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GENERAL CARDIOLOGY
Both short and long-term exposure to air pollution has been associated with an increase in cardiovascular morbidity and mortality, and the WHO estimates that air pollution causes 800 000 premature deaths each year. However, the exact mechanisms for this association remain relatively unexplored.
Mills et al performed a double-blind, randomised, crossover study of the effect of dilute diesel exhaust on 20 men with a previous history of myocardial infarction. In two separate sessions, the men were exposed to dilute diesel exhaust (300 µg per cubic metre) or filtered air for 1 hour during periods of both rest and moderate exercise. During the exposure experiment, continuous 12-lead electrocardiography was used to assess ST-segment changes. Six hours later, vasomotor and fibrinolytic function was assessed by means of intra-arterial agonist infusions.
Exercise-induced ST-segment depression was seen in all patients, but the changes seen were greater during exposure to diesel exhaust (–22 (SD 4)
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