Bunch T Jared, Horne Benjamin D, Asirvatham Samuel J, Day John D, Crandall Brian G, Weiss J Peter, Osborn Jeffrey S, Anderson Jeffrey L, Muhlestein Joseph B, Lappe Donald L, Pope C Arden
Intermountain Heart Rhythm Specialists, Intermountain Medical Center, Murray, Utah 84107, USA.
Pacing Clin Electrophysiol. 2011 Nov;34(11):1475-9. doi: 10.1111/j.1540-8159.2011.03200.x.
Previous studies have observed that short-term exposure to elevated concentrations of particulate matter (PM) air pollution increases risk of acute ischemic heart disease events and heart failure hospitalization, alters cardiac autonomic function, and increases risk of arrhythmias. This study explored the potential associations between short-term elevations in PM exposure and atrial fibrillation (AF).
A case-crossover study design was used to explore associations between fine PM (PM2.5, particles with an aerodynamic diameter ≤2.5 μm) and 10,457 AF hospitalizations from 1993 to 2008 of patients who lived on Utah’s Wasatch Front. Patients were hospitalized at Intermountain Healthcare facilities with a primary diagnosis of AF. Concurrent day exposure and cumulative lagged exposures for up to 21 days were explored and the data were stratified by sex, age, and previous or subsequent admission for myocardial infarction. Although the estimated associations between PM2.5 and AF hospitalizations for the various lag structures and strata were consistently positive suggestive of risk, they were not statistically significant and they were extremely small compared to previously observed associations with ischemic heart disease events and heart failure hospitalizations. Further, we observed no additive risk between PM2.5 and AF hospitalization in those with respiratory disease or sleep apnea.
Unlike previously observed associations with ischemic heart disease events and heart failure hospitalizations using similar study design and approaches, this study found that hospitalization for AF was not significantly associated with elevations in short-term exposure to fine PM air pollution.
先前的研究观察到，短期暴露于高浓度的颗粒物（PM）空气污染中会增加急性缺血性心脏病事件和心力衰竭住院的风险，改变心脏自主神经功能，并增加心律失常的风险。本研究探讨了短期PM暴露升高与心房颤动（AF）之间的潜在关联。
采用病例交叉研究设计，探讨细颗粒物（PM2.5，空气动力学直径≤2.5μm的颗粒）与1993年至2008年居住在犹他州瓦萨奇山前的患者的10457次AF住院之间存在的关联。患者在山间医疗保健机构住院，主要诊断为AF。研究了同期日暴露和长达21天的累积滞后暴露情况，并按性别、年龄以及既往或随后的心肌梗死入院情况对数据进行分层。尽管对于各种滞后结构和分层，PM2.5与AF住院之间的估计关联始终呈阳性，提示存在风险，但它们无统计学意义，且与先前观察到的与缺血性心脏病事件和心力衰竭住院之间的关联相比极小。此外，我们观察到在患有呼吸系统疾病或睡眠呼吸暂停的患者中，PM2.5与AF住院之间不存在附加风险。
与先前使用类似研究设计和方法观察到的与缺血性心脏病事件和心力衰竭住院之间的关联不同，本研究发现AF住院与短期暴露于细颗粒物空气污染升高之间无显著关联。
