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气候变化对人体心血管功能的影响。

The influence of climate change on human cardiovascular function.

作者信息

Gostimirovic Milos, Novakovic Radmila, Rajkovic Jovana, Djokic Vladimir, Terzic Dusko, Putnik Svetozar, Gojkovic-Bukarica Ljiljana

机构信息

Institute of Pharmacology, Clinical Pharmacology and Toxicology, Medical Faculty, University of Belgrade, Belgrade, Serbia.

Clinic for cardiosurgery, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia.

出版信息

Arch Environ Occup Health. 2020;75(7):406-414. doi: 10.1080/19338244.2020.1742079. Epub 2020 Mar 23.

Abstract

Climate change is considered to have great impact on human health. The heat waves have been associated with excess morbidity and mortality of cardiovascular diseases (CVD) across various populations and geographic locations. Important role in the heat-induced cardiovascular damage has endothelial dysfunction. It has been noticed that hot weather can impair tone and structure of the blood vessels via interfering with variety of biological factors such as nitric oxide synthesize, cytokine production and systemic inflammation. Also, due to dehydration and increased blood viscosity, by promoting thrombogenesis, heat has important impact on patients with atherosclerosis. During chronic exposure to the cold or hot weather cardiovascular function can be decreased, leading to a higher risk of developing heart attack, malignant cardiac arrhythmias, thromboembolic diseases and heat-induced sepsis like shock. It has been shown that changes in the ambient temperature through increasing blood pressure, blood viscosity, and heart rate, contribute to the cardiovascular mortality. The majority of deaths due to heat waves especially affect individuals with preexisting chronic CVD. This population can experience a decline in the health status, since extreme ambient temperature affects pharmacokinetic parameters of many cardiovascular drugs. Increased mortality from ischemic or hemorrhagic stroke can also be related to extreme temperature variations. On a cellular level, higher ambient temperature can limit storage of ATP and O increase amount of free radicals and toxic substances and induce neuronal apoptotic signal transduction, which all can lead to a stroke. Preserving cardiovascular function in context of extreme climate changing tends to be particularly challenging.

摘要

气候变化被认为对人类健康有重大影响。热浪已与不同人群和地理位置中心血管疾病(CVD)的发病率和死亡率过高相关。内皮功能障碍在热诱导的心血管损伤中起重要作用。人们已经注意到,炎热天气可通过干扰多种生物因素,如一氧化氮合成、细胞因子产生和全身炎症,损害血管的张力和结构。此外,由于脱水和血液粘度增加,热通过促进血栓形成,对动脉粥样硬化患者有重要影响。在长期暴露于寒冷或炎热天气期间,心血管功能可能会下降,导致心脏病发作、恶性心律失常、血栓栓塞性疾病和热诱导的败血症样休克的风险更高。研究表明,环境温度的变化通过增加血压、血液粘度和心率,导致心血管死亡率上升。热浪导致的大多数死亡尤其影响已有慢性心血管疾病的个体。由于极端环境温度会影响许多心血管药物的药代动力学参数,这一人群的健康状况可能会下降。缺血性或出血性中风死亡率的增加也可能与极端温度变化有关。在细胞水平上,较高的环境温度会限制ATP的储存,增加自由基和有毒物质的数量,并诱导神经元凋亡信号转导,所有这些都可能导致中风。在极端气候变化的背景下维持心血管功能往往特别具有挑战性。

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