Exposure to Elevated Nitrogen Dioxide Concentrations and Cardiac Remodeling in Patients With Dilated Cardiomyopathy.
Exposure to Elevated Nitrogen Dioxide Concentrations and Cardiac Remodeling in Patients With Dilated Cardiomyopathy.
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DOI：
10.1016/j.cardfail.2021.11.023
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发表时间：
2022-06
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
作者：
二氧化氮空气污染与扩张型心肌病患者不良心脏重构相关。女性似乎更容易受到这些影响。扩张型心肌病患者应意识到空气污染与心血管健康之间的联系，以便采取措施尽量减少接触污染物。经验证据表明，暴露于空气污染与心力衰竭发生率、住院率和死亡率之间存在密切联系，但其生物学基础尚不清楚。我们试图确定不同空气污染水平与扩张型心肌病患者心脏结构和功能变化之间的关系。我们对英国扩张型心肌病患者进行了一项前瞻性纵向观察队列研究（入组2009-2015年，n = 716例，66%为男性，85%为高加索人），并在入组时进行了横断面分析。在登记时，二氧化氮（NO2）和直径小于或等于2.5微米的颗粒物（PM2.5）的年平均空气污染暴露估计值分配给每个居住邮编（平均12户）。使用线性回归模型评估空气污染与心脏形态之间的关系。较高的环境NO2暴露与较高的左室（LV）质量指数（每四分位数范围内NO2增加4.3 g/m2, 95%置信区间为1.9-7.0 g/m2）和较低的左室射血分数（每四分位数范围内NO2增加-1.5%，95%置信区间为-2.7%至-0.2%）相关，与年龄、性别、社会经济地位和临床共变量无关。根据邮政编码区域调整吸烟状况和地理聚类，这些关联是稳健的。空气污染对左室质量的影响以女性最大。这些影响是二氧化氮暴露所特有的。暴露于空气污染与左室质量升高和左室射血分数降低有关，其中对女性的影响最大。虽然空气污染与心力衰竭之间的流行病学关联已经建立并得到临床前研究的支持，但我们的研究结果为心脏重塑和暴露于空气污染提供了新的经验证据，具有重要的临床和公共卫生意义。
Nitrogen dioxide air pollution is associated with adverse cardiac remodeling in patients with dilated cardiomyopathy. Women seem to be more susceptible to these effects. Patients with dilated cardiomyopathy should be aware of the link between air pollution and their cardiovascular health so that they may take steps to minimize their exposure to pollutants. Empirical evidence suggests a strong link between exposure to air pollution and heart failure incidence, hospitalizations, and mortality, but the biological basis of this remains unclear. We sought to determine the relationship between differential air pollution levels and changes in cardiac structure and function in patients with dilated cardiomyopathy. We undertook a prospective longitudinal observational cohort study of patients in England with dilated cardiomyopathy (enrollment 2009–2015, n = 716, 66% male, 85% Caucasian) and conducted cross sectional analysis at the time of study enrollment. Annual average air pollution exposure estimates for nitrogen dioxide (NO2) and particulate matter with diameter of 2.5 µm or less (PM2.5) at enrolment were assigned to each residential postcode (on average 12 households). The relationship between air pollution and cardiac morphology was assessed using linear regression modelling. Greater ambient exposure to NO2 was associated with higher indexed left ventricular (LV) mass (4.3 g/m2 increase per interquartile range increase in NO2, 95% confidence interval 1.9–7.0 g/m2) and lower LV ejection fraction (–1.5% decrease per interquartile range increase in NO2, 95% confidence interval –2.7% to –0.2%), independent of age, sex, socioeconomic status, and clinical covariates. The associations were robust to adjustment for smoking status and geographical clustering by postcode area. The effect of air pollution on LV mass was greatest in women. These effects were specific to NO2 exposure. Exposure to air pollution is associated with raised LV mass and lower LV ejection fraction, with the strongest effect in women. Although epidemiological associations between air pollution and heart failure have been established and supported by preclinical studies, our findings provide novel empirical evidence of cardiac remodeling and exposure to air pollution with important clinical and public health implications.
影响因子：
10.4
作者：
Van Hee VC;Adar SD;Szpiro AA;Barr RG;Diez Roux A;Bluemke DA;Sheppard L;Gill EA;Bahrami H;Wassel C;Sale MM;Siscovick DS;Rotter JI;Rich SS;Kaufman JD
通讯作者：
Kaufman JD