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We recently read the interesting article by Münzel et al.1 They provide an overview of the impact of particulate and gaseous pollutants on endothelial function from human and animal studies. However, we would like to point out an important aspect in relationship with the impact of naturally generated particulate matter (PM) emanating from dust storms and the adverse health effects on human populations. Sin financiación 22.673 JCR (2019) Q1, 2/138 Cardiac & Cardiovascular Systems 5.883 SJR (2019) Q1, 4/362 Cardiology and Cardiovascular Medicine No data IDR 2019 UEC

Objetivo. Evaluar si la exposición a episodios de polvo sahariano predice los ingresos hospitalarios de los pacientes con insuficiencia cardiaca aguda (ICA) atendidos en un servicio de urgencias hospitalario (SUH).Método. Estudio unicéntrico, de cohorte retrospectiva, de pacientes con ICA atendidos en un SUH. La población de estudio se dividió en 2 grupos: pacientes ingresados por ICA y pacientes con ICA dados de alta directa a domicilio desde el SUH. Se analizaron las concentraciones medias de material partículado (PMx) (respirables, diámetro aerodiná-mico, da < 10 μm), PM2,5 (finas, da < 2,5 μm) y PM2,5-10 (gruesas, da 2,5-10 μm) desde el día de la llegada al SUH hasta 5 días previos. Se definió exposición intensa al polvo sahariano cuando las concentraciones medias diarias de PM10 estaban entre 50 y 200 μg/m3. La relación para estimar el riesgo de ingresar por ICA en función de la exposición de PMx durante los 5 días previos a su llegada a urgencias se analizó mediante análisis multivariable.Resultados. Se incluyeron 1.097 pacientes con ICA, ingresaron 318 pacientes (29%), 779 (71%) se dieron de alta. Los pacientes ingresados por ICA tenían mayor edad, elevada comorbilidad y mayor proporción de pacientes expuestos a episodios intensos de polvo sahariano (p < 0,0001). En el análisis multivariable la exposición a episodios de polvo saha-riano intensos se relacionó con el ingreso hospitalario en los pacientes con ICA (OR = 2,36; IC 95% 1,21-4,58; p = 0,01).Conclusiones. En ausencia de estudios prospectivos, los resultados obtenidos de la serie analizada sugieren que la presencia de concentraciones elevadas de polvo sahariano (PM10: 50-200 μg/m3) puede constituir un factor precipi-tante de ingreso por ICA. Objectives: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). Methods: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. Results: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). Conclusion: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes. Keywords: Acute heart failure; Precipitating factors; Saharan dust; Polvo sahariano; Servicio de Urgencias; Emergency health services; Factor precipitante; Insuficiencia cardiaca aguda. Sin financiación 3.173 JCR (2019) Q1, 4/31 Emergency Medicine 0.373 SJR (2019) Q2, 36/87 Emergency Medicine No data IDR 2019 UEC