Air Pollution, Heart Failure and Atrial Fibrillation in MESA

MESA 的空气污染、心力衰竭和心房颤动

基本信息

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
项目类别：
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

项目摘要

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.

抽象的考夫曼：MESA 的空气污染、心力衰竭和心房颤动负担该提案研究了环境空气污染物对环境空气污染物的发展、负担和触发的影响。心力衰竭和心房颤动与空气污染物，尤其是颗粒物有关。心血管疾病的发病率，特别是冠心病和中风。由于预防工作的努力，心脏病和中风正在减少，而心力衰竭（HF、尤其是射血分数保留（HFpEF）和房性心律失常（尤其是心房颤动，AF）环境因素在心血管疾病负担中发挥着越来越重要的作用；这两种常见的共存疾病的因素在很大程度上尚未得到研究。动脉粥样硬化 (MESA) 是一个非常有价值的队列，用于了解动脉粥样硬化的预测因素和相关因素由于参与者的年龄、广泛的现有表型和计划，心力衰竭和心房颤动 2016 年开始的考试评估。此外，MESA 已成为研究最仔细的这项拟议的研究将扩大空气污染物的暴露范围。使用创新的低成本室内和室外家庭监控和最先进的技术进行表征我们将结合广泛的地理输入来描述这两种关系的建模方法。长期暴露于细颗粒物 (PM2.5)、氮氧化物 (NOX)、氮二氧化氮（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失常，以及短期暴露于空气污染物与心房颤动的触发之间的关系心律失常和房颤负担很重要，因为： 1) 空气污染物是与心血管死亡率相关；2) 心力衰竭和心力衰竭相关的结构性疾病是房颤的危险因素； 3) HFpEF 合并 AF 代表死亡风险特别高的群体，我们将估计长期（每年）。室外和室内 PM2.5、NOX、NO2、O3 和 CO 的平均）和短期（每小时和每日）浓度所有 MESA 参与者的家中都使用最先进的监控技术和时空统计我们将在 MESA 参与者的一部分家庭和地区使用新型低成本污染物监测传感器。流行的 HF 亚型和新出现的亚表型的早期证据将是使用检查中超声心动图心脏参数、6 分钟步行测试结果的信息进行评估，动脉张力测定和生物标志物（NTproBNP、sST2、galectin-3）。新型动态两周心电图监测。对植入起搏器和心律转复除颤器的询问将使我们能够评估长期空气污染暴露与房颤和短期空气污染以及触发房颤之间的关联通过这项努力，我们将前所未有地了解空气污染物在房性心律失常中的作用。心血管疾病的发展，重点关注 HF，尤其是 HFpEF 和 AF。