Black carbon exposure, oxidative stress markers and major adverse cardiovascular events in patients with acute coronary syndromes

Isa WYH. An Evaluation of the Role of Oxidative Stress in Non-Obstructive Coronary Artery Disease

Approximately half of all women presenting to the emergency department with angina chest pain do not have obstructive coronary artery disease (CAD) on coronary angiography. This condition is termed non-obstructive coronary artery disease (NOCAD), and includes ischemia with no obstructive coronary artery disease (INOCA) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Oxidative stress has been reported to be involved in the development and progression of CAD. However, a scarcity of studies has assessed a correlation between oxidative stress and NOCAD. Thus, a literature review was performed of available reports on the role of oxidative stress in NOCAD. Possible mechanisms involved in oxidative stress that may contribute to NOCAD were identified and evaluated. A key finding of this literature review was that oxidative stress caused vasoconstriction and endothelial damage, and this results in coronary microvascular dysfunction and vasospasm, which, in turn, lead to the pathogenesis of NOCAD.

Particulate Matter-Induced Acute Coronary Syndrome: MicroRNAs as Microregulators for Inflammatory Factors

The most prevalent cause of mortality and morbidity worldwide is acute coronary syndrome (ACS) and its consequences. Exposure to particulate matter (PM) from air pollution has been shown to impair both. Various plausible pathogenic mechanisms have been identified, including microRNAs (miRNAs), an epigenetic regulator for gene expression. Endogenous miRNAs, average 22-nucleotide RNAs (ribonucleic acid), regulate gene expression through mRNA cleavage or translation repression and can influence proinflammatory gene expression posttranscriptionally. However, little is known about miRNA responses to fine PM (PM_2.5, PM₁₀, ultrafine particles, black carbon, and polycyclic aromatic hydrocarbon) from air pollution and their potential contribution to cardiovascular consequences, including systemic inflammation regulation. For the past decades, microRNAs (miRNAs) have emerged as novel, prospective diagnostic and prognostic biomarkers in various illnesses, including ACS. We wanted to outline some of the most important studies in the field and address the possible utility of miRNAs in regulating particulate matter-induced ACS (PMIA) on inflammatory factors in this review.

Oxidative stress and the cardiovascular effects of air pollution

Cardiovascular causes have been estimated to be responsible for more than two thirds of the considerable mortality attributed to air pollution. There is now a substantial body of research demonstrating that exposure to air pollution has many detrimental effects throughout the cardiovascular system. Multiple biological mechanisms are responsible, however, oxidative stress is a prominent observation at many levels of the cardiovascular impairment induced by pollutant exposure. This review provides an overview of the evidence that oxidative stress is a key pathway for the different cardiovascular actions of air pollution.

Saharan Dust Events in the Dust Belt -Canary Islands- and the Observed Association with in-Hospital Mortality of Patients with Heart Failure

Recent studies have found increases in the cardiovascular mortality rates during poor air quality events due to outbreaks of desert dust. In Tenerife, we collected (2014–2017) data in 829 patients admitted with a heart failure diagnosis in the Emergency Department of the University Hospital of the Canaries. In this region, concentrations of PM₁₀ and PM_2.5 are usually low (~20 and 10 µg/m³), but they increase to 360 and 115 μg/m³, respectively, during Saharan dust events. By using statistical tools (including multivariable logistic regressions), we compared in-hospital mortality of patients with heart failure and exposure to PM₁₀ and PM_2.5 during dust and no-dust events. We found that 86% of in-hospital heart failure mortality cases occurred during Saharan dust episodes that resulted in PM₁₀ > 50 µg/m³ (interquartile range: 71–96 µg/m³). A multivariate analysis showed that, after adjusting for other covariates, exposure to Saharan dust events associated with PM₁₀ > 50 µg/m³ was an independent predictor of heart failure in-hospital mortality (OR = 2.79, 95% CI (1.066–7.332), p = 0.03). In conclusion, this study demonstrates that exposure to high Saharan dust concentrations is independently associated with in-hospital mortality in patients with heart failure.

