Changes in deceleration capacity of heart rate and heart rate variability induced by ambient air pollution in individuals with coronary artery disease

<p>Abstract</p> <p>Background and Objective</p> <p>Exposure to ambient particles has been shown to be responsible for cardiovascular effects, especially in elderly with cardiovascular disease. The study assessed the association between deceleration capacity (DC) as well as heart rate variability (HRV) and ambient particulate matter (PM) in patients with coronary artery disease (CAD).</p> <p>Methods</p> <p>A prospective study with up to 12 repeated measurements was conducted in Erfurt, Germany, between October 2000 and April 2001 in 56 patients with physician-diagnosed ischemic heart disease, stable angina pectoris or prior myocardial infarction at an age of at least 50 years. Twenty-minute ECG recordings were obtained every two weeks and 24-hour ECG recordings every four weeks. Exposure to PM (size range from 10 nm to 2.5 μm), and elemental (EC) and organic (OC) carbon was measured. Additive mixed models were used to analyze the association between PM and ECG recordings.</p> <p>Results</p> <p>The short-term recordings showed decrements in the high-frequency component of HRV as well as in RMSSD (root-mean-square of successive differences of NN intervals) in association with increments in EC and OC 0-23 hours prior to the recordings. The long-term recordings revealed decreased RMSSD and pNN50 (% of adjacent NN intervals that differed more than 50 ms) in association with EC and OC 24-47 hours prior to the recordings. In addition, highly significant effects were found for DC which decreased in association with PM_2.5, EC and OC concurrent with the ECG recordings as well as with a lag of up to 47 hours.</p> <p>Conclusions</p> <p>The analysis showed significant effects of ambient particulate air pollution on DC and HRV parameters reflecting parasympathetic modulation of the heart in patients with CAD. An air pollution-related decrease in parasympathetic tone as well as impaired heart rate deceleration capacity may contribute to an increased risk for cardiac morbidity and sudden cardiac death in vulnerable populations.</p

Erfurt male cohort study (ERFORT study): study design and descriptive results

Das Hauptziel der ERFORT-Studie bestand darin, kardiovaskul&auml;re Risikofaktoren, lebensstilabh&auml;ngige Verhaltensweisen und psychosoziale Charakteristika mit Blick auf die gesamt- und todesursachenspezifische Mortalit&auml;t und Morbidit&auml;t zu untersuchen. Der vorliegende Beitrag beschreibt das Studiendesign, Untersuchungsbefunde w&auml;hrend der drei Untersuchungswellen mit Blick auf kardiovaskul&auml;re und psychosoziale Faktoren sowie Ergebnisse zum Mortalit&auml;ts-Follow-up im 30-Jahres-Verlauf. Die ERFORT-Studie ist eine populationsbasierte prospektive Kohortenstudie mit M&auml;nnern mittleren Alters (35&ndash;61&nbsp;Jahre) zum Zeitpunkt des Baselinesurveys in den Jahren 1973&ndash;1975. 1160&nbsp;M&auml;nner (74,6% der Zufallsstichprobe von 1600&nbsp;M&auml;nnern) wurden f&uuml;r diese Studie rekrutiert. Nach dem Baselinesurvey gab es im Abstand von jeweils etwa 5&nbsp;Jahren weitere drei Untersuchungswellen. Die gesamte Kohorte wurde bis zum Jahr 2003 im Hinblick auf den Lebensstatus weiter verfolgt. W&auml;hrend des 15-j&auml;hrigen Follow-up-Programms verdoppelten sich etwa die H&auml;ufigkeiten f&uuml;r kardiovaskul&auml;re Erkrankungen wie Myokardinfarkt, Angina pectoris, Claudicatio intermittens. Die Diabetespr&auml;valenz stieg von 2,8% auf 12% im 15-Jahres-Follow-up. Die Pr&auml;valenz hoher Blutdruckwerte (&ge;&thinsp;160/95&nbsp;mmHg) nahm lediglich leicht zu, wobei die antihypertensive Behandlungsrate im 15-Jahres-Zeitraum von 8,7% auf 33,6% anstieg. Rauchen und Diabetes wurden als starke Risikofaktoren f&uuml;r Neuerkrankungen an Claudicatio intermittens w&auml;hrend des 15-j&auml;hrigen Follow-up-Zeitraums identifiziert. Erh&ouml;hte Plasmaglukosewerte nach Glukosebelastung zeigten sich als starker Langzeitpr&auml;diktor f&uuml;r die Gesamtsterblichkeit. Die ERFORT-Studie erlaubte es auch, die Schwankung des Relativgewichtes &uuml;ber einen Zeitraum von 15&nbsp;Jahren mit Blick auf die weitere Mortalit&auml;t im Verlauf von weiteren 15&nbsp;Jahren zu untersuchen. Dabei zeigte sich, dass die Fluktuation des Gewichtes ein st&auml;rkerer Risikofaktor f&uuml;r die Gesamtsterblichkeit ist als ein stabiles &Uuml;bergewicht. Die ERFORT-Studie zeigt als eine der fr&uuml;hesten epidemiologischen Kohorten-Studien in Deutschland nach dem Zweiten Weltkrieg, dass international eingef&uuml;hrte epidemiologische Untersuchungsmethoden in Deutschland etabliert werden k&ouml;nnen und dass Langzeitbeobachtungen zum Lebensstatus m&ouml;glich sind

