Respiratory Filter Reduces the Cardiovascular Effects Associated With Diesel Exhaust Exposure A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure: The FILTER-HF Trial
Carregando...
Citações na Scopus
37
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Citação
JACC-HEART FAILURE, v.4, n.1, p.55-64, 2016
Resumo
OBJECTIVES The goal of this study was to test the effects of a respiratory filter intervention (filter) during controlled pollution exposure. BACKGROUND Air pollution is considered a risk factor for heart failure (HF) decompensation and mortality. METHODS This study was a double-blind, randomized to order, controlled, 3-way crossover, single-center clinical trial. It enrolled 26 patients with HF and 15 control volunteers. Participants were exposed in 3 separate sessions to clean air, unfiltered diesel exhaust exposure (DE), or filtered DE. Endpoints were endothelial function assessed by using the reactive hyperemia index (RHi), arterial stiffness, serum biomarkers, 6-min walking distance, and heart rate variability. RESULTS In patients with HF, DE was associated with a worsening in RHi from 2.17 (interquartile range [IQR]: 1.8 to 2.5) to 1.72 (IQR: 1.5 to 2.2; p = 0.002) and an increase in B-type natriuretic peptide (BNP) from 47.0 pg/ml (IQR: 17.3 to 118.0 pg/ml) to 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml; p = 0.004). Filtration reduced the particulate concentration (325 +/- 31 mu g/m(3) vs. 25 +/- 6 mu g/m(3); p < 0.001); in the group with HF, filter was associated with an improvement in RHi from 1.72 (IQR: 1.5 to 2.2) to 2.06 (IQR: 1.5 to 2.6; p = 0.019) and a decrease in BNP from 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml) to 44.0 pg/ml (IQR: 20.0 to 110.0 pg/ml; p = 0.015) compared with DE. In both groups, DE decreased the 6-min walking distance and arterial stiffness, although filter did not change these responses. DE had no effect on heart rate variability or exercise testing. CONCLUSIONS To our knowledge, this trial is the first to show that a filter can reduce both endothelial dysfunction and BNP increases in patients with HF during DE. Given these potential benefits, the widespread use of filters in patients with HF exposed to traffic-derived air pollution may have beneficial public health effects and reduce the burden of HF. (Effects of Air Pollution Exposure Reduction by Filter Mask on Heart Failure; NCT01960920) (C) 2016 by the American College of Cardiology Foundation.
Palavras-chave
air pollution, endothelium, heart failure
Referências
- Brook RD, 2002, CIRCULATION, V105, P1534, DOI 10.1161/01.CIR.0000013838.94747.64
- Pery ARR, 2009, INHAL TOXICOL, V21, P1099, DOI 10.3109/08958370902748542
- Simkhovich BZ, 2007, BASIC RES CARDIOL, V102, P467, DOI 10.1007/s00395-007-0681-0
- Simkhovich BZ, 2008, J AM COLL CARDIOL, V52, P719, DOI 10.1016/j.jacc.2008.05.029
- Bocchi EA, 2002, CIRCULATION, V106, P1097, DOI 10.1161/01.CIR.0000027149.83473.B6
- Wallen MB, 2012, EUR J APPL PHYSIOL, V112, P1153, DOI 10.1007/s00421-011-2079-9
- Brook RD, 2008, CLIN SCI, V115, P175, DOI 10.1042/CS20070444
- Wellenius GA, 2006, AM J CARDIOL, V97, P404, DOI 10.1016/j.amjcard.2005.08.061
- Rundell KW, 2012, BRIT J SPORT MED, V46, P407, DOI 10.1136/bjsports-2011-090823
- Peretz A, 2008, ENVIRON RES, V107, P178, DOI 10.1016/j.envres.2008.01.012
- Storrow AB, 2014, JACC-HEART FAIL, V2, P269, DOI 10.1016/j.jchf.2014.01.006
- Devlin RB, 2014, TOXICOL SCI, V140, P61, DOI 10.1093/toxsci/kfu063
- Pope CA, 2006, J AIR WASTE MANAGE, V56, P709
- Lundback M, 2009, PART FIBRE TOXICOL, V6, DOI 10.1186/1743-8977-6-7
