The Association between Air Pollution (PM 2.5) and Cardiac Electrical Instability in an Urban South Asian Cohort Open Access

Jagtiani, Ashna (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/0z708x734?locale=en
Published

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 

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Degree
Submission
Language
  • English
Research Field
Keyword
Committee Chair / Thesis Advisor
Last modified

Primary PDF

Supplemental Files