• Am. J. Physiol. Heart Circ. Physiol. · Jun 2015

    Randomized Controlled Trial

    Exposure to medium and high ambient levels of ozone causes adverse systemic inflammatory and cardiac autonomic effects.

    • Mehrdad Arjomandi, Hofer Wong, Aneesh Donde, Jessica Frelinger, Sarah Dalton, Wendy Ching, Karron Power, and John R Balmes.
    • Human Exposure Laboratory, Division of Occupational and Environmental Medicine, San Francisco General Hospital Medical Center, San Francisco, California; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, California; Pulmonary Research Group, San Francisco Veterans Affairs Medical Center, San Francisco, California; mehrdad.arjomandi@ucsf.edu.
    • Am. J. Physiol. Heart Circ. Physiol. 2015 Jun 15; 308 (12): H1499-509.

    AbstractEpidemiological evidence suggests that exposure to ozone increases cardiovascular morbidity. However, the specific biological mechanisms mediating ozone-associated cardiovascular effects are unknown. To determine whether short-term exposure to ambient levels of ozone causes changes in biomarkers of cardiovascular disease including heart rate variability (HRV), systemic inflammation, and coagulability, 26 subjects were exposed to 0, 100, and 200 ppb ozone in random order for 4 h with intermittent exercise. HRV was measured and blood samples were obtained immediately before (0 h), immediately after (4 h), and 20 h after (24 h) each exposure. Bronchoscopy with bronchoalveolar lavage (BAL) was performed 20 h after exposure. Regression modeling was used to examine dose-response trends between the endpoints and ozone exposure. Inhalation of ozone induced dose-dependent adverse changes in the frequency domains of HRV across exposures consistent with increased sympathetic tone [increase of (parameter estimate ± SE) 0.4 ± 0.2 and 0.3 ± 0.1 in low- to high-frequency domain HRV ratio per 100 ppb increase in ozone at 4 h and 24 h, respectively (P = 0.02 and P = 0.01)] and a dose-dependent increase in serum C-reactive protein (CRP) across exposures at 24 h [increase of 0.61 ± 0.24 mg/l in CRP per 100 ppb increase in ozone (P = 0.01)]. Changes in HRV and CRP did not correlate with ozone-induced local lung inflammatory responses (BAL granulocytes, IL-6, or IL-8), but changes in HRV and CRP were associated with each other after adjustment for age and ozone level. Inhalation of ozone causes adverse systemic inflammatory and cardiac autonomic effects that may contribute to the cardiovascular mortality associated with short-term exposure. Copyright © 2015 the American Physiological Society.

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