Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
Occup Environ Med. 2012 Jun;69(6):428-36. doi: 10.1136/oemed-2011-100179. Epub 2011 Nov 17.
Elevated ozone levels have been associated with cardiovascular morbidity and mortality. We investigated the effects of ozone on heart rate (HR) and repolarisation parameters in potentially susceptible populations.
Between March 2007 and December 2008, 363 ECG recordings including >2000 1 h intervals were measured in 64 individuals with type 2 diabetes or impaired glucose tolerance and in 46 healthy individuals with a potential genetic predisposition on the detoxification pathways from Augsburg, Germany. Associations between 1 h averages of ozone and HR, Bazett-corrected QT-interval (QTc), T-wave amplitude and T-wave complexity were analysed using additive mixed models. A variable indicating season and participants' location during the 1 h ECG recordings (summer and outdoors vs winter or indoors) was used as a potential ozone effect modifier.
We observed concurrent and 1-4 h lagged increases in HR of 0.5-0.7% for each 20 μg/m(3) increase in ozone. These effects were stronger (1.0-1.2%) when participants were outdoors during the summer. We detected in all participants a concurrent (-1.31%; 95% CI -2.19% to -0.42%) and 1 h lagged (-1.32%; -2.19% to -0.45%) T-wave flattening. Elevated ozone levels were associated with 1 h (2.12%; 0.81 to 3.52) and 2 h lagged (1.89%; 0.55% to 3.26%) increases in T-wave complexity. However, no effects were seen for QTc. Ozone effects were generally more pronounced in individuals with metabolic disorders than a potential genetic predisposition.
Changes in repolarisation might contribute to underlying pathophysiological changes associated with the link between elevated ozone levels and reported adverse cardiovascular outcomes.
臭氧浓度升高与心血管发病率和死亡率有关。我们研究了臭氧对 2 型糖尿病或糖耐量受损患者及潜在遗传易感性个体的心率（HR）和复极参数的影响。
2007 年 3 月至 2008 年 12 月，在德国奥格斯堡，对 64 例 2 型糖尿病或糖耐量受损患者和 46 例具有潜在遗传易感性个体的 363 份心电图记录进行了测量，其中包括超过 2000 个 1 小时间隔的心电图记录。使用混合效应模型分析 1 小时臭氧平均值与 HR、Bazett 校正 QT 间期（QTc）、T 波振幅和 T 波复杂性之间的关联。作为臭氧效应潜在修饰因子，使用一个表示 1 小时心电图记录期间季节和参与者位置的变量（夏季和室外与冬季或室内）。
我们观察到 HR 同步增加 0.5-0.7%，臭氧每增加 20μg/m³增加 0.5-0.7%；当参与者在夏季户外时，这些影响更强（1.0-1.2%）。我们在所有参与者中均检测到同步（-1.31%；95%置信区间-2.19%至-0.42%）和 1 小时滞后（-1.32%；-2.19%至-0.45%）T 波变平。臭氧水平升高与 1 小时（2.12%；0.81%至 3.52%）和 2 小时滞后（1.89%；0.55%至 3.26%）T 波复杂性增加有关。然而，QTc 没有变化。在代谢紊乱个体中，臭氧的影响通常比潜在的遗传易感性更为明显。
复极变化可能导致与臭氧水平升高和报道的不良心血管结局相关的潜在病理生理变化。
