Air Pollution, Heart Failure and Atrial Fibrillation in MESA

MESA 的空气污染、心力衰竭和心房颤动

• 批准号: 9386363
• 负责人: Joel Daniel Kaufman
• 金额: $ 60.1万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9386363
• 关键词: Address; Age; Aging; Air; Air Pollutants; Air Pollution; Arrhythmia; Atrial Fibrillation; Biological Markers; Carbon Monoxide; Cardiac; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chemicals; Chronic Kidney Failure; Clinical; Cohort Studies; Communities; Coronary; Coronary Arteriosclerosis; Coronary heart disease; Data; Defibrillators; Dementia; Development; Devices; Diabetes Mellitus; Disease; EFRAC; Echocardiography; Electrocardiogram; Environmental Risk Factor; Exercise stress test; Exposure to; Galectin 3; Geography; Health; Heart Atrium; Heart failure; Home environment; Hour; Hypertension; Impaired cognition; Implant; Incidence; Laboratories; Link; Location; Lung; Machine Learning; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Mediating; Methods; Modeling; Modernization; Monitor; Multi-Ethnic Study of Atherosclerosis; Myocarditis; Nitrogen Dioxide; Nitrogen Oxides; Obesity; Ozone; Pacemakers; Participant; Particulate Matter; Phenotype; Physiological; Play; Policies; Population; Prevalence; Prevention; Process; Public Health; Risk; Risk Factors; Role; Source; Statistical Models; Stress; Stroke; Technology; Test Result; Testing; Variant; Walking; aging population; ambient air pollution; arterial tonometry; base; brachial artery; cardiogenesis; cardiovascular disorder risk; cohort; coronary fibrosis; cost; disability; environmental agent; fine particles; health inequalities; high risk; implantable device; innovation; insight; monitoring device; mortality; new technology; novel; pollutant; sensor; spatiotemporal; success

Abstract Kaufman: Air pollution, heart failure, and atrial fibrillation burden in MESA This proposal examines the impact of ambient air pollutants on the development, burden, and triggering of heart failure and atrial fibrillation. Air pollutants, especially particulate matter, have been associated with the incidence of cardiovascular disease, especially coronary heart disease and stroke. The incidence of coronary heart disease and stroke is declining due to prevention efforts, while development of heart failure (HF, especially with preserved ejection fraction, HFpEF) and atrial arrhythmias (especially atrial fibrillation, AF) are becoming more important components of the burden of cardiovascular disease; the role of environmental factors in these two frequently co-existing conditions diseases is largely unstudied. The Multi-Ethnic Study of Atherosclerosis (MESA) is an extraordinarily valuable cohort for understanding predictors and correlates of heart failure and atrial fibrillation, due to participants’ ages, extensive existing phenotyping, and planned assessment in an examination beginning in 2016. In addition, MESA has become the most carefully studied cohort in terms of exposure to ambient air pollutants. This proposed study will extend the air pollutant characterization using innovative low-cost indoor and outdoor home-based monitoring and state-of-the-art modeling approaches incorporating extensive geographic inputs. We will characterize both the relationship between long-term ambient exposures to fine particulate matter (PM2.5), oxides of nitrogen (NOX), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO), and development of early stage heart failure and atrial arrhythmias, and the relationship between short-term exposure to air pollutants and triggering of atrial arrhythmias and AF burden. It is important to understand these relationships since: 1) Air pollutants are associated with cardiovascular mortality; 2) HF and structural disease correlates of HF are risk factors for AF; and 3) HFpEF with AF represents a group at especially high mortality risk. We will estimate long-term (annual average) and short-term (hourly and daily) concentrations of PM2.5, NOX, NO2, O3, and CO, outside and inside all MESA participants’ homes using state-of-the-art monitoring technology and spatiotemporal statistical models. We will use novel low-cost pollutant monitoring sensors at a subset of MESA participant homes and community locations. Early evidence of prevalent HF subtypes and newly emerging sub-phenotypes will be assessed using information from in-exam echocardiographic cardiac parameters, 6-minute walk test results, arterial tonometry, and biomarkers (NTproBNP, sST2, galectin-3). Ambulatory novel two-week ECG monitoring and interrogations of implanted pacemakers and cardioverter-defibrillators will allow us to assess the association between long-term air pollution exposure and AF and short-term air pollution and the triggering of atrial arrhythmias. Through this effort, we will gain unprecedented insight into the role of air pollutants in development of cardiovascular disease, with a focus on HF, especially HFpEF, and on AF.

抽象的 Kaufman：Mesa中的空气污染，心力衰竭和房颤伯恩 该提案研究了环境空气污染物对开发，伯恩的影响 心力衰竭和心房颤动。空气污染物，尤其是特别的问题，与 心血管疾病的发生率，尤其是冠心病和中风。冠状动脉的发病率 心脏病和中风由于预防努力而下降，而心力衰竭的发展（HF， 特别是保留的射血分数，HFPEF）和心律不齐（尤其是心房颤动，AF） 成为燃烧心血管疾病的较重要组成部分；环境的作用 在这两种经常共存的疾病中，疾病的因素在很大程度上没有研究。多民族研究 动脉粥样硬化（MESA）是理解预测因子和相关性的非常有价值的队列 由于参与者的年龄，广泛的现有表型和计划，心力衰竭和心房颤动 从2016年开始的考试中的评估。此外，梅萨已成为最仔细的研究 在暴露于环境空气污染物的方面。这项拟议的研究将扩大空气污染物 使用创新的低成本室内和室外家庭监控以及最先进的表征 建模方法增加了广泛的地理输入。我们将表征这两个关系 在长期环境暴露于细节（PM2.5），氮（NOX）的氧化物之间，氮 二氧化物（NO2），臭氧（O3）和一氧化碳（CO），以及早期心力衰竭和心房的发展 心律不齐，以及短期暴露于空气污染物与触发的关系 心律不齐和AF Burnen。了解这些关系很重要，因为：1）空气污染物是 与心血管死亡率有关； 2）HF和HF的结构疾病相关性是AF的危险因素； 3）具有AF的HFPEF代表一个特别高死亡率风险的群体。我们将估计长期（年度） 平均）和短期（每小时和每日）PM2.5，NOX，NOX，O3和CO，外部和内部 所有MESA参与者的房屋都使用最先进的监测技术和时空统计数据 型号。我们将在台面参与者房屋的子集和 社区地点。普遍的HF亚型和新出现的亚类型的早期证据将是 使用来自检查中的超声心动图心脏参数的信息进行评估，步行6分钟的测试结果， 动脉渗透和生物标志物（NTPROBNP，SST2，GALECTIN-3）。卧床小说两周的心电图监测 对植入的起搏器和心脏扭曲器构造者的审讯将使我们能够评估 长期空气污染与AF之间的关联与短期空气污染与触发 心律不齐。通过这项努力，我们将对空气污染物在 心血管疾病的发展，重点是HF，尤其是HFPEF，以及AF。