Ambient fine particulate matter (PM2.5) exposure is associated with idiopathic ventricular premature complexes burden: A cohort study with consecutive Holter recordings

Abstract

Background Epidemiological evidence has shown an association between ambient fine particulate matter (PM2.5) exposure and cardiovascular mortality. Increased ventricular premature complex (VPC) burden can cause left ventricular dilatation and dysfunction. We aimed to investigate the relationship between acute PM2.5 exposure and VPC burden in patients without structural heart disease. Methods We reviewed 26 820 patients who underwent 24‐hour Holter electrocardiogram (ECG) recordings between 1 Jan 2013 and 1 Dec 2016. We enrolled patients with significant idiopathic (structurally normal heart) VPC burden defined as ≥30 VPCs/h (Lown grade 2) who had at least two Holter ECG recordings. The VPC burden between the studies on high and low PM2.5 exposure dates was compared in 24 and 12 hours time periods. Result Sixty‐seven patients (31 men, 56.49 ± 18.35 years) were enrolled. Patients were exposed to 25.63 ± 11.47 and 14.66 ± 7.51 μg/m 3 of PM2.5 during the high and low study dates, respectively. The overall VPC counts (10,490.69 ± 10,681.63/day) and burden (10.22% ± 10.17%) were significantly higher on the days with higher PM2.5 exposure compared with low PM2.5 exposure dates (8293.31 ± 9009.09; P = 0.014% and 9.14% ± 12.73%, P = 0.012, respectively). Compared with low PM2.5 exposure dates, the VPC burden on high exposure dates was significantly higher from 9 am to 9 pm (5.85% ± 6.41% vs 4.84% ± 6.97%; P = 0.025) but not at nocturnal periods. Conclusion Our study demonstrated a significantly higher VPC burden on high PM2.5 exposure date. The burden was increased in the daytime but not at nighttime. This result suggests that daytime PM2.5 exposure may be associated with ventricular arrhythmia burden in the healthy population.

Neural Mechanism Facilitating PM2.5-Related Cardiac Arrhythmias Through Cardiovascular Autonomic and Calcium Dysregulation in a Rat Model

“…In previous studies, we demonstrated that acute PM2.5 exposure is associated with sympathetic activation in a diurnal pattern and that PM2.5 exposure is associated with increased arrhythmia burden. [31,32] These ndings are consistent with many other human observations. [33,34] In the current study, we found similar ndings in rats after acute exposure to PM2.5.…”

Neural mechanism facilitating PM2.5-related cardiac arrhythmias through cardiovascular autonomic and calcium dysregulation in a rat model

“…In previous studies, we demonstrated that acute PM2.5 exposure is associated with sympathetic activation in a diurnal pattern and that PM2.5 exposure is associated with increased arrhythmia burden 14 , 15 . These findings are consistent with many other human observations 34 , 35 .…”

“…The alteration of autonomic function after PM2.5 exposures are demonstrated in studies of heart rate variability (HRV) and blood pressure in humans 13 . Our group has previously demonstrated the diurnal change of autonomic modulation after acute PM2.5 exposure as well as its impact on arrhythmia burden 14 , 15 . However, the observed changes in the cardiovascular system are the result of the complex interaction between PM2.5 and many other associated factors.…”

Air Pollution and Cardiac Arrhythmias: From Epidemiological and Clinical Evidences to Cellular Electrophysiological Mechanisms

“…The study also showed that patients who had previous myocardial infarction were more prone to PMinduced ventricular arrhythmias (32). Tsai et al reported that PM 2.5 exposure was associated with high ventricular premature complex (VPC) burden in patients without structural heart disease (33). The VPC burden is one of the clinical indicators of decreased cardiac function in continuous ECG monitoring (34,35).…”