The potential pathophysiology mediating the relationship between extreme heat and adverse cardiovascular outcomes (IMAGE)
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Extreme heat is associated with a greater risk of adverse cardiovascular (CV) outcomes, albeit the underlying mechanisms remain unknown. Cutaneous vasodilation during heat exposure reduces peripheral vascular resistance and is paralleled by a redistribution of blood flow and volume towards the skin circulation. Consequently, central blood volume is decreased and can be further reduced if sweating is not offset by adequate fluid intake. To compensate, cardiac output and contractility increase, presumably leading to greater myocardial oxygen consumption (MVO2) that may predispose to ischemic events in individuals with limited coronary flow reserve (CFR). In parallel, changes in blood rheology may promote an environment that is prone to thrombosis. Combined, these responses may underlie the greater risk of adverse CV outcomes during extreme heat exposure.
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Canadian Journal of Cardiology
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