Characterization of the cardiorespiratory function and its relationship with oxidative stress in women exposed to wood smoke who live at high altitude (3,850 m a.s.l.)
DOI:
https://doi.org/10.24265/horizmed.2021.v21n3.06Keywords:
Oxidative stress, Malondialdehyde, Carboxyhemoglobin, AltitudeAbstract
Objective: To characterize the cardiorespiratory function and the state of oxidative stress resulting from the exposure to wood smoke in women who live at high altitude (3,850 m a.s.l.). Materials and methods: An observational case-series study. The cardiorespiratory function was analyzed, and the
biomarkers of oxidative stress malondialdehyde (MDA) and carboxyhemoglobin (COHb) were quantified. Measures of central tendency and dispersion were determined. The statistical methods of association and correlation were implemented. Results: Sixty (60) patients were included in the research. Fifty percent (50.00 %) of the participants showed clinical evidence of heart disease and 25.00 % had clinical symptoms of respiratory disease. Forty-five percent (45.00 %) of the spirometries revealed normal values. Thirty-six point six seven percent (36.67 %) showed a decrease in the forced expiratory
volume in one second (FEV₁), forced expiratory volume in one second/forced vital capacity ratio (FEV₁/FVC) and/or forced expiratory flow 25-75% (FEF25-75). A decrease in FEV₁/FVC, FEF25-75 and FVC occurred in 8.33 %, 3.33 % and 1.67 % of the study participants, respectively. Moreover, a 5.00 % decrease was found in more than two parameters. Sixty percent (60.00 %) of the electrocardiograms revealed normal values, 36.67 % presented an intraventricular conduction disorder and 3.33 % showed dextrorotation of the heart. Eighty-one point six seven percent (81.67 %) of the participants presented an echocardiographic alteration, 73.33% showed valvular insufficiency, 20.00 % presented pulmonary hypertension and 6.67 % had an enlarged right ventricle. The mean MDA was 6 µM/L ± 2, which was positively correlated with the age (p: 0.029). The median COHb accounted for 1.00 % (p25: 0.70 – p75: 1.68). No statistically significant association was found between the COHb concentration and spirometric alterations. A positive correlation was found between MDA values and the right ventricle
wall thickness (p: 0.001). Conclusions: The different alterations of the cardiorespiratory function found in the study population show that both chronic exposure to wood smoke derivatives and hypobaric hypoxia are an important source of free radicals and lead to a permanent and sustained state of oxidative stress, which is responsible for the progressive deterioration of the cardiorespiratory function with no early clinical manifestation.
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Pope D, Diaz E, Smith-Sivertsen T, Lie RT, Bakke P, Balmes JR, et al. Exposure to household air pollution from wood combustion and association with respiratory symptoms and lung function in nonsmoking women: Results from the RESPIRE trial, Guatemala. Environ Health Perspect. 2015; 123(4): 285-92.
Smith-Sivertsen T, Díaz E, Pope D, Lie RT, Díaz A, McCracken J, et al. Effect of reducing indoor air pollution on women’s respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala. Am J Epidemiol. 2009; 170(2): 211-20.
Zhang J, Zhu T, Kipen H, Wang G, Huang W, Rich D, et al. Cardiorespiratory biomarker responses in healthy young adults to drastic air quality changes surrounding the 2008 Beijing Olympics. Res Rep Health Eff Inst. 2013; (174): 5-174.
Pardo M, Li C, He Q, Levin-Zaidman S, Tsoory M, Yu Q, et al. Mechanisms of lung toxicity induced by biomass burning aerosols. Part Fibre Toxicol. 2020; 17(1): 4.
Farmer SA, Nelin TD, Falvo MJ, Wold LE. Ambient and household air pollution: Complex triggers of disease. VAm J Physiol Heart Circ Physiol. 2014; 307(4): H467-76.
Kodgule R, Salvi S. Exposure to biomass smoke as a cause for airway disease in women and children. Curr Opin Allergy Clin Immunol. 2012; 12(1): 82-90.
Debevec T, Millet GP, Pialoux V. Hypoxia-induced oxidative stress modulation with physical activity. Front Physiol. 2017; 8: 84.
Instituto Nacional de Estadística. Necesidades Básicas Insatisfechas [Internet]. INE: Bolivia; 2019. Disponible en: https://www.ine.gob.bo/index.php/podreza-desarrollo/introduccion.
Horscroft JA, Kotwica AO, Laner V, West JA, Hennis PJ, Levett DZH, et al. Metabolic basis to sherpa altitude adaptation. Proc Natl Acad Sci U S A . 2017; 114(24): 6382-7.
