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Environ Res. 2019 Apr;171:239-246. doi: 10.1016/j.envres.2019.01.023. Epub 2019 Jan 14.

Ambient air pollution is associated with cardiac repolarization abnormalities in healthy adults.

Author information

1
Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing 100191, China; Key Laboratory of Molecular Cardiovascular Sciences of the Ministry of Education, Health Science Center, Peking University Medicine, Beijing 100191, China.
2
Department of Prevention and Health Care, Hospital of Health Science Center, Peking University, Beijing 100191, China.
3
Division of Cardiology, Peking University First Hospital, Beijing 100034, China; Key Laboratory of Molecular Cardiovascular Sciences of the Ministry of Education, Health Science Center, Peking University Medicine, Beijing 100191, China.
4
Division of Cardiovascular Medicine, Case Western Reserve University, OH 10900, USA.
5
Division of Cardiovascular Medicine, University of Michigan, MI 48109, USA.
6
Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing 100191, China; Key Laboratory of Molecular Cardiovascular Sciences of the Ministry of Education, Health Science Center, Peking University Medicine, Beijing 100191, China. Electronic address: whuang@bjmu.edu.cn.

Abstract

BACKGROUND:

Ambient air pollution has been associated with acute cardiovascular events; however, the underlying mechanisms remain incompletely understood. We aimed to examine the impacts of ambient air pollutants on cardiac ventricular repolarization in a highly polluted urban region.

METHODS:

Seventy-three healthy non-smoking young adults (66% female, mean age of 23.3 ± 5.4 years) were followed with four repeated 24-h electrocardiogram recordings in 2014-2016 in Beijing, China. Continuous concentrations of ambient particulates in size fractions of 5-560 nm diameter, black carbon (BC), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and ozone (O3) were measured at a fixed-location air pollution monitoring station. Generalized linear mixed models, with adjustment for individual risk factors, time-varying factors and meteorological parameters, were used to evaluate the effects of air pollution on 5-min segments of heart rate-corrected QT interval (QTc), an index of cardiac ventricular repolarization.

RESULTS:

During the study period, the mean levels of number concentrations of particulates in size range of 5-560 nm (PNC5-560) were 20,711 particles/cm3. Significant increases in QTc of 0.56% (95% CI: 0.27, 0.84) to 1.76% (95% CI: 0.73, 2.79) were associated with interquartile range increases in PNC50-560 at prior 1-5 moving average days. Significant increases in QTc were also associated with increases in exposures to traffic-related air pollutants (BC, NO2 and CO), a combustion pollutant SO2, and the secondary pollutant O3. The associations were stronger in participants who were male, overweight, with abdominal obesity, and with higher levels of high-sensitivity C-reactive protein.

CONCLUSIONS:

Our findings suggest that exposures to higher levels of ambient particulates in small size fractions and traffic pollutants were associated with cardiac repolarization abnormalities in healthy adults, and the cardio-metabolic risks may modify the adverse cardiac effects attributable to air pollution.

KEYWORDS:

Cardiac repolarization; Cardio-metabolic risk; Effect modification; Size-fractioned particulate; Traffic pollution

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