Research Projects

Project at a Glance

Title: Personal, indoor, and outdoor particulate air pollution and heart rate variability in elderly subjects with coronary artery disease

Principal Investigator / Author(s): Delfino, Ralph and Scott Bartell

Contractor: UC Irvine

Contract Number: 08-307


Research Program Area: Health & Exposure

Topic Areas: Health Effects of Air Pollution, Vulnerable Populations


Abstract:

Background: Decreased heart rate variability (HRV) is a marker of autonomic dysfunction and has been associated with future cardiac morbidity and mortality. HRV has been inconsistently associated with exposure to particulate matter (PM) air pollution. Fewer studies have examined whether air pollution exposure is a risk factor for cardiac arrhythmias. We aimed in this study to evaluate the relationships of heart rate variability and cardiac arrhythmias to PM exposures.

Methods: Heart rate variability and arrhythmias were measured with ambulatory electrocardiographs using available raw data collected in a cohort panel study the National Institutes of Health, National Institute of Environmental Health Sciences (funded by NIH NIEHS R01 ES-012243). Electrocardiograph data (8,952 person-hours) were collected in 50 nonsmokers with coronary artery disease age 71 years and older living in four retirement communities in the Los Angeles air basin. Exposures included hourly markers of traffic-related PM and secondary organic aerosols, daily size-fractionated particle mass, and hourly outdoor criteria gases. Subjects were genotyped for the glutathione S-transferase M1 and T1 null (risk) alleles. Repeated measures regression analyses were adjusted for actigraph-derived physical activity and heart rate, temperature, day of week, season, and community location.
Results: Risk of ventricular tachycardia was significantly increased with higher exposure to markers of traffic-related particles, secondary organic carbon, and ozone. We found stronger associations of ventricular tachycardia with OC and both its primary and secondary OC fractions among subjects who had the GSTM1 null genotype. Few consistent associations were observed for supraventricular tachycardia. PM exposure was significantly associated with decreased heart rate variability only in the 20 subjects using ACE inhibitors and in those with glutathione S-transferase M1 non-null (lower risk) genotype.

Conclusions: Results support the hypothesis that exposure to PM and ozone increases the risk of ventricular tachycardia among elderly subjects with coronary artery disease. These results are consistent with previous findings in this cohort for adverse effects of air pollution on systemic inflammation, blood pressure and electrocardiographic evidence of ischemia. However, decreased heart rate variability did not appear to be clearly affected except in subjects using ACE inhibitors.


 

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