在患有乳腺癌的患者中,空气污染和心脏重塑和功能
Wonyoung Jung1,2, Kyunga Ko1,2, Amanda M Smith1,2
1Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
JAMA network open
|January 15, 2026
概括
空气污染,特别是细颗粒物 (PM2.5) 和臭氧 (O3),在接受心脏毒性治疗的乳腺癌患者中与心脏损伤有关. 减少这些污染物的暴露可能会降低心血管疾病的风险.
科学领域:
- 心脏病学 心脏病学
- 环境健康 环境健康
- 在瘤学瘤学.
背景情况:
- 空气污染对接受心脏毒性治疗的癌症患者心脏重塑的影响尚不清楚.
- 心脏毒性疗法,如 antracyclines 和 trastuzumab,对于治疗乳腺癌至关重要,但可能导致心血管并发症.
研究的目的:
- 调查暴露于环境空气污染物和心脏结构,功能和心脏重塑在接受心脏毒性治疗的乳腺癌患者之间的关联.
- 为了确定可能会加剧心脏毒性的特定空气污染物在这个患者群体.
主要方法:
- 一项纵向前性队列研究,涉及580名女性乳腺癌患者开始心脏毒性治疗.
- 评估心脏功能和重塑,使用连续回声心脏图超过3.1年的中位数.
- 用多变量回归和危险模型分析人口普查通道水平的空气污染物度,包括PM2.5,PM10,NO2和O3,以及它们与心脏结果的关联.
主要成果:
- 细颗粒物 (PM2.5) 和臭氧 (O3) 暴露与不良的心脏重塑和功能障碍显著相关,包括左心室喷射率 (LVEF) 减少和左心室质量增加.
- 每次PM2.5和O3的增量增加都与LVEF和纵向应变的下降以及左心室质量的增加有关.
- 暴露于PM2.5和O3较高的患者患心脏功能障碍的风险明显增加.
结论:
- 暴露于PM2.5和O3与乳腺癌患者接受心脏毒剂治疗的心脏重塑和功能的恶化独立相关.
- 这些发现强调了减轻环境空气污染暴露的潜在好处,以减少癌症幸存者的心血管疾病风险.
- 需要进一步的研究,以探索在脆弱患者群体中减少空气污染的有针对性的干预措施.
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