Baheti Bota, Chen Gongbo, Ding Zhongao, Wu Ruiyu, Zhang Caiyun, Zhou Lue, Liu Xiaotian, Song Xiaoqin, Wang Chongjian
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Environ Res. 2023 Nov 15;237(Pt 1):116862. doi: 10.1016/j.envres.2023.116862. Epub 2023 Aug 12.
Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM exposure and cardiac conduction parameters. Additionally, the interactive effects of PM and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown.
A total of 27483 individuals were enrolled from the Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM were evaluated by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM and residential greenness exposure with cardiac conduction abnormalities risk, and the interaction plot method was performed to visualize their interaction effects.
The 3-year median concentration of PM was 56.47 (2.55) μg/m, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m increase in PM were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM had increased risks of abnormal HR (OR = 1.221, 95%CI: 1.144, 1.303), PR (OR = 1.061, 95%CI: 0.940, 1.196), QRS (OR = 1.225, 95%CI: 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI: 1.121, 1.271) compared with lower levels of PM. Negative interactive effects of exposure to PM and residential greenness on abnormal HR, QRS, and QTc intervals were observed (P < 0.05).
Long-term PM exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas.
环境空气污染与心血管不良事件风险升高有关，心脏电生理特性的改变可能是潜在途径。然而，仍缺乏探索颗粒物（PM）暴露与心脏传导参数之间关联的研究。此外，在资源有限地区，PM与居住绿地对心脏传导参数的交互作用仍不清楚。
从河南农村队列研究中纳入了总共27483名个体。通过12导联心电图测试心脏传导参数。PM浓度通过基于卫星的时空模型进行评估。使用增强植被指数（EVI）和归一化植被指数（NDVI）评估居住绿地水平。采用逻辑回归模型和受限立方样条来探索PM和居住绿地暴露与心脏传导异常风险的关联，并使用交互作用图方法来可视化它们的交互作用。
PM的3年中位浓度为56.47（2.55）μg/m³，PM每增加1μg/m³，心率（HR）、PR间期、QRS波群和QTc间期异常风险的调整比值比（OR）及95%置信区间（CI）分别为1.064（1.044，1.085）、1.037（1.002，1.074）、1.061（1.044，1.077）和1.046（1.028，1.065）。与较低水平的PM相比，暴露于较高水平PM的参与者发生HR异常（OR = 1.221，95%CI：1.144，1.303）、PR间期异常（OR = 1.061，95%CI：0.940，1.196）、QRS波群异常（OR = 1.225，95%CI：1.161，1.294）和QTc间期异常（OR = 1.193，95%CI：1.121，1.271）的风险增加。观察到PM暴露与居住绿地对HR异常、QRS波群异常和QTc间期异常存在负向交互作用（P < 0.05）。
长期PM暴露与心脏传导异常风险升高有关，这种不良关联可能在一定程度上被居住绿地缓解。这些发现强调，控制PM污染和提高绿地水平可能是减轻资源有限地区心血管疾病负担的有效策略。
