CARDIOVASCULAR VULNERABILITY TO PARTICULATE EXPOSURE

颗粒物暴露导致的心血管脆弱性

• 批准号: 6502519
• 负责人: DIANE R GOLD
• 金额: $ 19.62万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6502519
• 关键词: aerobic exercise; air pollution; air sampling /monitoring; arrhythmia; blood pressure; body physical characteristic; carbon monoxide; cardiovascular disorder epidemiology; clinical research; disease /disorder proneness /risk; electrocardiography; hazardous substances; heart conduction system; heart rate; human old age (65+); human subject; humidity; myocardial infarction; outcomes research; oximetry; particle; seasons; self care; smoking; temperature

Epidemiologic associations between particulate air pollution and cardiovascular hospitalization and mortality have been found, but little is understood about the physiologic mechanisms by which humans respond to particulate exposure. Canines respond to concentrated fly-ash and/or fine particles with ECG repolarization abnormalities including ST segment abnormalities, T-wave alternans (an index of susceptibility to sudden death), and changes typical of both hyperadrenergic activity and vagally mediated effects, depending on the underlying status of the dogs. In susceptible adults we propose to examine whether particle exposure results in similar changes, particularly in measures of autonomic function, myocardial conductance, repolarization, and irritability. Outdoor and indoor PM2~5, PM10, CO, O3, NO2, 502 and temperature will be considered as exposures. A Boston community-based panel of 50 active adults 60-90 yr of age will be recruited and evaluated over two 3-month summer periods; this panel study will be repeated in a higher pollution community in two subsequent summers. Once per week for l2 weeks the participants will receive supine and upright blood pressure, oximetry and continuous ECG Holter monitoring for a 25 minute period (5 minutes of rest supine, 5 minutes of standing upright, 5 minutes of exercise, 5 minutes of recovery and 5 minutes of slow breathing.) Electrophysiologic outcomes will include ECG repolarization abnormalities, ventricular premature beats, measures of heart rate variability; PR and QT intervals. Modification or response by underlying disease and medication will be considered. A second study of >800 outpatients will assess the associations between particulate exposure and cardiopulmonary exercise data routinely collected during repeated exercise in two Boston cardiac and pulmonary rehabilitation units. These will enable us to assess whether particulate exposure is associated with physiologic changes predictive of cardiovascular vulnerability and sudden death in active humans who are susceptible on the basis of age or disease.

已经发现了颗粒空气污染与心血管住院和死亡率之间的流行病学关联，但是关于人类对颗粒物暴露的反应的生理机制几乎没有理解。犬对具有ECG复极异常的浓缩蝇灰和/或细颗粒反应，包括ST段异常，T波替代品（对猝死的易感性指数），以及甲状腺素能活性的典型变化和模糊的介导的效果，取决于狗的基础状态。在敏感的成年人中，我们建议检查粒子暴露是否会导致相似的变化，尤其是在自主功能，心肌电导，复极化和易怒的措施中。室外和室内PM2〜5，PM10，CO，O3，NO2，502和温度将被视为暴露。在两个3个月的夏季期间，将招募和评估一个由50名活跃成年人组成的波士顿社区小组。这项小组研究将在随后两个夏季的较高污染社区中重复。每周一次L2周每周一次，参与者将在25分钟内接受仰卧和直立的血压，血氧仪和连续的ECG地球监测（5分钟的休息仰卧，直立5分钟，直立5分钟，锻炼5分钟，恢复5分钟和5分钟的恢复5分钟和缓慢的呼吸。 PR和QT间隔。将考虑通过潜在疾病和药物进行修改或反应。对> 800个门诊患者进行的第二项研究将评估在两个波士顿心脏和肺部康复单位重复运动期间经常收集的颗粒物暴露与心肺运动数据之间的关联。这些将使我们能够评估颗粒物暴露是否与在年龄或疾病基础上易感的活跃人类的心血管脆弱性和猝死的生理变化有关。