vaping and the long-term effects of nicotine on the cardiovascular system," said Alavi. "When the vessels become impaired, this will eventually impact the heart. We want to help people make informed decisions about whether to use a substance and its impact on their cardiovascular health." A smartphone application is a simple, effective tool for people who vape and smoke to assess their risk. This technology has the potential to create increased health equity for the early detection of cardiovascular disease, paving the way for easily accessible, widespread testing.

Alavi is known for developing hybrid physics-based artificial intelligence (AI) approaches for the non-invasive diagnosis of cardiovascular and neurovascular diseases (e.g., heart attacks, heart failure, and stroke). "My goal is to use cutting-edge technology and AI predictive models to help people reduce their risk for cardiovascular and neurovascular diseases," said Alavi. "My research focuses on leveraging biomarkers derived from biofluid dynamics and biomechanics to create smartphone-adaptable tools that enable individuals to monitor habitual health risks regularly, and make informed lifestyle choices to prevent disease progression," Alavi added.

Alavi's postdoctoral mentorship team includes Robert A. Kloner, MD, PhD; Morteza Gharib, PhD, professor of Medical Engineering and Aeronautics at Caltech; and Niema Pahlevan, PhD.

Full list of authors:
Rashid Alavi, PhD; Wangde Dai, MD; Sohrab P. Mazandarani, MA; Rebecca J. Arechavala, PhD; David A. Herman, PhD; Michael T. Kleinman, PhD; Robert A. Kloner, MD, PhD; Niema M. Pahlevan, PhD

Sources of Funding:
The University of California Office of the President Special Research Programs: Tobacco-Related Disease Research Program study (grant number: 28IR- 0057).
The James G. Boswell Foundation.

DOI: https://doi.org/10.1161/JAHA.124.035462

About HMRI
Based in Pasadena, California, Huntington Medical Research Institutes (HMRI) is a pioneer in scientific research with a 70-year track record of groundbreaking discoveries that have changed the world – from seatbelts to lifesaving diagnostic technology like the MRI. Today, HRMI's work is laser-focused on biomedical research that investigates diseases of the heart and brain, and it is committed to inspiring and educating the next generation of scientists.

SOURCE Huntington Medical Research Institutes