Schwartz J, Litonjua A, Suh H, Verrier M, Zanobetti A, Syring M, Nearing B, Verrier R, Stone P, MacCallum G, Speizer F E, Gold D R
Department of Environmental Health, Environmental Epidemiology Program, Harvard School of Public Health, 401 Park Drive,P O Box 15677, Landmark Center, Suite 415, Boston, MA 02215, USA.
Thorax. 2005 Jun;60(6):455-61. doi: 10.1136/thx.2004.024836.
Particulate air pollution has been associated with increased cardiovascular deaths and hospital admissions. To help understand the mechanisms, the types of particles most involved, and the types of persons most susceptible, the association between exposure to summertime air pollution and heart rate variability (HRV) was examined in a panel study of 28 elderly subjects.
Subjects were seen once a week for up to 12 weeks and HRV (SDNN, r-MSSD, PNN50, low frequency/high frequency ratio (LFHFR)) was measured for approximately 30 minutes at each session using a defined protocol. Temperature, day of the week, and hour of the day were controlled, and dummy variables for each subject were controlled for subject specific risk factors.
PM2.5 was associated with r-MSSD (-10.1% change for an interquartile range (IQR) increase in exposure (95% CI -2.8 to -16.9)) and PNN50, but stronger associations were seen with black carbon, an indicator of traffic particles, which was also associated with SDNN (-4.6% per IQR (95% CI -2.0 to -7.2)) and LFHFR. Secondary particles were more weakly associated with r-MSSD, as was ozone. No associations were seen with SO2 or NO2. CO had similar patterns of association to black carbon, which disappeared after controlling for black carbon. Black carbon had a substantially higher effect on SDNN in subjects who had had a previous myocardial infarction (-12.7%, 95% CI -5.7 to -19.25).
Particles, especially from traffic, are associated with disturbances of autonomic control of the heart.
空气中的颗粒物污染与心血管疾病死亡人数增加及住院率上升有关。为了帮助理解其机制、最相关的颗粒物类型以及最易受影响的人群类型,在一项对28名老年受试者的群组研究中,考察了夏季空气污染暴露与心率变异性(HRV)之间的关联。
受试者每周接受一次检查,为期最长12周,每次检查时使用特定方案测量约30分钟的HRV(包括标准偏差(SDNN)、平方根连续差值的均方根(r-MSSD)、相邻NN间期差值大于50ms的心搏数占总心搏数的百分比(PNN50)、低频/高频比值(LFHFR))。对温度、星期几和一天中的时间进行了控制,并针对每个受试者的特定风险因素对虚拟变量进行了控制。
PM2.5与r-MSSD(暴露增加一个四分位数间距(IQR)时变化-10.1%(95%置信区间-2.8至-16.9))和PNN50相关,但与交通颗粒物指标黑碳的相关性更强,黑碳还与SDNN(每IQR-4.6%(95%置信区间-2.0至-7.2))和LFHFR相关。二次颗粒物与r-MSSD的相关性较弱,臭氧也是如此。未发现与二氧化硫(SO2)或二氧化氮(NO2)相关。一氧化碳(CO)与黑碳的关联模式相似,在控制黑碳后这种关联消失。在既往有心肌梗死的受试者中,黑碳对SDNN的影响显著更高(-12.7%,95%置信区间-5.7至-19.25)。
颗粒物,尤其是来自交通的颗粒物,与心脏自主控制的紊乱有关。