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      Effect of nighttime aircraft noise exposure on endothelial function and stress hormone release in healthy adults

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          Abstract

          Aims

          Aircraft noise disturbs sleep, and long-term exposure has been shown to be associated with increases in the prevalence of hypertension and an overall increased risk for myocardial infarction. The exact mechanisms responsible for these cardiovascular effects remain unclear.

          Methods and results

          We performed a blinded field study in 75 healthy volunteers (mean age 26 years), who were exposed at home, in random order, to one control pattern (no noise) and two different noise scenarios [30 or 60 aircraft noise events per night with an average maximum sound pressure level (SPL) of 60 dB(A)] for one night each. We performed polygraphy during each study night. Noise caused a worsening in sleep quality ( P < 0.0001). Noise60, corresponding to equivalent continuous SPLs of 46.3 dB (Leq) and representing environmental noise levels associated with increased cardiovascular events, caused a blunting in FMD ( P = 0.016). As well, although a direct comparison among the FMD values in the noise groups (control: 10.4 ± 3.8%; Noise30: 9.7 ± 4.1%; Noise60: 9.5 ± 4.3%, P = 0.052) did not reach significance, a monotone dose-dependent effect of noise level on FMD was shown ( P = 0.020). Finally, there was a priming effect of noise, i.e. the blunting in FMD was particularly evident when subjects were exposed first to 30 and then to 60 noise events ( P = 0.006). Noise-induced endothelial dysfunction (ED) was reversed by the administration of Vitamin C ( P = 0.0171). Morning adrenaline concentration increased from 28.3 ± 10.9 to 33.2 ± 16.6 and 34.1 ± 19.3 ng/L ( P = 0.0099). Pulse transit time, reflecting arterial stiffness, was also shorter after exposure to noise ( P = 0.003).

          Conclusion

          In healthy adults, acute nighttime aircraft noise exposure dose-dependently impairs endothelial function and stimulates adrenaline release. Noise-induced ED may be in part due to increased production in reactive oxygen species and may thus be one mechanism contributing to the observed association of chronic noise exposure with cardiovascular disease.

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          Most cited references61

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          Endothelial nitric oxide synthase in vascular disease: from marvel to menace.

          Nitric oxide (NO*) is an important protective molecule in the vasculature, and endothelial NO* synthase (eNOS) is responsible for most of the vascular NO* produced. A functional eNOS oxidizes its substrate L-arginine to L-citrulline and NO*. This normal function of eNOS requires dimerization of the enzyme, the presence of the substrate L-arginine, and the essential cofactor (6R)-5,6,7,8-tetrahydro-L-biopterin (BH4), one of the most potent naturally occurring reducing agents. Cardiovascular risk factors such as hypertension, hypercholesterolemia, diabetes mellitus, or chronic smoking stimulate the production of reactive oxygen species in the vascular wall. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases represent major sources of this reactive oxygen species and have been found upregulated and activated in animal models of hypertension, diabetes, and sedentary lifestyle and in patients with cardiovascular risk factors. Superoxide (O2*-) reacts avidly with vascular NO* to form peroxynitrite (ONOO-). The cofactor BH4 is highly sensitive to oxidation by ONOO-. Diminished levels of BH4 promote O2*- production by eNOS (referred to as eNOS uncoupling). This transformation of eNOS from a protective enzyme to a contributor to oxidative stress has been observed in several in vitro models, in animal models of cardiovascular diseases, and in patients with cardiovascular risk factors. In many cases, supplementation with BH4 has been shown to correct eNOS dysfunction in animal models and patients. In addition, folic acid and infusions of vitamin C are able to restore eNOS functionality, most probably by enhancing BH4 levels as well.
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            Annoyance from transportation noise: relationships with exposure metrics DNL and DENL and their confidence intervals.

            We present a model of the distribution of noise annoyance with the mean varying as a function of the noise exposure. Day-night level (DNL) and day-evening-night level (DENL) were used as noise descriptors. Because the entire annoyance distribution has been modeled, any annoyance measure that summarizes this distribution can be calculated from the model. We fitted the model to data from noise annoyance studies for aircraft, road traffic, and railways separately. Polynomial approximations of relationships implied by the model for the combinations of the following exposure and annoyance measures are presented: DNL or DENL, and percentage "highly annoyed" (cutoff at 72 on a scale of 0-100), percentage "annoyed" (cutoff at 50 on a scale of 0-100), or percentage (at least) "a little annoyed" (cutoff at 28 on a scale of 0-100). These approximations are very good, and they are easier to use for practical calculations than the model itself, because the model involves a normal distribution. Our results are based on the same data set that was used earlier to establish relationships between DNL and percentage highly annoyed. In this paper we provide better estimates of the confidence intervals due to the improved model of the relationship between annoyance and noise exposure. Moreover, relationships using descriptors other than DNL and percentage highly annoyed, which are presented here, have not been established earlier on the basis of a large dataset.
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              THE FIRST NIGHT EFFECT: AN EEG STUDYOF SLEEP

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                Author and article information

                Journal
                Eur Heart J
                Eur. Heart J
                eurheartj
                ehj
                European Heart Journal
                Oxford University Press
                0195-668X
                1522-9645
                1 December 2013
                2 July 2013
                2 July 2013
                : 34
                : 45 , Focus Issue on Vascular Medicine
                : 3508-3514
                Affiliations
                [1 ]Department of Medicine II, University Medical Center, Johannes Gutenberg University Mainz , Langenbeckstrasse 1, 55131 Mainz, Germany
                [2 ]Unit of Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA, USA
                [3 ]Institut für Arbeits-, Sozial- und Umweltmedizin, University of Mainz , Mainz, Germany
                [4 ]Institute for Medical Biometry, Epidemiology and Informatics, University of Mainz , Mainz, Germany
                Author notes
                [* ]Corresponding author. Tel: +49 6131 17 7250, Fax: +49 6131 17 6615, Email: tmuenzel@ 123456uni-mainz.de
                Article
                eht269
                10.1093/eurheartj/eht269
                3844151
                23821397
                49f6e9e1-e341-40f2-a8e1-f5a96d884501
                © The Author 2013. Published by Oxford University Press on behalf of the European Society of Cardiology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 31 January 2013
                : 6 June 2013
                : 20 June 2013
                Page count
                Pages: 8
                Categories
                Clinical Research
                Vascular Medicine
                Editor's choice

                Cardiovascular Medicine
                endothelial function,aircraft noise,cardiovascular risk
                Cardiovascular Medicine
                endothelial function, aircraft noise, cardiovascular risk

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