动脉粥样硬化多民族研究中的颗粒物暴露与心肺差异
Particulate Matter Exposure and Cardiopulmonary Differences in the Multi-Ethnic Study of Atherosclerosis.
作者信息
Aaron Carrie P, Chervona Yana, Kawut Steven M, Diez Roux Ana V, Shen Mingwu, Bluemke David A, Van Hee Victor C, Kaufman Joel D, Barr R Graham
机构信息
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
出版信息
Environ Health Perspect. 2016 Aug;124(8):1166-73. doi: 10.1289/ehp.1409451. Epub 2016 Feb 9.
BACKGROUND
Particulate matter (PM) exposure may directly affect the pulmonary vasculature. Although the pulmonary vasculature is not easily measurable, differential associations for right ventricular (RV) and left ventricular (LV) mass may provide an indirect assessment of pulmonary vascular damage.
OBJECTIVES
We tested whether long-term exposure to PM < 2.5 μm (PM2.5) is associated with greater RV mass and RV mass/end-diastolic volume ratio relative to the LV.
METHODS
The Multi-Ethnic Study of Atherosclerosis performed cardiac magnetic resonance (CMR) imaging among participants 45-84 years old without clinical cardiovascular disease in 2000-2002 in six U.S. cities. A fine-scale spatiotemporal model estimated ambient PM2.5 exposure in the year before CMR; individually weighted estimates accounted for indoor exposure to ambient PM2.5. Linear regression models were adjusted for demographics, anthropometrics, smoking status, cardiac risk factors, and LV parameters, with additional adjustment for city.
RESULTS
The 4,041 included participants had a mean age of 61.5 years, and 47% were never smokers. The mean ambient PM2.5 was 16.4 μg/m3 and individually weighted PM2.5 was 11.0 μg/m3. PM2.5 exposure was associated with greater RV mass [ambient: 0.11 g per 5 μg/m3 (95% CI: -0.05, 0.27); individually weighted: 0.20 g per 5 μg/m3 (95% CI: 0.04, 0.36)] and a greater RV mass/end-diastolic volume ratio conditional on LV parameters. City-adjusted results for RV mass were of greater magnitude and were statistically significant for both measures of PM2.5, whereas those for RV mass/end-diastolic volume ratio were attenuated.
CONCLUSIONS
Long-term PM2.5 exposures were associated with greater RV mass and RV mass/end-diastolic volume ratio conditional on the LV; however, additional adjustment for city attenuated the RV mass/end-diastolic volume findings. These findings suggest that PM2.5 exposure may be associated with subclinical cardiopulmonary differences in this general population sample.
CITATION
Aaron CP, Chervona Y, Kawut SM, Diez Roux AV, Shen M, Bluemke DA, Van Hee VC, Kaufman JD, Barr RG. 2016. Particulate matter exposure and cardiopulmonary differences in the Multi-Ethnic Study of Atherosclerosis. Environ Health Perspect 124:1166-1173; http://dx.doi.org/10.1289/ehp.1409451.
背景
接触颗粒物（PM）可能直接影响肺血管系统。尽管肺血管系统不易测量，但右心室（RV）和左心室（LV）质量的差异关联可能提供肺血管损伤的间接评估。
目的
我们测试了长期接触直径小于2.5μm的颗粒物（PM2.5）是否与相对于左心室更大的右心室质量及右心室质量/舒张末期容积比相关。
方法
动脉粥样硬化多民族研究于2000 - 2002年在美国六个城市对45 - 84岁无临床心血管疾病的参与者进行了心脏磁共振（CMR）成像。一个精细的时空模型估计了CMR检查前一年的环境PM2.5暴露情况；个体加权估计考虑了室内对环境PM2.5的暴露。线性回归模型针对人口统计学、人体测量学、吸烟状况、心脏危险因素和左心室参数进行了调整，并对城市进行了额外调整。
结果
纳入的4041名参与者平均年龄为61.5岁，47%为从不吸烟者。平均环境PM2.5为16.4μg/m³，个体加权PM2.5为11.0μg/m³。PM2.5暴露与更大的右心室质量相关[环境暴露：每5μg/m³增加0.11g（95%置信区间：-0.05，0.27）；个体加权暴露：每5μg/m³增加0.20g（95%置信区间：0.04，0.36）]，并且在左心室参数条件下右心室质量/舒张末期容积比更高。右心室质量的城市调整结果幅度更大，两种PM2.5测量方法的结果均具有统计学意义，而右心室质量/舒张末期容积比的结果有所减弱。
结论
长期PM2.5暴露与在左心室条件下更大的右心室质量及右心室质量/舒张末期容积比相关；然而，对城市进行额外调整减弱了右心室质量/舒张末期容积的研究结果。这些发现表明，在这个普通人群样本中，PM2.5暴露可能与亚临床心肺差异相关。
引用文献
Aaron CP, Chervona Y, Kawut SM, Diez Roux AV, Shen M, Bluemke DA, Van Hee VC, Kaufman JD, Barr RG. 2016. Particulate matter exposure and cardiopulmonary differences in the Multi-Ethnic Study of Atherosclerosis. Environ Health Perspect 124:1166 - 1173; http://dx.doi.org/10.1289/ehp.1409451.
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