细颗粒物(PM2.5)在动脉粥样硬化和心肌损伤发生中作用的现代概念:临床和流行病学数据,主要病理生理机制。

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Aleksey Michailovich Chaulin, Artem Konstantinovich Sergeev
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引用次数: 0

摘要

由于动脉粥样硬化性心血管疾病(CVD)在人群的发病率、致残率和死亡率结构中占主导地位,研究动脉粥样硬化性心血管病发展的危险因素及其潜在的发病机制是现代医学最重要的科学研究领域。了解这些方面将有助于改进一套治疗和预防措施及活动。细颗粒物(PM2.5)的空气污染是动脉粥样硬化发展的重要危险因素之一,近年来一直在积极研究。根据临床和流行病学数据,PM2.5的空气污染水平超过了世界大多数地区的标准指标,并与动脉粥样硬化的亚临床标志物和动脉粥样硬化性心血管疾病的死亡率有关。本文的目的是从流行病学和发病机制的角度,系统地详细讨论PM2.5在动脉粥样硬化和心肌损伤发展中的作用。材料和方法:这篇叙述性综述基于对Medline、PubMed和Embase数据库中出版物的分析。术语“细颗粒物”和“PM2.5”与“病理生理机制”、“心血管疾病”、“动脉粥样硬化”、“心肌肌钙蛋白”、“心脏损伤”和“心肌损伤”一起用于搜索出版物。结论:根据所进行的叙述性综述,PM2.5应被视为动脉粥样硬化性心血管疾病发展的重要危险因素。细颗粒物的促动脉粥样硬化作用基于几个基本且密切相关的病理生理机制:内皮功能障碍、脂质代谢受损、氧化应激和炎症反应增加、植物神经系统功能受损和止血系统活性增加。此外,PM2.5通过几种机制对心肌细胞造成亚临床损伤:细胞凋亡、氧化应激、冠状动脉粥样硬化导致的氧气输送减少和心肌细胞的缺血性损伤。高灵敏度的心肌肌钙蛋白是检测污染地区人群亚临床心肌损伤的有前途的标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern Concepts of the Role of Fine Particles (PM 2.5) in the Genesis of Atherosclerosis and Myocardial Damage: Clinical and Epidemiological Data, the Main Pathophysiological Mechanisms.

Due to the fact that atherosclerotic cardiovascular diseases (CVDs) dominate in the structure of morbidity, disability and mortality of the population, the study of the risk factors for the development of atherosclerotic CVDs, as well as the study of the underlying pathogenetic mechanisms thereof, is the most important area of scientific research in modern medicine. Understanding these aspects will allow improving the set of treatment and preventive measures and activities. One of the important risk factors for the development of atherosclerosis, which has been actively studied recently, is air pollution with fine particulate matter (PM 2.5). According to clinical and epidemiological data, the level of air pollution with PM 2.5 exceeds the normative indicators in most regions of the world and is associated with subclinical markers of atherosclerosis and mortality from atherosclerotic CVDs. The aim of this article is to systematize and discuss in detail the role of PM 2.5 in the development of atherosclerosis and myocardial damage with the consideration of epidemiological and pathogenetic aspects. Materials and Methods: This narrative review is based on the analysis of publications in the Medline, PubMed, and Embase databases. The terms "fine particles" and "PM 2.5" in combination with "pathophysiological mechanisms," "cardiovascular diseases", "atherosclerosis", "cardiac troponins", "myocardial damage" and "myocardial injury" were used to search publications. Conclusion: According to the conducted narrative review, PM 2.5 should be regarded as the significant risk factor for the development of atherosclerotic CVDs. The pro-atherogenic effect of fine particulate matter is based on several fundamental and closely interrelated pathophysiological mechanisms: endothelial dysfunction, impaired lipid metabolism, increased oxidative stress and inflammatory reactions, impaired functioning of the vegetative nervous system and increased activity of the hemostatic system. In addition, PM 2.5 causes subclinical damage to cardiac muscle cells by several mechanisms: apoptosis, oxidative stress, decreased oxygen delivery due to coronary atherosclerosis and ischemic damage of cardiomyocytes. Highly sensitive cardiac troponins are promising markers for detecting subclinical myocardial damage in people living in polluted regions.

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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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