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Zhou Y, Jin Y, Zhang Z. Short-term exposure to various ambient air pollutants and emergency department visits for cause-stable ischemic heart disease: a time-series study in Shanghai, China. Sci Rep 2023; 13:16989. [PMID: 37813933 PMCID: PMC10562371 DOI: 10.1038/s41598-023-44321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023] Open
Abstract
Studying the impact of local meteorological conditions and air pollution on cardiovascular disease is crucial for reducing the burden of cardiovascular disease. However, there have been few studies on the acute effects of various air pollutants on stable ischemic heart disease (SIHD), and the effects of these factors are not well defined and require further investigation. We performed a time-series study aimed at exploring the association between short-term exposure to various air pollutants and emergency department (ED) visits for SIHD during 2013-2020 in Baoshan District Renhe Hospital of Shanghai, China. The associations between air pollution (NO2, PM2.5, PM10, SO2 O3-8 h and CO) and ED visits were analyzed using quasi-Poisson regression. Subgroup and sensitivity analyses were conducted. From 2013 to 2020, a total of 18,241 ED visits for SIHD were recorded. Elevated PM2.5, PM10, NO2, SO2 and CO were significantly associated with increased ED visits for SIHD at lag (0, 5), lag 0, lag (0-4, 01-03), lag (0-3, 5, 01-03) and lag (3-5). When the concentration of O3-8 h was lower than the threshold recommended by the WHO, exposure to O3-8 h was associated with a slightly decreased risk of SIHD. Moreover, the relationship between different types of air pollution and the frequency of ED visits exhibited variations based on gender, age, and seasonality. This study suggests that short-term exposure to PM2.5, PM10, NO2, SO2 and CO might induce SIHD, especially in old females. Air pollution control measures should be encouraged to prevent the occurrence and development of SIHD.
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Affiliation(s)
- Yonghong Zhou
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China
| | - Yi Jin
- Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
| | - Zheng Zhang
- Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), School of Medicine, Shanghai University, Shanghai, China.
- Service of Endocrinology, Affiliated Renhe Hospital of Shanghai University (Renhe Hospital, Baoshan District), Shanghai, China.
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Park H, Lim S, Lee S, Mun D, Kang J, Kim H, Park H, Kim C, Park S, Lim YM, Joung B. High Level of Real Urban Air Pollution Promotes Cardiac Arrhythmia in Healthy Mice. Korean Circ J 2021; 51:157-170. [PMID: 33525071 PMCID: PMC7853890 DOI: 10.4070/kcj.2020.0255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/13/2020] [Accepted: 10/13/2020] [Indexed: 12/23/2022] Open
Abstract
Background and Objectives Ambient particulate matter (PM) in real urban air pollution (RUA) is an environmental health risk factor associated with increased cardiac events. This study investigated the threshold level to induce arrhythmia, as well as arrhythmogenic mechanism of RUA that mainly consisted of PM <2.5 μm in aerodynamic diameter close to ultrafine particles. Methods RUA was artificially produced by a lately developed pyrolysis based RUA generator. C57BL/6 mice were divided into 4 groups: a control group (control, n=12) and three groups with exposure to RUA with the concentration of 200 µg/m3 (n=12), 400 µg/m3 (n=12), and 800 µg/m3 (n=12). Mice were exposed to RUA at each concentration for 8 hr/day and 5 day/week to mimic ordinary human activity during 3 weeks. Results The QRS and QTc intervals, as well as intracellular Ca2+ duration, apicobasal action potential duration (APD) gradient, fibrosis, and inflammation of left ventricle of mouse hearts were increased dose-dependently with the increase of RUA concentration, and significantly increased at RUA concentration of 400 µg/m3 compared to control (all p<0.001). In mice exposed to RUA concentration of 800 µg/m3, spontaneous ventricular arrhythmia was observed in 42%, with significant increase of inflammatory markers, phosphorylated Ca2+/calmodulin-dependent protein kinase II (CaMKII), and phospholamban (PLB) compared to control. Conclusions RUA could induce electrophysiological changes such as APD and QT prolongation, fibrosis, and inflammation dose-dependently, with significant increase of ventricular arrhythmia at the concentration of 400 µg/m3. RUA concentration of 800 µg/m3 increased phosphorylation of CaMKII and PLB.
