Association of short-term ambient air pollution concentrations and ventricular arrhythmias
Association of short-term ambient air pollution concentrations and ventricular arrhythmias
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DOI：
10.1093/aje/kwi143
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发表时间：
2005-06-15
影响因子：
5
通讯作者：
Dockery, DW
中科院分区：
文献类型：
--
作者：
Rich, DQ;Schwartz, J;Dockery, DW
作者评估了植入式心脏复律除颤器检测到的室性心律失常与心律失常发生前几小时内环境空气污染浓度之间的关联。 1995 年中至 1999 年期间，在马萨诸塞州波士顿新英格兰医疗中心接受植入式心律转复除颤器治疗的患者（n = 203）居住在距中心监测点 40 公里以内的患者（n = 203），随访至 2002 年 7 月。作者采用病例交叉设计来研究环境空气污染与 84 名受试者中多达 798 例确诊的室性心律失常之间的关系。作者发现，空气动力学直径小于 2.5 μm 的 24 小时移动平均颗粒物和臭氧的四分位距增加分别与室性心律失常风险增加 19% 和 21% 相关。对于每一个，都有线性暴露反应的证据，并且关联似乎是独立的。这些关联比同一日历日和之前日历日的平均浓度的关联更强。作者没有发现与心律失常发生前 24 小时内污染物浓度的关联。与最近没有发生心律失常的病例相比，72 小时内既往发生过室性心律失常的病例与空气污染物相关的风险更大。这些结果证实了之前的发现，并表明污染周期与心律失常的匹配对于检测此类关联非常重要。
The authors evaluated the association between ventricular arrhythmias detected by implantable cardioverter defibrillators and ambient air pollution concentrations in the hours immediately before the arrhythmia. Patients given implantable cardioverter defibrillators at the New England Medical Center in Boston, Massachusetts, between mid-1995 and 1999 who lived within 40 km of a central monitoring site (n = 203) were followed until July 2002. The authors used a case-crossover design to study the association between ambient air pollution and up to 798 confirmed ventricular arrhythmias among 84 subjects. The authors found that interquartile range increases in 24-hour moving average particulate matter less than 2.5 mu m in aerodynamic diameter and ozone were associated with 19% and 21% increased risks of ventricular arrhythmia, respectively. For each, there was evidence of a linear exposure response, and the associations appeared independent. These associations were stronger than associations with mean concentrations on the same calendar day and previous calendar days. The authors did not find associations with pollutant concentrations less than 24 hours before the arrhythmia. Cases with a prior ventricular arrhythmia within 72 hours had greater risk associated with air pollutants than did cases without a recent arrhythmia. These results confirm previous findings and suggest that matching of pollution periods to arrhythmias is important in detecting such associations.