Differences in oxidative potential of black carbon from three combustion emission sources in China

Black carbon (BC) is mainly derived from the incomplete combustion of fossil fuels and biomass, and poses a serious threat to human health. Actual BC from extensive emission sources presents a variety of characteristics that are likely associated with different oxidative potentials (OP) and health endpoints. In the present study, BC derived from three main emission sources (residential coal combustion, biomass burning, and diesel engine exhaust) in China was subjected to physiochemical characterization and its OP was tested using dithiothreitol (DTT) assay. In order to obtain actual BC, the water-soluble part (WS) and organic extract (OE) were eluted successively from PM and the residue particle (RP) were reserved. PM from diesel vehicles had the most effective DTT consumption capacity, followed by PM from biomass and coal burning. And the OP of PM was mostly attributed to its RP part which mainly consisted of metals and BC. SEM/TEM, OC/EC, IC, and ICP-MS measurements confirmed that soluble ions and organic compounds were washed off effectively, while some metals were still retained in the RP part. Thus, the OP of BC was evaluated after adding DTPA to inhibit DTT activity caused by metals in the RP. Significant differences in OP and physiochemical characteristics of BC from the three emission sources were observed. BC from diesel exhaust exhibited the highest DTT activity (15.5 ± 12.6 pmol min^-1 μg^-1) compared to that of BC from biomass (2.5 ± 1.0 pmol min^-1 μg^-1) and coal (1.3 ± 0.5 pmol min^-1 μg^-1) burning. Diesel exhaust BC, which was emitted under the highest combustion temperature, had the smallest size. Coal consumption in China contributes to the highest amount of BC mass emission, but our result indicates that diesel exhaust BC has the greatest OP. An emission inventory based on health impacts is urgently needed to control air pollution sources in the future.

Short-term effects of ultrafine particles on daily mortality by primary vehicle exhaust versus secondary origin in three Spanish cities

BACKGROUND

Evidence on the short-term effects of ultrafine particles (with diameter<100nm, UFP) on health is still inconsistent. New particles in ambient urban air are the result of direct emissions and also the formation of secondary UFP from gaseous precursors. We segregated UFP into these two components and investigated their impact on daily mortality in three Spanish cities affected by different sources of air pollution.

METHODS

We separated the UFP using a method based on the high correlation between black carbon (BC) and particle number concentration (N). The first component accounts for aerosol constituents emitted by vehicle exhaust (N1) and the second for the photochemical new particle formation enhancements (N2). We applied city-specific Poisson regression models, adjusting for long-term trends, temperature and population dynamics.

RESULTS

Mean BC levels were higher in Barcelona and Tenerife (1.8 and 1.2μg·m^-3, respectively) than in Huelva (0.8μg·m^-3). While mean UFP concentrations were similar in the three cities, from which N1 was 40% in Barcelona, 46% in Santa Cruz de Tenerife, and 27% in Huelva. We observed an association with N1 and daily mortality in Barcelona, by increasing approximately 1.5% between lags 0 and 2, per an interquartile increase (IQR) of 3277cm^-3, but not with N2. A similar pattern was found in Santa Cruz de Tenerife, although none of the associations were significant. Conversely, in the industrial city of Huelva mortality was associated with N2 at lag 0, by increasing 3.9% per an IQR of 12,032·cm^-3.

CONCLUSION

The pattern and origin of UFP determines their short-term effect on human health. BC is possibly the better parameter to evaluate the health effects of particulate vehicle exhaust emissions, although in areas influenced by domestic solid fuel combustion this should also be taken into account.