Torres-Duque CA, García-Rodriguez MC, González-García M. Enfermedad pulmonar obstructiva crónica por humo de leña: ¿un fenotipo diferente o una entidad distinta?. Arch Bronconeumol. 2016; 52(8): 425-31.
Naeher LP, Brauer M, Lipsett M, Zelikoff JT, Simpson CD, Koenig JQ, et al. Woodsmoke health effects: A review. Inhal Toxicol. 2007; 19(1): 67-106.
Yagi K. Lipid peroxides and related radicals in clinical medicine. Adv Exp Med Biol. 1994; 366: 1-15.
Melgarejo-Pomar IG, Balanza-Erquicia E, Torrez-Colmena L, Quisberth-Barrera S, Suzaño-Vargas PL. Concentración de malondialdehido, en sujetos residentes de gran altura: estudio exploratorio. Rev Peru Med Exp Salud Publica. 2017; 34(4): 677-81.
Melgarejo-Pomar IG, Balanza-Erquicia E, Gómez-Mendivil JS, Torrez-Colmena L. Estrés oxidativo por humo de leña en mujeres nativas de gran altura - 3850 m s. n. m. Horiz Med. 2020; 20(1): 61-8.
Naeher LP, Brauer M, Lipsett M, Zelikoff JT, Simpson CD, Koenig JQ, et al. Woodsmoke Health Effects: A Review. Inhal Toxicol. 2007; 19(1): 67-106.
Sada-Ovalle I, Ocaña-Guzmán R, Torre-Bouscoulet L. Humo de biomasa, inmunidad innata y Mycobacterium tuberculosis. Neumol Cir Torax. 2015; 74(2): 118-26.
Gupta A, Shah A. Bronchial anthracofibrosis: An emerging pulmonary disease due to biomass fuel exposure. Int J Tuberc Lung Dis. 2011; 15(5): 602-12.
Frampton MW. Systemic and cardiovascular effects of airway injury and inflammation: Ultrafine particle exposure in humans. Environ Health Perspect. 2001; 109(Suppl 4): 529-32.
Alonso T, Sobradillo P, de Torres JP. Enfermedad pulmonar obstructiva crónica en mujeres: ¿somos diferentes?. Arch Bronconeumol. 2017; 53(4): 222-7.
Gupta D, Agarwal R, Aggarwal AN, Maturu VN, Dhooria S, Prasad KT, et al. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations. Lung India. 2013; 30(3): 228-67.
Riojas-Rodríguez H, Romieu I, Holguin F, González-Hermosillo A. Use of heartrate variability as a marker of cardiovascular effects associated with air pollution. Salud Publica Mex. 2006; 48(4): 348-57.
Salih S Bin, Alenezi H, Alghamdi A. A case of first degree AV block in carbon monoxide poisoning patient. J Saudi Hear Assoc. 2013; 25(4): 255-9.
Burroughs Peña MS, Velazquez EJ, Rivera JD, Alenezi F, Wong C, Grigsby M, et al. Biomass fuel smoke exposure was associated with adverse cardiac remodeling and left ventricular dysfunction in Peru. Indoor Air. 2017; 27(4): 737-45.
Hamanaka RB, Mutlu GM. Particulate Matter Air Pollution: Effects on the Cardiovascular System. Front Endocrinol (Lausanne). 2018; 9: 680.
Gorr MW, Falvo MJ, Wold LE. Air pollution and other environmental modulators of cardiac function. Compr Physiol. 2017; 7(4): 1479-95.
Robinson JC, Abbott C, Meadows CA, Roach RC, Honigman B, Bull TM. Long-Term Health Outcomes in High-Altitude Pulmonary Hypertension. High Alt Med Biol. 2017; 18(1): 61-6.
Kim D, Chen Z, Zhou L-F, Huang S-X. Air pollutants and early origins of respiratory diseases. Chronic Dis Transl Med. 2018; 4(2): 75-94.
Frump AL, Bonnet S, de Jesus Perez VA, Lahm T. Emerging role of angiogenesis in adaptive and maladaptive right ventricular remodeling in pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol. 2018; 314(4): L443-60.
Sydykov A, Mamazhakypov A, Petrovic A, Kosanovic D, Sarybaev AS, Weissmann N, et al. Inflammatory mediators drive adverse right ventricular remodeling and dysfunction and serve as potential biomarkers. Front Physiol. 2018; 9: 609.
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