CARDIAC VULNERABILITY IN POTENTIALLY SUSCEPTIBLE PATIENTS AND SUBJECTS

潜在易感患者和受试者的心脏脆弱性

• 批准号: 6502517
• 负责人: FRANK E SPEIZER
• 金额: $ 19.62万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6502517
• 关键词: air pollution; air sampling /monitoring; cardiotoxin; clinical research; coronary disorder; disease /disorder proneness /risk; electrocardiography; functional ability; hazardous substances; heart conduction system; heart electrical activity; heart rate; human middle age (35-64); human morbidity; human mortality; human subject; myocardial infarction; outcomes research; ozone; patient monitoring device; personal log /diary; respiratory function; seasons; sudden cardiac death; sulfates

Over the last 10 years numerous epidemiologic studies have found increase morbidity and mortality associated with particulate air pollution. Much of the excess risk is associated with cardiovascular disease events and concern has been raised as to the potential mechanisms whereby such effects can be explained. In addition the effects to date have been associated with total particle loads expressed in terms of mass. These data have led to toxicologic investigatiolls that have raised several hypotheses related to autonomic nervous system control over cardiac function and how such control might relate to an excess of sudden death and or other cardiovascular events. We propose to identify and physiologically characterize potentially high risk free-living patients and monitor them repeatedly for 48 hours for heart rate, heart rate variability, ST segment and T-wave changes in association with detailed outdoor and indoor particle monitoring. Respiratory variation will be taken into account in overnight studies and activity diaries will be used during the day. We postulate that evidence of electrophysiologic changes will be associated with particulate load and will be changes that have been associated with risk of myocardial infarction~ and other cardiovascular events. These findings may help to better identify mechanisms of injury associated with the reported excess morbidity and mortality and may allow for the identification of particle characteristics associated with these outcomes and development of suggestions for preventive strategies.

在过去10年中，许多流行病学研究发现，与颗粒空气污染有关的发病率和死亡率增加。许多超额风险与心血管疾病事件有关，人们对解释这种影响的潜在机制表示关切。此外，迄今为止的影响与以质量表示的总颗粒负荷有关。这些数据导致毒理学研究，提出了几种与自主神经系统对心脏功能的控制有关的假设，以及这种控制如何与过量的猝死和/或其他心血管事件有关。我们建议识别和生理特征的潜在高风险的自由生活的患者，并反复监测他们的心率，心率变异性，ST段和T波的变化与详细的室外和室内颗粒监测48小时。在夜间研究中将考虑呼吸变化，并在白天使用活动日记。我们假设电生理学改变的证据将与颗粒负荷相关，并且将是与心肌梗死和其他心血管事件风险相关的变化。这些发现可能有助于更好地识别与报告的过度发病率和死亡率相关的损伤机制，并可能允许识别与这些结果相关的颗粒特征，并提出预防策略的建议。