Exercise Combined with Rhodiola sacra Supplementation Improves Exercise Capacity and Ameliorates Exhaustive Exercise-Induced Muscle Damage through Enhancement of Mitochondrial Quality Control

Mounting evidence has firmly established that increased exercise capacity (EC) is associated with considerable improvements in the survival of patients with cardiovascular disease (CVD) and that antistress capacity is a prognostic predictor of adverse cardiovascular events in patients with CVD. Previous studies have indicated that aerobic exercise (AE) and supplementation with Rhodiola sacra (RS), a natural plant pharmaceutical, improve EC and enable resistance to stress; however, the underlying mechanism remains unclear. This study explored the ability of AE and RS, alone or combined, to improve EC and ameliorate exhaustive exercise- (EE-) induced stress and elucidate the mechanism involved. We found that AE and RS significantly increased EC in mice and ameliorated EE-induced stress damage in skeletal and cardiac muscles (SCM); furthermore, a synergistic effect was detected for the first time. To our knowledge, the present work is the first to report that AE and RS activate mitophagy, mitochondrial dynamics, and biogenesis in SCM, both in the resting state and after EE. These data indicate that AE and RS synergistically improve EC in mice and protect SCM from EE-induced stress by enhancing mitochondrial quality control, including the activation of mitophagy, mitochondrial dynamics, and biogenesis, both at rest and after EE.

Short-term effects of ambient air pollution on emergency room admissions due to cardiovascular causes in Beijing, China

Ambient air pollution has been a major global public health issue. A number of studies have shown various adverse effects of ambient air pollution on cardiovascular diseases. In the current study, we investigated the short-term effects of ambient air pollution on emergency room (ER) admissions due to cardiovascular causes in Beijing from 2009 to 2012 using a time-series analysis. A total of 82430 ER cardiovascular admissions were recorded. Different gender (male and female) and age groups (15yrs ≤ age <65 yrs and age ≥ 65 yrs) were also examined by single model and multiple-pollutant model. Three major pollutants (SO₂, NO₂ and PM₁₀) had lag effects of 0-2 days on cardiovascular ER admissions. The relative risks (95% CI) of per 10 μg/m³ increase in PM₁₀, SO₂ and NO₂ were 1.008 (0.997-1.020), 1.008(0.999-1.018) and 1.014(1.003-1.024), respectively. The effect was more pronounced in age ≥65 and males in Beijing. We also found the stronger acute effects on the elderly and females at lag 0 than on the younger people and males at lag 2.

Role of oxidative stress in cardiovascular disease outcomes following exposure to ambient air pollution

Exposure to ambient air pollution is associated with adverse cardiovascular outcomes. These are manifested through several, likely overlapping, pathways including at the functional level, endothelial dysfunction, atherosclerosis, pro-coagulation and alterations in autonomic nervous system balance and blood pressure. At numerous points within each of these pathways, there is potential for cellular oxidative imbalances to occur. The current review examines epidemiological, occupational and controlled exposure studies and research employing healthy and diseased animal models, isolated organs and cell cultures in assessing the importance of the pro-oxidant potential of air pollution in the development of cardiovascular disease outcomes. The collective body of data provides evidence that oxidative stress (OS) is not only central to eliciting specific cardiac endpoints, but is also implicated in modulating the risk of succumbing to cardiovascular disease, sensitivity to ischemia/reperfusion injury and the onset and progression of metabolic disease following ambient pollution exposure. To add to this large research effort conducted to date, further work is required to provide greater insight into areas such as (a) whether an oxidative imbalance triggers and/or worsens the effect and/or is representative of the consequence of disease progression, (b) OS pathways and cardiac outcomes caused by individual pollutants within air pollution mixtures, or as a consequence of inter-pollutant interactions and (c) potential protection provided by nutritional supplements and/or pharmacological agents with antioxidant properties, in susceptible populations residing in polluted urban cities.

Short-term effects of air pollution, markers of endothelial activation, and coagulation to predict major adverse cardiovascular events in patients with acute coronary syndrome: insights from AIRACOS study

The aim of this study was to determine whether markers of inflammation and coagulation are associated with short-term particulate matter exposure and predict major adverse cardiovascular events at 360 d in patients with acute coronary syndrome (ACS). We included 307 consecutive patients, and assessed the average concentrations of data on atmospheric pollution in ambient air and meteorological variables from 1 d up to 7 d prior to admission. In patients with ACS, the markers of endothelial activation and coagulation, but not black carbon exposure, are associated with major adverse cardiovascular events at one-year follow-up.