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Affiliation(s)
- Hyewon Park
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.,Department of Cardiology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Sangchul Lim
- Department of Mechanical Engineering, Dankook University, Yongin, Korea
| | - Seunghoon Lee
- Department of Mechanical Engineering, Dankook University, Yongin, Korea
| | - Dasom Mun
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - JiYoung Kang
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoeun Kim
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyelim Park
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.,Department of Otorhinolaryngology, Head and Neck Surgery, Inha University College of Medicine, Incheon, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - Sunho Park
- Department of Mechanical Engineering, Dankook University, Yongin, Korea
| | - Yeong Min Lim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,The Division of Cardiology, Saint Carollo Hospital, Suncheon, Korea.
| | - Boyoung Joung
- Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
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Wang X, Yu Y, Yu C, Shi F, Zhang Y. Associations between acute exposure to ambient air pollution and length of stay for inpatients with ischemic heart disease: a multi-city analysis in central China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:43743-43754. [PMID: 32737787 DOI: 10.1007/s11356-020-10256-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
Ambient air pollution (AAP) has been widely associated with increased morbidity of ischemic heart disease (IHD). However, no prior studies have investigated the effects of AAP exposure on the length of stay (LOS) due to IHD. Hospital data during 2015-2017 were obtained from hospital information system in five cities of Hubei province, China. We collected daily mean concentrations of air pollutants, including PM2.5, PM10, SO2, NO2, O3, and CO, and meteorological data during the same time period. Poisson regression was applied to estimate the acute impacts of AAP on the LOS of IHD inpatients. A total of 42,114 inpatients with primary diagnosis of IHD were included, 50.63% of which were chronic IHD inpatients. Annual average concentrations of PM2.5, PM10, SO2, NO2, O3, and CO were 61.93 μg/m3, 95.47 μg/m3, 18.59 μg/m3, 35.87 μg/m3, 100.30 μg/m3, and 1.117 mg/m3, respectively. After adjusting for temperature, relative humidity, gender, age group, payment method, number of hospital beds, location of hospital, and surgery or not, exposures to PM2.5, PM10, SO2, O3, and CO were associated with increased LOS for all IHD patients in both single- and multi-pollutant models, and stronger associations were observed among chronic IHD patients. In addition, subgroup analyses demonstrated that males and the group aged 65+ years were more vulnerable to air pollution, and the adverse effects were also promoted by low temperature in cold season. This study provides the first investigation of the adverse effects of AAP on the LOS for IHD patients. In order to shorten the LOS of IHD, measures should be taken to strengthen the AAP management and protect the high-risk population.
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Affiliation(s)
- Xuyan Wang
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yong Yu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, China
| | - Chuanhua Yu
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, 430071, China.
| | - Fang Shi
- Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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Cui L, Shi L, Li D, Li X, Su X, Chen L, Jiang Q, Jiang M, Luo J, Ji A, Chen C, Wang J, Tang J, Pi J, Chen R, Chen W, Zhang R, Zheng Y. Real-Ambient Particulate Matter Exposure-Induced Cardiotoxicity in C57/B6 Mice. Front Pharmacol 2020; 11:199. [PMID: 32296328 PMCID: PMC7136766 DOI: 10.3389/fphar.2020.00199] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
It is generally accepted that exposure to particulate matter (PM) increases the risk of cardiovascular-related morbidity and mortality, though the exact mechanism behind this has yet to be elucidated. Oxidative stress plays a potentially important role in the mechanism of toxicity, with Nrf2 serving as a major antioxidant gene. In the current study, a Nrf2 knockout mouse model was used in combination with an individual ventilated cage (IVC)-based real-ambient PM exposure system to assess the potential cardiotoxicity induced by real-ambient PM exposure and the potential role of Nrf2 and related signaling in this endpoint. After 6- or 11-weeks exposure to PM, ICP-mass spectrometry was used to assess the metal depositions in the heart tissue following PM exposure. Functional and morphological changes in the hearts were investigated with echocardiography and histopathology, and oxidative stress levels were assessed with a serum malondialdehyde content assay. In the further mechanistic study, an RNA-seq technique was utilized to assess the gene transcription status in the hearts of C57/B6 mice exposed to PM with or without Nrf2 knockout. The expression levels of genes of interest were then further investigated with quantitative real-time PCR and western blotting. The results indicated that PM exposure resulted in significant elevation of sodium, potassium, selenium, and ferrum levels in mouse heart tissue. Meanwhile, significantly altered heart function and morphology were observed. Interestingly, Nrf2 knockout led to abolishment of PM-induced effects in several functional parameters but not the morphological changes. Meanwhile, elevated malondialdehyde content was observed in Nrf2 knockout animals. RNA-seq results revealed thousands of genes altered by PM exposure and/or Nrf2 knockout, and this affected several pathways, such as MAPK, phagosome, calcium signaling, and JAK-STAT. In subsequent molecular studies, enhanced nuclear translocation of Nrf2 was also observed following PM exposure, while the MAPK signaling pathway along with related JAK-STAT and TGF-β1 pathway genes, such as p38MAPK, AKT, TAK1, JAK1, STAT3, GRB2, TGFb1, and SMAD2, were confirmed to be affected by PM exposure and/or Nrf2 knockout. The data suggested that PM may induce cardiotoxicity in C57/B6 mice in which Nrf2 plays both protective and detrimental roles involving cardiac-related pathways, such as MAPK, JAK-STAT, and TGF-β1.
