RESUMO
OBJECTIVE: We investigated whether personal exposure to particulate matter = 10 microm in diameter (PM10) contributes to impaired cardiovascular function and increased systemic inflammation and oxidative stress in diabetic patients. METHODS: We monitored 25 patients' personal exposure to PM10 for 24 hours and then measured their heart rate, blood pressure, brachial arterial diameter, flow-mediated vasodilation (FMD), plasma cytokines, and thiobarbituric acid reactive substances (TBARS), which is an oxidative stress marker. We repeated this procedure for 7 weeks on each subject. We tested the associations using mixed-effects models. RESULTS: PM10 was significantly positively associated with FMD and TBARS but inversely associated with end-systolic basal brachial arterial diameter (P < 0.05). Moreover, in subjects not taking vasoactive medications, PM10 was significantly positively associated with blood pressure but inversely associated with artery flow. CONCLUSION: Elevated PM10 may contribute to oxidative stress and impaired cardiovascular function in patients with diabetes mellitus.
Assuntos
Poluição do Ar/efeitos adversos , Diabetes Mellitus/sangue , Exposição Ambiental/efeitos adversos , Estresse Oxidativo , Adulto , Biomarcadores/sangue , Pressão Sanguínea/fisiologia , Artéria Braquial/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Umidade , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Tamanho da Partícula , Fluxo Sanguíneo Regional , Temperatura , Vasodilatação/fisiologiaRESUMO
OBJECTIVES: This study assessed the feasibility of treadmill exercise rubidium-82 ((82)Rb) positron emission tomography (PET) and compared image quality and diagnostic content with dipyridamole (82)Rb PET in patients referred for evaluation of coronary artery disease (CAD). BACKGROUND: Dipyridamole stress (82)Rb PET myocardial perfusion imaging (MPI) is an accurate imaging modality used to diagnose CAD and determine prognosis. Although pharmacologic stress is used routinely, exercise treadmill stress may be an alternative and provide clinical information helpful to decision making, particularly for patients unwilling or unable to tolerate pharmacologic stress. METHODS: Fifty patients (mean age, 60 +/- 10 years; 47 men) underwent treadmill exercise and dipyridamole (82)Rb PET. Images were assessed: 1) qualitatively using a 17-segment model and a semiquantitative visual score on a five-point scale and with calculation of summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS); and 2) quantitatively with a 70% threshold for abnormal perfusion and expressed as extent of abnormal perfusion (% left ventricular). RESULTS: Treadmill exercise was preferred by 74% of patients (37 of 50, p < 0.001). The exercise and dipyridamole (82)Rb PET summed scores and quantitative extent of abnormal perfusion were very similar and highly correlated. Results of Bland-Altman analysis showed no significant bias. Image quality was superior with exercise stress with greater myocardial uptake and higher target to background ratios. CONCLUSIONS: Treadmill exercise (82)Rb PET is feasible and provides imaging results of similar diagnostic content and superior image quality compared with dipyridamole stress. Treadmill exercise is a reasonable alternative to pharmacologic stress with (82)Rb PET MPI.
Assuntos
Circulação Coronária/fisiologia , Doença das Coronárias/diagnóstico por imagem , Dipiridamol , Teste de Esforço , Tomografia por Emissão de Pósitrons/métodos , Vasodilatadores , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prognóstico , Estudos Prospectivos , Radioisótopos de RubídioAssuntos
Aminofilina/efeitos adversos , Dipiridamol , Toxidermias/etiologia , Teste de Esforço , Idoso , Feminino , HumanosRESUMO
OBJECTIVE: To investigate the associations between exposure to particulate air pollution and changes in cardiovascular function and plasma mediators in seniors. METHODS: We monitored daily indoor and outdoor black carbon and particulate matter < or = 2.5 microm (pm(2.5)) and personal pm(2.5) repeatedly for 28 nonsmoking seniors. We then measured their blood pressure, heart rate, and brachial artery function, and determined plasma mediators of inflammation, vascular function, and oxidative stress. We tested associations using mixed-effects models. RESULTS: Increases in black carbon and pm2.5 were associated with increases in blood pressure, heart rate, endothelin-1, vascular endothelial growth factor, and oxidative stress marker thiobarbituric acid reactive substances, and a decrease in brachial artery diameter (P < 0.05). CONCLUSION: Daily exposure to particulate pollution, likely traffic-related, may result in adverse effects on cardiovascular function and blood mediators that modulate vascular system in seniors.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/etiologia , Material Particulado/efeitos adversos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar em Ambientes Fechados/efeitos adversos , Biomarcadores/sangue , Determinação da Pressão Arterial , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Estudos de Coortes , Monitoramento Ambiental/métodos , Poluentes Ambientais/efeitos adversos , Monitoramento Epidemiológico , Feminino , Seguimentos , Avaliação Geriátrica , Frequência Cardíaca , Humanos , Incidência , Masculino , Medição de RiscoRESUMO
OBJECTIVE: Particulate air pollution is associated with cardiovascular morbidity but mechanisms are not well understood. We tested the effects on vascular reactivity of exposure to fine particulates matter mass (PM(2.5)), number of particles Assuntos
Vasos Sanguíneos/fisiopatologia
, Veículos Automotores
, Material Particulado/análise
, Adolescente
, Adulto
, Feminino
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Ontário
, Material Particulado/efeitos adversos
, População Urbana