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Left ventricular function in relation to chronic residential air pollution in a general population
Wen-Yi Yang1, Zhen-Yu Zhang1, Lutgarde Thijs1
11 Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Belgium.
European Journal of Preventive Cardiology
|June 16, 2017
Summary
Long-term exposure to air pollution, including particulate matter and nitrogen dioxide, is linked to impaired heart function in the general population. This suggests air pollution may be a risk factor for heart failure.
Area of Science:
- Cardiology
- Environmental Health
- Public Health
Background:
- Increasing prevalence of heart failure globally.
- Growing evidence on the detrimental effects of environmental pollution on human health.
- Need to understand the impact of air pollutants on cardiovascular health in the general population.
Purpose of the Study:
- To investigate the association between long-term exposure to common air pollutants and left ventricular structure and function.
- To assess subclinical changes in cardiac performance related to air pollution levels.
- To identify potential mediators in the relationship between air pollution and cardiac impairment.
Main Methods:
- Cross-sectional study of 671 randomly recruited Flemish adults.
- Echocardiographic assessment of left ventricular systolic strain, strain rate, and mitral inflow/annular velocities.
- Correlation of cardiac parameters with residential long-term exposure to black carbon, PM2.5, PM10, and nitrogen dioxide (NO2).
- Statistical analysis accounting for clustering and confounders, including path analysis for mediation.
Main Results:
- Higher long-term exposure to black carbon, PM2.5, PM10, and NO2 was associated with worse systolic left ventricular function (reduced longitudinal strain and strain rate).
- Elevated levels of black carbon, PM2.5, and PM10 correlated with lower mitral inflow and annular velocities (E and a' peak velocities).
- Geographic analysis supported the association between systolic longitudinal strain and air pollution gradients; systemic inflammation emerged as a potential mediator for black carbon.
Conclusions:
- Long-term exposure to low levels of air pollution is associated with subclinical impairment of left ventricular performance.
- Air pollution may represent a significant, modifiable risk factor contributing to the development of heart failure.
- Further research into the mechanisms and public health interventions is warranted.
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