- Marti CN, 2012, J AM COLL CARDIOL, V60, P1455, DOI 10.1016/j.jacc.2011.11.082
- Kreyling WG, 2002, J TOXICOL ENV HEAL A, V65, P1513, DOI 10.1080/00984100290071649
- O'Neill MS, 2005, CIRCULATION, V111, P2913, DOI 10.1161/CIRCULATIONAHA.104.517110
- Ostro B, 2014, ENVIRON RES, V132, P168, DOI 10.1016/j.envres.2014.03.042
- Peretz A, 2008, ENVIRON HEALTH PERSP, V116, P937, DOI 10.1289/ehp.11027
- Shah ASV, 2013, LANCET, V382, P1039, DOI 10.1016/S0140-6736(13)60898-3
- Dominici F, 2006, JAMA-J AM MED ASSOC, V295, P1127, DOI 10.1001/jama.295.10.1127
- Langrish JP, 2009, PART FIBRE TOXICOL, V6, DOI 10.1186/1743-8977-6-8
- Mills NL, 2011, EUR HEART J, V32, P2660, DOI 10.1093/eurheartj/ehr195
- Matsuzawa Y, 2010, J AM COLL CARDIOL, V55, P1688, DOI 10.1016/j.jacc.2009.10.073
- Chaudhry SI, 2013, J AM COLL CARDIOL, V61, P635, DOI 10.1016/j.jacc.2012.11.027
- Mills NL, 2005, CIRCULATION, V112, P3930, DOI 10.1161/CIRCULATIONAHA.105.588962
- Mills NL, 2006, AM J RESP CRIT CARE, V173, P426, DOI 10.1164/rccm.200506-865OC
- Cutrufello PT, 2011, INHAL TOXICOL, V23, P658, DOI 10.3109/08958378.2011.604106
- Mills NL, 2011, HEART, V97, P544, DOI 10.1136/hrt.2010.199042
- Nemmar A, 2002, CIRCULATION, V105, P411, DOI 10.1161/hc0402.104118
- Ruckerl R, 2006, AM J RESP CRIT CARE, V173, P432, DOI 10.1164/rccm.200507-1123OC
- Geiser M, 2005, ENVIRON HEALTH PERSP, V113, P1555, DOI 10.1289/ehp.8006
- Oremus M, 2014, HEART FAIL REV, V19, P471, DOI 10.1007/s10741-014-9439-6
- Wiebert P, 2006, INHAL TOXICOL, V18, P741, DOI 10.1080/08958370600748455
- Cassee FR, 2013, INHAL TOXICOL, V25, P802, DOI 10.3109/08958378.2013.850127
- Nakane Hideo, 2012, Environmental Health and Preventive Medicine, V17, P263, DOI 10.1007/s12199-011-0252-8
- Martinelli N, 2013, EUR J INTERN MED, V24, P295, DOI 10.1016/j.ejim.2013.04.001
- Mills NL, 2009, NAT CLIN PRACT CARD, V6, P36, DOI 10.1038/ncpcardio1399
- Kuvin JT, 2003, AM HEART J, V146, P168, DOI 10.1016/S0002-8703(03)00094-2
- Wellenius GA, 2005, AM J EPIDEMIOL, V161, P1030, DOI 10.1093/aje/kwi135
- Hwang SJ, 2014, INT J CARDIOL, V176, P494, DOI 10.1016/j.ijcard.2014.07.063
- Lucking AJ, 2008, EUR HEART J, V29, P3043, DOI 10.1093/eurheartj/ehn464
- Brauner EV, 2008, AM J RESP CRIT CARE, V177, P419, DOI 10.1164/rccm.200704-632OC
- Allen RW, 2011, AM J RESP CRIT CARE, V183, P1222, DOI 10.1164/rccm.201010-1572OC
- Barath S, 2010, PART FIBRE TOXICOL, V7, P19
- Chen J, 1998, JAMA-J AM MED ASSOC, V306, P1669
- Frohlich E, 2014, INT J MOL SCI, V15, P4795, DOI 10.3390/ijms15034795
- Ghio AJ, 2012, SWISS MED WKLY, V142, DOI 10.4414/smw.2012.13597
- Grunig Gabriele, 2014, Pulm Circ, V4, P25, DOI 10.1086/674902
- Hoek G, 2013, ENVIRON HEALTH-GLOB, V12, DOI 10.1186/1476-069X-12-43
- Krishnan RM, 2013, PART FIBRE TOXICOL, V10, DOI 10.1186/1743-8977-10-7
- Mills NL, 2007, NEW ENGL J MED, V357, P1075, DOI 10.1056/NEJMoa066314
- Moerland M, 2012, INT J VASC MED, V2012
- Morishita M, 2015, CURR CARDIOVASC RISK, V9
- Nemmar A., 2013, BIOMED RES INT, V2013, DOI 10.1155/2013/279371
- Neophytou AM, 2013, ENVIRON HEALTH-GLOB, V12, DOI 10.1186/1476-069X-12-105
- Saber AT, 2014, WIRES NANOMED NANOBI, V6, P517, DOI 10.1002/wnan.1279
- Saldiva P., 2013, GLOBO NEWS
- Wellenius GA, 2007, ENVIRON HEALTH-GLOB, V6, DOI 10.1186/1476-069X-6-26
- WHO, AMB OUTD AIR QUAL HL
Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/05
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03
Carregar mais Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/05
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03