Bloomfield Gerald S, Lagat David K, Akwanalo O Constantine, Carter E Jane, Lugogo Njira, Vedanthan Rajesh, Velazquez Eric J, Kimaiyo Sylvester, Sherman Charles B
Division of Cardiology and Duke Clinical Research Institute, Duke University, 2400 Pratt Street, DUMC Box 3850, Durham, NC 27705; Division of Cardiology and Duke Clinical Research Institute, Duke University, 2400 Pratt Street, DUMC Box 3850, Durham, NC 27705,
Glob Heart. 2012 Sep 1;7(3):249-259. doi: 10.1016/j.gheart.2012.06.015.
The health effects of exposure to household air pollution are gaining international attention. While the bulk of the known mortality estimates due to these exposures are derived from respiratory conditions, there is growing evidence of adverse cardiovascular health effects. Pulmonary hypertension and right heart failure are common conditions in low- and middle-income countries whose etiology may be related to common exposures in these regions such as schistosomiasis, human immunodeficiency virus, tuberculosis infections and other causes. While little is known of the interplay between exposure to household air pollution, right heart function and such conditions, the large burden of pulmonary hypertension and right heart failure in regions where there is significant exposure to household air pollution raises the possibility of a linkage. This review is presented in three parts. First, we explore what is known about pulmonary hypertension and right heart failure in low- and middle-income countries by focusing on eight common causes thereof. We then review what is known of the impact of household air pollution on pulmonary hypertension and posit that when individuals with one of these eight common comorbidities are exposed to household air pollution they may be predisposed to develop pulmonary hypertension or right heart failure. Lastly, we posit that there may be a direct link between exposure to household air pollution and right heart failure independent of pre-existing conditions which merits further investigation. Our overall aim is to highlight the multifactorial nature of these complex relationships and offer avenues for research in this expanding field of study.
接触家庭空气污染对健康的影响正日益受到国际关注。虽然已知因这些接触导致的大部分死亡率估计来自呼吸系统疾病，但越来越多的证据表明心血管健康会受到不利影响。肺动脉高压和右心衰竭在低收入和中等收入国家很常见，其病因可能与这些地区的常见接触因素有关，如血吸虫病、人类免疫缺陷病毒、结核病感染及其他原因。虽然对于接触家庭空气污染、右心功能与这些疾病之间的相互作用了解甚少，但在家庭空气污染暴露严重的地区，肺动脉高压和右心衰竭的沉重负担增加了存在关联的可能性。本综述分为三个部分。首先，我们通过关注肺动脉高压和右心衰竭在低收入和中等收入国家的八个常见病因，来探讨我们对它们的了解。然后，我们回顾家庭空气污染对肺动脉高压影响的已知情况，并假定当患有这八种常见合并症之一的个体接触家庭空气污染时，他们可能易患肺动脉高压或右心衰竭。最后，我们假定接触家庭空气污染与右心衰竭之间可能存在直接联系，且独立于先前存在的疾病，这值得进一步研究。我们的总体目标是强调这些复杂关系的多因素性质，并为这个不断扩展的研究领域提供研究途径。
