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Effects of reducing particulate air pollution exposure on chemoreflex, baroreflex and endotelial function in patients with chronic heart failure: crossover, randomized double-blind trial


Heart Failure (HF) is the end result of most cardiovascular disease states. This major clinical challenge is a public health problem and the leading cause of hospitalization for adults older than 65 years, therefore, the identification of precipitating factors that lead to acute cardiac decompensation and subsequent hospitalization is of public health interest. Particulate air pollution is associated with a 1.28% increase in hospital admission risk for acute decompensated heart failure per 10 mg/m3 elevation in same-day fine particles and the reduction in this exposure would decrease the number of hospitalizations by 3.156 in the U.S.A. Chronic heart failure patients have poor exercise capacity, and this reduced tolerance seems to be associated with neurohumoral excitation including arterial and cardiopulmonary baroreceptors, central and peripheral chemoreceptors and cardiac chemoreceptors. Air pollution exposure is associated with increased cardiovascular morbidity and mortality, and adverse effects on chemoreceptors, baroreceptors and endotelial function. The exposure reduction appears to abrogate the adverse effects of air pollution on acute cardiac decompensation. In fact, the simple intervention with a facemask has the potential to protect susceptible heart failure patients and prevent cardiovascular events in cities with high concentrations of ambient air pollution. The neurohumoral and cardiovascular effects of reducing pollutants exposure in HF patients are the trial endpoints. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
VIEIRA, JEFFERSON L.; GUIMARAES, GUILHERME V.; DE ANDRE, PAULO A.; NASCIMENTO SALDIVA, PAULO H.; BOCCHI, EDIMAR A.. Effects of reducing exposure to air pollution on submaximal cardiopulmonary test in patients with heart failure: Analysis of the randomized, double-blind and controlled FILTER-HF trial. INTERNATIONAL JOURNAL OF CARDIOLOGY, v. 215, p. 92-97, . (10/50150-0)

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