Cardiovascular Effects of Fine and Ultrafine Particles

Abstract

Epidemiological studies of the past decades have provided a strong body of evidence that elevated levels of ambient particulate air pollution (PM) are associated with increased cardiovascular and respiratory morbidity and mortality. Exacerbations of ischemic and/or arrhythmic cardiac diseases have been linked to PM exposure. At a workshop held at the GSF- National Center for Environment and Health in November 2003, relevant epidemiological and toxicological data of the past 5 years were compiled and potential biological pathways discussed. Available clinical and experimental evidence lends support to the following mechanisms mediating cardiovascular effects of inhaled ambient particles: (i) pulmonary and/or systemic inflammatory responses inducing endothelial dysfunction, a pro-coagulatory state and promotion of atherosclerotic lesions, (ii) dysfunction of the autonomic nervous system in response to direct reflexes from receptors in the lungs and/or to local or systemic inflammatory stimuli, and (iii) cardiac malfunction due to ischemic responses in the myocardium and/or altered ion-channel functions in myocardial cells. While an increasing number of studies addressing these questions support the notion that PM exposure is associated with cardiovascular effects, these studies at present provide only a fragmentary and at times inconclusive picture of the complex biological pathways involved. The available data are consistent with the occurrence of a systemic inflammatory response and an alteration of autonomic cardiac control, but evidence on endothelial dysfunction, pro-coagulatory states, and PM-related myocardial malfunction is as yet scarce. Further studies are therefore needed to substantiate our current understanding of the pathophysiological links between PM exposure and adverse cardiovascular outcomes.

Air pollution and cardiac remodeling: a role for RhoA/Rho-kinase

“…The locus of these interactions at the present time is unclear but there is intriguing information that inhaled particulates particularly those in the ultrafine range, may directly transgress into the circulation where it may mediate effects. (33,34,45) There is also interesting evidence of heightened oxidant stress with inhaled particulates in the myocardium mediated through the autonomic nervous system. (15) Regardless of the mechanism, the fact that inhaled particles induce these effects in the myocardium in hypertension has important implications for the cardiovascular effects of air pollution.…”

Daily mortality and particulate matter in different size classes in Erfurt, Germany

“…High levels of ambient PM were reported to be associated with decreased heart rate variability, arterial vasoconstriction, augmented systolic blood pressure, increased plasma viscosity, and cardiac arrhythmias (Brook et al, 2002;Schulz et al, 2005). Through these possible pathways air pollution may lead to increased hospital admissions and mortality.…”

“…Evidence suggests that increased PM concentrations mainly affect the cardiovascular and respiratory systems (Peters et al, 1997a(Peters et al, , 1999Gold et al, 2000;Ibald-Mulli et al, 2001;Brook et al, 2002;Devlin et al, 2003;Schulz et al, 2005) and are especially associated with increased cardiovascular hospital admissions (Schwartz, 1999;Zanobetti et al, 2000;Le Tertre et al, 2002;D'Ippoliti et al, 2003;von Klot et al, 2005;Dominici et al, 2006) or increased cardiovascular mortality (Clancy et al, 2002;Forastiere et al, 2005;Zeka et al, 2005;Ostro et al, 2006). The physical or chemical particle properties (e.g.…”

Health Effects of Fine Particulate Air Pollution: Lines that Connect

“…Beginning in the late 1990s, studies dealing with air pollution and cardiovascular disease were being published, including in journals of cardiovascular medicine, where they were receiving useful editorial discussion 238 -241 and reviews. 138,[242][243][244][245][246][247][248][249] In 2004, the American Heart Association published a Scientific Statement that concluded that "studies have demonstrated a consistent increase risk for cardiovascular events in relation to both short-and long-term exposure to present-day concentrations of ambient particulate matter." 250 Table 4 provides a brief overview of recent evidence of cardiovascular and related effects associated with PM air pollution.…”