Associations between PM2.5 and heart rate variability are modified by particle composition and beta-blocker use in patients with coronary heart disease.
Associations between PM2.5 and heart rate variability are modified by particle composition and beta-blocker use in patients with coronary heart disease.
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DOI：
10.1289/ehp.11062
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发表时间：
2009-01
影响因子：
10.4
通讯作者：
Pekkanen, Juha
中科院分区：
文献类型：
--
作者：
de Hartog, Jeroen J.;Lanki, Timo;Timonen, Kirsi L.;Hoek, Gerard;Janssen, Nicole A. H.;Ibald-Mulli, Angela;Peters, Annette;Heinrich, Joachim;Tarkiainen, Tuula H.;van Grieken, Rene;van Wijnen, Joop H.;Brunekreef, Bert;Pekkanen, Juha
关键词：
据推测，环境颗粒物空气污染能够改变心脏的自主神经控制，即心率变异性（HRV）。之前我们报道了三个研究中心空气动力学直径< 2.5 μm （PM2.5）的颗粒物与HRV之间的异质性关联。我们评估了暴露错误分类、药物影响或颗粒组成差异是否可以解释不一致。患有冠心病的受试者每两周到荷兰阿姆斯特丹的诊所就诊；德国埃尔福特;芬兰赫尔辛基6-8个月。在有节奏呼吸时，用动态心电图测量心电图（ECG； SDNN）上神经网络间隔的标准差（SD）和HRV高频功率（HF）。室外PM2.5水平是在中心地点测量的。在阿姆斯特丹和赫尔辛基，在诊所就诊前24小时测量室内和个人PM2.5。使用主成分分析对不同来源的PM2.5进行分配。我们使用线性回归分析了室内/个人PM2.5、PM2.5元素和源特异性PM2.5与HRV的关系。室内和个人PM2.5与HRV无关。在未使用β受体阻滞剂药物的人群中，室外PM2.5的增加仅在滞后2天和3天后与SDNN和HF的降低相关。交通相关的PM2.5与SDNN降低相关，而远距离运输的PM2.5与SDNN和HF降低相关，在未使用受体阻滞剂的人群中最为明显。来自交通和远程运输的PM2.5指标也与HRV下降有关。我们的研究结果表明，颗粒组成、β受体阻滞剂使用和研究对象肥胖的差异可能解释了以往HRV研究之间的一些不一致。
It has been hypothesized that ambient particulate air pollution is able to modify the autonomic nervous control of the heart, measured as heart rate variability (HRV). Previously we reported heterogeneous associations between particulate matter with aerodynamic diameter < 2.5 μm (PM2.5) and HRV across three study centers. We evaluated whether exposure misclassification, effect modification by medication, or differences in particle composition could explain the inconsistencies. Subjects with coronary heart disease visited clinics biweekly in Amsterdam, the Netherlands; Erfurt, Germany; and Helsinki, Finland for 6–8 months. The standard deviation (SD) of NN intervals on an electrocardiogram (ECG; SDNN) and high frequency (HF) power of HRV was measured with ambulatory ECG during paced breathing. Outdoor levels of PM2.5 were measured at a central site. In Amsterdam and Helsinki, indoor and personal PM2.5 were measured during the 24 hr preceding the clinic visit. PM2.5 was apportioned between sources using principal component analyses. We analyzed associations of indoor/personal PM2.5, elements of PM2.5, and source-specific PM2.5 with HRV using linear regression. Indoor and personal PM2.5 were not associated with HRV. Increased outdoor PM2.5 was associated with decreased SDNN and HF at lags of 2 and 3 days only among persons not using beta-blocker medication. Traffic-related PM2.5 was associated with decreased SDNN, and long-range transported PM2.5 with decreased SDNN and HF, most strongly among persons not using beta blockers. Indicators for PM2.5 from traffic and long-range transport were also associated with decreased HRV. Our results suggest that differences in the composition of particles, beta-blocker use, and obesity of study subjects may explain some inconsistencies among previous studies on HRV.
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