Study reports influence of air pollution on pulmonary vascular function


"This is the first human study to report an influence of air pollution on pulmonary vascular function," said lead author Dr Jean-Francois Argacha, a cardiologist at the University Hospital (UZ) Brussels, Belgium. "This is a major public health issue for people living in polluted urban areas where exercise could damage the lungs and potentially lead to decompensated heart failure."

Promoting a safer environment appears to be as important as controlling conventional risk factors, like high cholesterol, in reducing cardiovascular disease. Air pollution consists of particles (particulate matter [PM] of different sizes) and gases (nitrogen dioxide, ozone, etc). The first vascular bed in contact with air pollutants is the pulmonary circulation yet few studies have investigated the impact.

"Such studies are important because if air pollution causes narrowing of the blood vessels in the lungs (vasoconstriction), this combined with the systemic effects of pollution could cause decompensated heart failure," said Dr Argacha.

The current study examined the effect of air pollution on pulmonary haemodynamics in a population and in individuals. The population study assessed whether common levels of outdoor air pollution influence the echocardiography parameters conventionally used to evaluate the pulmonary circulation and right ventricular function. Between 2009 and 2013, transthoracic echocardiography including an evaluation of pulmonary pressure was conducted in 16 295 individuals and correlated with average air pollution in Brussels on the same day and in the last five and ten days. The authors examined whether any patient subgroups were more susceptible to the effects of air pollution.




The individual study showed that exposure to diesel exhaust did not modify the pulmonary circulation compared to ambient air when the volunteers were resting but did when dobutamine was administered. "This suggests that pollution is more harmful to the lung circulation during exercise," said Dr Argacha.

He continued: "Our dual approach provides original data on the impact of air pollution on the pulmonary circulation. The individual study strengthens the plausible link emerging from the epidemiological research."


He added that legislation protecting the population from air pollution is weak. He said: "Diesel emission control has been associated with health outcomes5 but unfortunately the standards defined by the European Union differ from those of the World Health Organization."


European Society of Cardiology


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