Pieters Nicky, Plusquin Michelle, Cox Bianca, Kicinski Michal, Vangronsveld Jaco, Nawrot Tim S
Hasselt University, Agoralaan Gebouw D, Diepenbeek, Belgium.
Heart. 2012 Aug;98(15):1127-35. doi: 10.1136/heartjnl-2011-301505. Epub 2012 May 23.
Studies on the association between short-term exposure to ambient air pollution and heart rate variability (HRV) suggest that particulate matter (PM) exposure is associated with reductions in measures of HRV, but there is heterogeneity in the nature and magnitude of this association between studies. The authors performed a meta-analysis to determine how consistent this association is.
The authors searched the Pubmed citation database and Web of Knowledge to identify studies on HRV and PM.
Of the epidemiologic studies reviewed, 29 provided sufficient details to be considered. The meta-analysis included 18667 subjects recruited from the population in surveys, studies from patient groups, and from occupationally exposed groups.
Two investigators read all papers and computerised all relevant information.
The authors computed pooled estimates from a random-effects model. In the combined studies, an increase of 10 μg/m(3) in PM(2.5) was associated with significant reductions in the time-domain measurements, including low frequency (-1.66%, 95% CI -2.58% to -0.74%) and high frequency (-2.44%, 95% CI -3.76% to -1.12%) and in frequency-domain measurements, for SDNN (-0.12%, 95% CI -0.22% to -0.03%) and for rMSSD (-2.18%, 95% CI -3.33% to -1.03%). Funnel plots suggested that no publication bias was present and a sensitivity analysis confirmed the robustness of our combined estimates.
The meta-analysis supports an inverse relationship between HRV, a marker for a worse cardiovascular prognosis, and particulate air pollution.
关于短期暴露于环境空气污染与心率变异性（HRV）之间关联的研究表明，颗粒物（PM）暴露与HRV指标降低有关，但不同研究之间这种关联的性质和程度存在异质性。作者进行了一项荟萃分析，以确定这种关联的一致性如何。
作者检索了PubMed引文数据库和Web of Knowledge，以识别有关HRV和PM的研究。
在 reviewed 的流行病学研究中，29项提供了足够详细的信息以供考虑。荟萃分析包括从调查人群、患者组研究和职业暴露组中招募的18667名受试者。
两名研究人员阅读了所有论文，并将所有相关信息进行了计算机化处理。
作者通过随机效应模型计算了合并估计值。在综合研究中，PM2.5每增加10μg/m³，与时域测量值的显著降低相关，包括低频（-1.66%，95%CI -2.58%至-0.74%）和高频（-2.44%，95%CI -3.76%至-1.12%），以及频域测量值，SDNN（-0.12%，95%CI -0.22%至-0.03%）和rMSSD（-2.18%，95%CI -3.33%至-1.03%）。漏斗图表明不存在发表偏倚，敏感性分析证实了我们合并估计值的稳健性。
荟萃分析支持了HRV（心血管预后较差的一个标志物）与颗粒物空气污染之间的负相关关系。
