Effects of ultrafine and fine particulate and gaseous air pollution on cardiac autonomic control in subjects with coronary artery disease: The ULTRA study

Abstract

Previous studies have shown an association between elevated concentrations of particulate air pollution and cardiovascular morbidity and mortality. Therefore, the association between daily variation of ultrafine and fine particulate air pollution and cardiac autonomic control measured as heart rate variability (HRV) was studied in a large multicenter study in Amsterdam, the Netherlands, Erfurt, Germany, and Helsinki, Finland. Elderly subjects (n=37 in Amsterdam, n=47 in both Erfurt and Helsinki) with stable coronary artery disease were followed for 6 months with biweekly clinical visits. During the visits, ambulatory electrocardiogram was recorded during a standardized protocol including a 5-min period of paced breathing. Time and frequency domain analyses of HRV were performed. A statistical model was built for each center separately. The mean 24-h particle number concentration (NC) (1,000/cm(3)) of ultrafine particles (diameter 0.01-0.1 microm) was 17.3 in Amsterdam, 21.1 in Erfurt, and 17.0 in Helsinki. The corresponding values for PM2.5 were 20.0, 23.1, and 12.7 microg/m(3). During paced breathing, ultrafine particles, NO(2), and CO were at lags of 0-2 days consistently and significantly associated with decreased low-to-high frequency ratio (LF/HF), a measure of sympathovagal balance. In a pooled analysis across the centers, LF/HF decreased by 13.5% (95% confidence interval: -20.1%, -7.0%) for each 10,000/cm(3) increase in the NC of ultrafine particles (2-day lag). PM2.5 was associated with reduced HF and increased LF/HF in Helsinki, whereas the opposite was true in Erfurt, and in Amsterdam, there were no clear associations between PM2.5 and HRV. The results suggest that the cardiovascular effects of ambient ultrafine and PM2.5 can differ from each other and that their effect may be modified by the characteristics of the exposed subjects and the sources of PM2.5.

Impact of traffic-related air pollution on acute changes in cardiac autonomic modulation during rest and physical activity: a cross-over study

“…This was particularly true for PM 2.5 although evidence of non-linearity was also observed for UFPs and BC. The multi-centre ULTRA study found that equivalent increases in fine PM could be positively associated with HRV, but not in each of its sites with equivalent increases which suggests that effects may differ according to the sources of PM at a particular site (14). While findings have not been consistent in previous studies, a strong and consistent increase in HRV in association with fine PM (but not gaseous co-pollutants also measured) has been observed among healthy young men, suggesting increased vagal activity possibly due to a local inflammatory reaction in the lungs (15).…”

Personal, Indoor, and Outdoor Concentrations of Fine and Ultrafine Particles Using Continuous Monitors in Multiple Residences

“…More recent studies have implicated other components of PM with reductions in both respiratory and cardiovascular health (Delfino et al 2004;2005;Timonen et al 2006;Beelen et al 2008), as well as increased mortality (Ostro et al 2010).…”

Transparent air filter for high-efficiency PM2.5 capture

“…PM 2.5 pollution is particularly harmful since it can penetrate human bronchi and lungs owing to the small particle size 9 . Hence, long-term exposure to PM 2.5 increases morbidity and mortality [10][11][12][13][14] . Recently, there have been serious PM pollution problems in developing countries with a large manufacturing industry such as China.…”