Aggravation of exercise performance in patients with anemia by 3% carboxyhemoglobin

Aronow, Wilbert S.; Schlueter, William J.; Williams, Mark A.; Petratis, M. Marlene; Sketch, Michael H.

doi:10.1016/0013-9351(84)90145-2

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…In addition, it has been reported that the inhalation of CO levels, comparable with smoking or urban atmospheric pollution, decreases performance among healthy volunteers. 12 , 13 Similar exercise capacity decrements in subjects with anemia 19 and chronic obstructive pulmonary disease have been observed. 18 , 23 Among CAD patients exposed to CO during exercise protocols, reduced oxygen uptake ( V · O 2 ) level at angina-onset 16 and shorter mean duration of exercise have been reported after CO inhalation (COHb 3.9% and 5.9%, respectively).…”

Section: Carbon Monoxidesupporting

confidence: 56%

“…64 These findings have not been confirmed among healthy subjects, 12 , 13 patients with chronic obstructive pulmonary disease, 18 anemia, 19 and CAD. 15 Similarly, investigators also found that O 3 inhalation during exercise does not influence BP in CAD patients.…”

Section: Blood Pressurecontrasting

confidence: 46%

“…However, it has been reported that CO usually does not impair maximal HR (HR max ) during maximal exercise testing among healthy subjects, 9 , 11-14 patients with coronary artery disease (CAD), 15-17 chronic obstructive pulmonary disease, 18 and anemia. 19 In this context, maximal effort may not fully allow the HR compensatory response, and therefore no changes of HR max during maximal effort may be explained. Among cohorts of young subjects exposed to high doses of CO decreases in maximal O 2 uptake ( V · O 2max ) have been reported during exercise testing.…”

Section: Carbon Monoxidementioning

confidence: 99%

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Air Pollution and Exercise

Giorgini

Rubenfire

Bard

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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Although regular aerobic exercise improves overall health, increased physical activity can lead to heightened exposures to a variety of air pollutants. As such, the cardiovascular health benefits of exercise may be abrogated to some degree by the harmful actions of inhaled pollutants. This review aims to provide an up-to-date summary for health professionals of the cardiovascular responses as well as the risks of exercising in air pollution. Aerobic exercise augments the overall inhaled air pollution dose, potentiates the diffusion of pollutants into circulating blood, and augments oxidative stress and inflammation. The inhalation of particulate matter during exercise can raise blood pressure, impair vascular function, and unfavorably affect autonomic balance. Several studies suggest that air pollutants can increase ischemic symptoms and signs during exercise and can even be capable of impairing exercise performance in some scenarios. The overall evidence supports that the risk-to-benefit ratio generally favors that health care providers continue to strongly encourage their patients to perform regular aerobic exercise. Nevertheless, a greater effort should be made to educate patients about the risks of air pollutant exposures during exercise, particularly those at heightened cardiovascular risk. Although no strategy has been directly tested to reduce morbidity and mortality rate, several prudent actions can be taken to lessen the degree of exposures during exercise which may thereby help mitigate the adverse effects of air pollutants on exercise performance and cardiovascular risk.

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Section: Carbon Monoxidesupporting

confidence: 56%

Section: Blood Pressurecontrasting

confidence: 46%

Section: Carbon Monoxidementioning

confidence: 99%

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Air Pollution and Exercise

Giorgini

Rubenfire

Bard

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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“…Most studies involved healthy adults, predominantly young males (31) [ 22 – 50 ], and persons with cardiovascular disease (20) [ 51 – 70 ]. One study was conducted among persons with COPD [ 71 ], one was conducted among persons with disease-related anemia [ 72 ], and one among healthy older persons (aged ≥60 years) [ 73 ]. We found no studies conducted among persons with CBD, heart failure, or multiple co-morbidities.…”

Section: Resultsmentioning

confidence: 99%

“…The mean change in COHb from baseline to post-exposure was highest in a study conducted in subjects with COPD (2.6%), compared with healthy subjects (2.3%) and in subjects with CVD (1.5, 2.1, and 2.4% for the three studies). Additionally, two studies which were conducted among subjects with CVD ( n = 15) [ 58 ] and anemia [ 72 ] investigated CO exposures of 50 ppm for 1-h, (n = 10). The mean change in COHb was higher in the study conducted in subjects with anemia (1.2%) compared with that conducted in subjects with CVD (0.9%).…”

Section: Resultsmentioning

confidence: 99%

A review of the experimental evidence on the toxicokinetics of carbon monoxide: the potential role of pathophysiology among susceptible groups

Barn¹,

Giles²,

Héroux³

et al. 2018

Environ Health

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BackgroundAcute high level carbon monoxide (CO) exposure can cause immediate cardio-respiratory arrest in anyone, but the effects of lower level exposures in susceptible persons are less well known. The percentage of CO-bound hemoglobin in blood (carboxyhemoglobin; COHb) is a marker of exposure and potential health outcomes. Indoor air quality guidelines developed by the World Health Organization and Health Canada, among others, are set so that CO exposure does not lead to COHb levels above 2.0%, a target based on experimental evidence on toxicodynamic relationships between COHb and cardiac performance among persons with cardiovascular disease (CVD). The guidelines do not consider the role of pathophysiological influences on toxicokinetic relationships. Physiological deficits that contribute to increased CO uptake, decreased CO elimination, and increased COHb formation can alter relationships between CO exposures and resulting COHb levels, and consequently, the severity of outcomes. Following three fatalities attributed to CO in a long-term care facility (LTCF), we queried whether pathologies other than CVD could alter CO-COHb relationships. Our primary objective was to inform susceptibility-specific modeling that accounts for physiological deficits that may alter CO-COHb relationships, ultimately to better inform CO management in LTCFs.MethodsWe reviewed experimental studies investigating relationships between CO, COHb, and outcomes related to health or physiological outcomes among healthy persons, persons with CVD, and six additional physiologically susceptible groups considered relevant to LTCF residents: persons with chronic obstructive pulmonary disease (COPD), anemia, cerebrovascular disease (CBD), heart failure, multiple co-morbidities, and persons of older age (≥ 60 years).ResultsWe identified 54 studies published since 1946. Six studies investigated toxicokinetics among healthy persons, and the remaining investigated toxicodynamics, mainly among healthy persons and persons with CVD. We identified one study each of CO dynamics in persons with COPD, anemia and persons of older age, and no studies of persons with CBD, heart failure, or multiple co-morbidities. Considerable heterogeneity existed for exposure scenarios and outcomes investigated.ConclusionsLimited experimental human evidence on the effects of physiological deficits relevant to CO kinetics exists to support indoor air CO guidelines. Both experimentation and modeling are needed to assess how physiological deficits influence the CO-COHb relationship, particularly at sub-acute exposures relevant to indoor environments. Such evidence would better inform indoor air quality guidelines and CO management in indoor settings where susceptible groups are housed.

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Wirkungen von Kohlenmonoxid auf das kardiovaskuläre System

Pankow

Hoffmann

1993

UWSF - Z. Umweltchem. Ökotox.

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Aggravation of exercise performance in patients with anemia by 3% carboxyhemoglobin

Cited by 5 publications

References 19 publications

Air Pollution and Exercise

Air Pollution and Exercise

A review of the experimental evidence on the toxicokinetics of carbon monoxide: the potential role of pathophysiology among susceptible groups

Wirkungen von Kohlenmonoxid auf das kardiovaskuläre System

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