Abstract
IntroductionExposure to air pollution is associated with increased cardiovascular morbidity, although the underlying mechanisms are unclear. Vascular dysfunction reduces arterial compliance and increases central arterial pressure and left ventricular after-load. We determined the effect of diesel exhaust exposure on arterial compliance using a validated non-invasive measure of arterial stiffness.MethodsIn a double-blind randomized fashion, 12 healthy volunteers were exposed to diesel exhaust (approximately 350 μg/m3) or filtered air for one hour during moderate exercise. Arterial stiffness was measured using applanation tonometry at the radial artery for pulse wave analysis (PWA), as well as at the femoral and carotid arteries for pulse wave velocity (PWV). PWA was performed 10, 20 and 30 min, and carotid-femoral PWV 40 min, post-exposure. Augmentation pressure (AP), augmentation index (AIx) and time to wave reflection (Tr) were calculated.ResultsBlood pressure, AP and AIx were generally low reflecting compliant arteries. In comparison to filtered air, diesel exhaust exposure induced an increase in AP of 2.5 mmHg (p = 0.02) and in AIx of 7.8% (p = 0.01), along with a 16 ms reduction in Tr (p = 0.03), 10 minutes post-exposure.ConclusionAcute exposure to diesel exhaust is associated with an immediate and transient increase in arterial stiffness. This may, in part, explain the increased risk for cardiovascular disease associated with air pollution exposure. If our findings are confirmed in larger cohorts of susceptible populations, this simple non-invasive method of assessing arterial stiffness may become a useful technique in measuring the impact of real world exposures to combustion derived-air pollution.
Highlights
Exposure to air pollution is associated with increased cardiovascular morbidity, the underlying mechanisms are unclear
Augmentation pressure (AP) and augmentation index (AIx) increased immediately after diesel exhaust exposure compared to filtered air (p = 0.01 and p = 0.02 respectively) and normalised over 30 minutes (Figure 1 and figure 2)
If our findings were confirmed in larger cohorts of susceptible populations, this simple non-invasive method of assessing arterial stiffness may become a useful technique in measuring the impact of real world exposures to combustion-derived air pollution
Summary
Exposure to air pollution is associated with increased cardiovascular morbidity, the underlying mechanisms are unclear. We determined the effect of diesel exhaust exposure on arterial compliance using a validated non-invasive measure of arterial stiffness. In complementary studies using venous occlusion plethysmography, we have reported impaired vasodilatation in response to intraarterial infusion of endothelium-dependent and -independent agonists immediately after exposure to DE [7]. These sophisticated techniques are ideal for small scale experimental exposure studies. There is a need to develop a simple non invasive bedside test to assess the effects of real world exposures to ambient air pollution on vascular function in larger population studies
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