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职业队列中颗粒物暴露后心率变异性下降的时间进程。

Time course of heart rate variability decline following particulate matter exposures in an occupational cohort.

作者信息

Cavallari Jennifer M, Fang Shona C, Eisen Ellen A, Schwartz Joel, Hauser Russ, Herrick Robert F, Christiani David C

机构信息

Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.

出版信息

Inhal Toxicol. 2008 Feb;20(4):415-22. doi: 10.1080/08958370801903800.

Abstract

Although research suggests that particles influence cardiac autonomic response as evidenced by decreases in heart rate variability (HRV), the time course of the response remains unclear. Using a crossover panel study, we monitored 36 male boilermaker welders, occupationally exposed to metal-rich particulate matter (PM) to investigate the temporal trend of hourly HRV subsequent to PM exposure. Ambulatory electrocardiograms were collected over work (exposure) and non-work (control) periods and the mean of the standard deviations of all normal-to-normal intervals for all 5-min segments (SDNN(i)) was calculated hourly for up to 14-hrs post-work. The exposure-response relationship was examined with linear mixed effects regression models to account for participants monitored over multiple occasions. Models were adjusted for non-work HRV to control for diurnal fluctuations and individual predictors of HRV. The mean (SD) work PM(2. 5) concentration was 1.12 (0.76) mg/m(3). Hourly SDNN(i) was consistently lower post-work as compared to the same time period on a non-work day. HRV was inversely associated with work PM(2. 5) exposures in each of the 14-hrs post-work. The hourly associations suggested an early and later phase response, with the largest regression coefficients observed 2-3 hrs (beta = -6.86 (95% CI: -11.91, -1.81) msec/1 mg/m(3) at 3-hrs), and then 9-13 hrs (beta = -8.60 (95% CI: -17.45, 0.24) msec/1 mg/m(3) at 11-hrs), after adjusting for non-work HRV, smoking status, and age. This investigation demonstrates declines in HRV for up to 14 hours following PM exposure and a multiphase cardiovascular autonomic response with immediate (2 hrs) and delayed (9-13 hrs) responses.

摘要

尽管研究表明颗粒物会影响心脏自主神经反应,心率变异性(HRV)降低即为证据,但该反应的时间进程仍不明确。我们采用交叉面板研究,对36名职业性接触富含金属颗粒物(PM)的男性锅炉工焊工进行监测,以调查PM暴露后每小时HRV的时间趋势。在工作(暴露)和非工作(对照)期间收集动态心电图,并在工作后长达14小时内每小时计算所有5分钟时段正常到正常间隔的标准差均值(SDNN(i))。使用线性混合效应回归模型检查暴露-反应关系,以考虑在多个场合监测的参与者。模型针对非工作HRV进行了调整,以控制昼夜波动和HRV的个体预测因素。工作时PM(2.5)的平均(标准差)浓度为1.12(0.76)mg/m³。与非工作日的同一时间段相比,工作后每小时的SDNN(i)持续较低。在工作后14小时内的每一小时,HRV都与工作时PM(2.5)暴露呈负相关。每小时的关联表明存在早期和后期反应阶段,在调整非工作HRV、吸烟状况和年龄后,最大回归系数出现在2 - 3小时(3小时时β = -6.86(95%置信区间:-11.91,-1.81)msec/1 mg/m³),然后是9 - 13小时(11小时时β = -8.60(95%置信区间:-17.45,0.24)msec/1 mg/m³)。这项调查表明,PM暴露后长达14小时HRV会下降,并且存在多阶段心血管自主神经反应,包括即时(2小时)和延迟(9 - 13小时)反应。

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