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Affiliation(s)
- Lianhua Cui
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Limei Shi
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Daochuan Li
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaobo Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Xuan Su
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Liping Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qixiao Jiang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Menghui Jiang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jing Luo
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Andong Ji
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Chen Chen
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jianxun Wang
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - JingLong Tang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jingbo Pi
- School of Public Health, China Medical University, Shenyang, China
| | - Rui Chen
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Wen Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Yuxin Zheng
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
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Joung B. Risk Factor Management for Atrial Fibrillation. Korean Circ J 2019; 49:794-807. [PMID: 31456373 PMCID: PMC6713828 DOI: 10.4070/kcj.2019.0212] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/16/2019] [Indexed: 12/17/2022] Open
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. Many cardiovascular diseases and concomitant conditions increase the risk of the development of AF, recurrent AF, and AF-associated complications. Knowledge of these factors and their management is hence important for the optimal management of patients with AF. Recent studies have suggested that lowering the blood pressure threshold can improve the patients' outcome. Moreover, adverse events associated with a longer duration of hypertension can be prevented through strict blood pressure control. Pre-hypertension, impaired fasting glucose, abdominal obesity, weight fluctuation, and exposure to air pollution are related to the development of AF. Finally, female sex is not a risk factor of stroke, and the age threshold for stroke prevention should be lowered in Asian populations. The management of diseases related to AF should be provided continuously, whereas lifestyle factors should be monitored in an integrated manner.
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Affiliation(s)
- Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Yu Y, Yao S, Dong H, Ji M, Chen Z, Li G, Yao X, Wang SL, Zhang Z. Short-term effects of ambient air pollutants and myocardial infarction in Changzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:22285-22293. [PMID: 29808399 DOI: 10.1007/s11356-018-2250-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/07/2018] [Indexed: 05/06/2023]
Abstract
Ambient air pollution had been shown strongly associated with cardiovascular diseases. However, the association between air pollution and myocardial infarction (MI) is inconsistent. In the present study, we conducted a time-series study to investigate the association between air pollution and MI. Daily air pollutants, weather data, and MI data were collected from January 2015 to December 2016 in Changzhou, China. Generalized linear model (GLM) was used to assess the immediate effects of air pollutants (PM2.5, PM10, NO2, SO2, and O3) on MI. We identified a total of 5545 cases for MI, and a 10-μg/m3 increment in concentrations of PM2.5 and PM10 was associated with respective increases of 1.636% (95% confidence interval [CI] 0.537-2.740%) and 0.805% (95% CI 0.037-1.574%) for daily MI with 2-day cumulative effects. The associations were more robust among males and in the warm season versus the cold one. No significant effect was found in SO2, NO2, or O3. This study suggested that short-term exposure to PM2.5 and PM10 was associated with the increased MI risks. Our results might be useful for the primary prevention of MI exacerbated by air pollutants.
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Affiliation(s)
- Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Minghui Ji
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Zhiyong Chen
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Guiying Li
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Shou-Lin Wang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Zhan Zhang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China.
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Kim EA. Particulate Matter (Fine Particle) and Urologic Diseases. Int Neurourol J 2017; 21:155-162. [PMID: 28954465 PMCID: PMC5636961 DOI: 10.5213/inj.1734954.477] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/08/2017] [Indexed: 12/28/2022] Open
Abstract
Particulate matter (PM) has been found to damage vital body organs, including the lungs and heart, through vascular damage and oxidative stress. Recently, renal function and chronic urologic diseases have also been found to be related to PM. To investigate this, we reviewed the characteristics of PM related to renal toxicity, including recent studies on the associations of urologic diseases with PM. PM can include constituents that cause renal toxicity, such as lead, cadmium, arsenic, and crystalline silica, which result in renal tubular or interstitial damage. Since 2008, 7 studies have evaluated the renal effects of PM. Two prospective cohort studies and a quantitative study of consecutive patients showed that PM may be related to decreased renal function, as shown by the estimated glomerular filtration rate of diseased or aged participants. Two cross-sectional studies found an association between PM and chronic kidney disease. One of those studies identified the specific renal diseases of immunoglobulin A nephropathy and membranous nephropathy. Two studies that analyzed renal cancer and PM showed no evidence that renal cancer is related to PM. Nine studies were evaluated regarding the relationship of bladder and prostate cancer with PM. The evidence for an association of PM with bladder and prostate cancer is still inconclusive. Although some recently published studies have shown a significant relationship, the causal relationship is not clear. Further well-designed studies on specific renal diseases are required.
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Affiliation(s)
- Eun-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
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