The Association between Air Pollution (PM 2.5) and Cardiac Electrical Instability in an Urban South Asian Cohort Open Access
Jagtiani, Ashna (Spring 2022)
Abstract
Introduction: Air pollution is a growing global health issue with known adverse effects on cardiovascular health. South Asia, a region with highest levels of particulate matter of diameter < 2.5 μm (PM2.5) are also at a disproportionately high risk for cardiovascular diseases and a growing prevalence of sudden cardiac death (SCD). There is a need to uncover the mechanism between PM2.5 and SCD to develop targeted clinical and public health interventions. This study aimed to evaluate the association between short-term ambient PM2.5 exposure and global electrical heterogeneity derived from electrocardiogram (ECG) parameters, a known predictor of SCD.
Methods: Baseline data from the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) cohort, an ongoing population-based cohort in urban South Asia was used for this study. Analysis was restricted to participants with baseline ECG parameters, household geocode, and relevant covariates. A spatiotemporal model was used to predict individual PM2.5 levels 7 days before baseline ECG measurements. Multivariable linear regression models were used adjusting socio-demographic factors (age, sex, education, and income) and traditional cardiovascular risk factors (systolic blood pressure, diabetes, smoking status, and alcohol consumption; and proximity to roads).
Results: Of the 1,384 participants studied, 54% were female and the mean age was 45 years. The median short-term PM2.5 exposure was 81.6 μg/m3 (IQR, 61.1–106.4). For each 1 μg/m3 increase in PM2.5, the average SVG magnitude significantly increased by 1.98 μV (95% CI, 0.18–3.78) in the unadjusted model. PM2.5 was associated with a smaller spatial QRS-T angle, sum absolute QRS-T integral, SVG azimuth, SVG elevation, PR interval, QRS duration, and QTc interval after adjusting for socio-demographic factors, traditional cardiovascular risk factors, and proximity to roads. In women, the relationship was more negative than in men for spatial QRS-T angle and SVG elevation (interaction p<0.05).
Conclusions: We did not find significant relationships between PM2.5 exposure and worsened ECG metrics. Additionally, we also observed some negative relationships that were unexpected. Given the large amount of literature supporting a pathological cardiovascular impact of air pollution, additional studies with larger sample size and repeated sampling are needed.
Table of Contents
Background .................................................................................................................................... 1
Methods ......................................................................................................................................... 5
Results ........................................................................................................................................... 9
Discussion..................................................................................................................................... 13
References .................................................................................................................................... 18
Tables and figures ........................................................................................................................ 24
Supplementary material ............................................................................................................... 29
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The Association between Air Pollution (PM 2.5) and Cardiac Electrical Instability in an Urban South Asian Cohort () | 2022-04-20 18:59:09 -0400 |
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