Gold D R, Litonjua A, Schwartz J, Lovett E, Larson A, Nearing B, Allen G, Verrier M, Cherry R, Verrier R
Channing Laboratory, Brigham and Women's Hospital and the Harvard Medical School, Boston, MA 02115-5804, USA.
Circulation. 2000 Mar 21;101(11):1267-73. doi: 10.1161/01.cir.101.11.1267.
We investigated associations between ambient pollution levels and cardiovascular function in a repeated measures study including 163 observations on twenty-one 53- to 87-year-old active Boston residents observed up to 12 times from June to September 1997. Particles with aerodynamic diameter </=2.5 microm (PM(2.5)) were measured continuously using a tapered element oscillating microbalance.
The protocol involved 25 minutes per week of continuous Holter ECG monitoring, including 5 minutes of rest, 5 minutes of standing, 5 minutes of exercise outdoors, 5 minutes of recovery, and 20 cycles of slow breathing. Heart rate variability (HRV) was assessed through time domain variables: the standard deviation of normal RR intervals (SDNN) and the square root of the mean of the squared differences between adjacent normal RR intervals (r-MSSD). Mean 4-hour PM(2.5) levels ranged from 3 to 49 microg/m(3); 1-hour ozone levels ranged from 1 to 77 ppb. In multivariate analyses, significantly less HRV (SDNN and r-MSSD) was associated with elevated PM(2.5). During slow breathing, a reduction in r-MSSD of 6.1 ms was associated with an interquartile (14.3 microg/m(3)) increase in PM(2.5) during the hour of and the 3 hours previous to the Holter session (P=0.006). During slow breathing, a multiple pollution model was associated with a reduction in r-MSSD of 5.4 ms (P=0.02) and 5.5 ms (P=0.03) for interquartile changes in PM(2.5) and ozone, respectively, resulting in a combined effect equivalent to a 33% reduction in the mean r-MSSD.
Particle and ozone exposure may decrease vagal tone, resulting in reduced HRV.
在一项重复测量研究中,我们调查了环境污染水平与心血管功能之间的关联。该研究纳入了21名年龄在53至87岁之间、居住在波士顿且活动量较大的居民,于1997年6月至9月期间对他们进行了多达12次的观察,共获得163份观察数据。使用锥形元件振荡微天平连续测量空气动力学直径≤2.5微米的颗粒物(PM2.5)。
该方案包括每周25分钟的动态心电图连续监测,其中包括5分钟休息、5分钟站立、5分钟户外锻炼、5分钟恢复以及20个慢呼吸周期。通过时域变量评估心率变异性(HRV):正常RR间期的标准差(SDNN)以及相邻正常RR间期平方差均值的平方根(r-MSSD)。4小时平均PM2.5水平在3至49微克/立方米之间;1小时臭氧水平在1至77 ppb之间。在多变量分析中,较高的PM2.5水平与显著降低的HRV(SDNN和r-MSSD)相关。在慢呼吸期间,r-MSSD降低6.1毫秒与动态心电图监测时段及之前3小时内PM2.5四分位数间距增加(14.3微克/立方米)相关(P = 0.006)。在慢呼吸期间,多污染模型显示,PM2.5和臭氧四分位数间距变化分别与r-MSSD降低5.4毫秒(P = 0.02)和5.5毫秒(P = 0.03)相关,综合效应相当于平均r-MSSD降低33%。
接触颗粒物和臭氧可能会降低迷走神经张力,导致HRV降低。