Topriceanu Constantin-Cristian, Gong Xiangpu, Shah Mit, Shiwani Hunain, Eminson Katie, Atilola Glory O, Jephcote Calvin, Adams Kathryn, Blangiardo Marta, Moon James C, Hughes Alun D, Gulliver John, Rowlands Alex V, Chaturvedi Nishi, O'Regan Declan P, Hansell Anna L, Captur Gabriella
UCL MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom; UCL Institute of Cardiovascular Science, University College London, London, United Kingdom; Cardiac MRI Unit, Barts Heart Centre, London, United Kingdom.
Centre for Environmental Health and Sustainability, University of Leicester, Leicester, United Kingdom; NIHR Health Protection Research Unit in Environmental Exposure and Health, University of Leicester, Leicester, United Kingdom.
J Am Coll Cardiol. 2025 Feb 11;85(5):454-469. doi: 10.1016/j.jacc.2024.09.1217. Epub 2025 Jan 8.
Aircraft noise is a growing concern for communities living near airports.
This study aimed to explore the impact of aircraft noise on heart structure and function.
Nighttime aircraft noise levels (L) and weighted 24-hour day-evening-night aircraft noise levels (L) were provided by the UK Civil Aviation Authority for 2011. Health data came from UK Biobank (UKB) participants living near 4 UK major airports (London Heathrow, London Gatwick, Manchester, and Birmingham) who had cardiovascular magnetic resonance (CMR) imaging starting from 2014 and self-reported no hearing difficulties. Generalized linear models investigated the associations between aircraft noise exposure and CMR metrics (derived using a validated convolutional neural network to ensure consistent image segmentations), after adjustment for demographic, socioeconomic, lifestyle, and environmental confounders. Mediation by cardiovascular risk factors was also explored. Downstream associations between CMR metrics and major adverse cardiac events (MACE) were tested in a separate prospective UKB subcohort (n = 21,360), to understand the potential clinical impact of any noise-associated heart remodeling.
Of the 3,635 UKB participants included, 3% experienced higher L (≥45 dB) and 8% higher L (≥50 dB). Participants exposed to higher L had 7% (95% CI: 4%-10%) greater left ventricular (LV) mass and 4% (95% CI: 2%-5%) thicker LV walls with a normal septal-to-lateral wall thickness ratio. This concentric LV remodeling is relevant because a 7% greater LV mass associates with a 32% greater risk of MACE. They also had worse LV myocardial dynamics (eg, an 8% [95% CI: 4%-12%] lower global circumferential strain which associates with a 27% higher risk of MACE). Overall, a hypothetical individual experiencing the typical CMR abnormalities associated with a higher L exposure may have a 4 times higher risk of MACE. Findings were clearest for L but were broadly similar in analyses using L. Body mass index and hypertension appeared to mediate 10% to 50% of the observed associations. Participants who did not move home during follow-up and were continuously exposed to higher aircraft noise levels had the worst CMR phenotype.
Higher aircraft noise exposure associates with adverse LV remodeling, potentially due to noise increasing the risk of obesity and hypertension. Findings are consistent with the existing literature on aircraft noise and cardiovascular disease, and need to be considered by policymakers and the aviation industry.
飞机噪音日益引起机场附近社区的关注。
本研究旨在探讨飞机噪音对心脏结构和功能的影响。
英国民航局提供了2011年的夜间飞机噪音水平（L）和加权24小时昼-夜-晚飞机噪音水平（L）。健康数据来自英国生物银行（UKB）中居住在英国4个主要机场（伦敦希思罗机场、伦敦盖特威克机场、曼彻斯特机场和伯明翰机场）附近的参与者，他们从2014年开始进行心血管磁共振成像（CMR），且自我报告无听力困难。在调整了人口统计学、社会经济、生活方式和环境混杂因素后，广义线性模型研究了飞机噪音暴露与CMR指标（使用经过验证的卷积神经网络得出以确保一致的图像分割）之间的关联。还探讨了心血管危险因素的中介作用。在一个单独的前瞻性UKB亚组（n = 21,360）中测试了CMR指标与主要不良心脏事件（MACE）之间的下游关联，以了解任何与噪音相关的心脏重塑的潜在临床影响。
在纳入的3635名UKB参与者中，3%经历了更高的L（≥45分贝），8%经历了更高的L（≥50分贝）。暴露于更高L的参与者左心室（LV）质量增加7%（95%可信区间：4%-10%），室间隔与侧壁厚度比正常时LV壁增厚4%（95%可信区间：2%-5%）。这种向心性LV重塑具有相关性，因为LV质量增加7%与MACE风险增加32%相关。他们的LV心肌动力学也更差（例如，整体圆周应变降低8%[95%可信区间：4%-12%]，这与MACE风险增加27%相关）。总体而言，一个经历与更高L暴露相关的典型CMR异常的假设个体发生MACE的风险可能高出4倍。L的结果最明显，但在使用L的分析中大致相似。体重指数和高血压似乎介导了观察到的关联的10%至50%。在随访期间未搬家且持续暴露于更高飞机噪音水平的参与者具有最差的CMR表型。
更高的飞机噪音暴露与不良的LV重塑相关，可能是因为噪音增加了肥胖和高血压的风险。研究结果与关于飞机噪音和心血管疾病的现有文献一致，政策制定者和航空业需要予以考虑。