Short-Term Mortality Rates during a Decade of Improved Air Quality in Erfurt, Germany

BACKGROUND: Numerous studies have shown associations between ambient air pollution and daily mortality. OBJECTIVES: Our goal was to investigate the association of ambient air pollution and daily mortality in Erfurt, Germany, over a 10.5-year period after the German unification, when air quality improved. METHODS: We obtained daily mortality counts and data on mass concentrations of particulate matter (PM) < 10 μm in aerodynamic diameter (PM(10)), gaseous pollutants, and meteorology in Erfurt between October 1991 and March 2002. We obtained ultrafine particle number concentrations (UFP) and mass concentrations of PM < 2.5 μm in aerodynamic diameter (PM(2.5)) from September 1995 to March 2002. We analyzed the data using semiparametric Poisson regression models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology. We evaluated cumulative associations between air pollution and mortality using polynomial distributed lag (PDL) models and multiday moving averages of air pollutants. We evaluated changes in the associations over time in time-varying coefficient models. RESULTS: Air pollution concentrations decreased over the study period. Cumulative exposure to UFP was associated with increased mortality. An interquartile range (IQR) increase in the 15-day cumulative mean UFP of 7,649 cm(−3) was associated with a relative risk (RR) of 1.060 [95% confidence interval (CI), 1.008–1.114] for PDL models and an RR/IQR of 1.055 (95% CI, 1.011–1.101) for moving averages. RRs decreased from the mid-1990s to the late 1990s. CONCLUSION: Results indicate an elevated mortality risk from short-term exposure to UFP. They further suggest that RRs for short-term associations of air pollution decreased as pollution control measures were implemented in Eastern Germany

Short-term mortality rates during a decade of improved air quality in Erfurt, Germany.

Numerous studies have shown associations between ambient air pollution and daily mortality. OBJECTIVES: Our goal was to investigate the association of ambient air pollution and daily mortality in Erfurt, Germany, over a 10.5-year period after the German unification, when air quality improved. METHODS: We obtained daily mortality counts and data on mass concentrations of particulate matter (PM) &lt; 10 mu m in aerodynamic diameter (PM10), gaseous pollutants, and meteorology in Erfurt between October 1991 and March 2002. We obtained ultrafine particle number concentrations (UFP) and mass concentrations of PM &lt; 2.5 mu m in aerodynamic diameter (PM2.5) from September 1995 to March 2002. We analyzed the data using semiparametric Poisson regression models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology. We evaluated cumulative associations between air pollution and mortality using polynomial distributed lag (PDL) models and multiday moving averages of air pollutants. We evaluated changes in the associations over time in time-varying coefficient models. RESULTS: Air pollution concentrations decreased over the study period. Cumulative exposure to UFP was associated with increased mortality. An interquartile range (IQR) increase in the 15-day cumulative mean UFP of 7,649 cm(-3) was associated with a relative risk (RR) of 1.060 [95% confidence interval (CI), 1.008-1.114] for PDL models and an RR/IQR of 1.055 (95% CI, 1.011-1.101) for moving averages. RRs decreased from the mid-1990s to the late 1990s. CONCLUSION: Results indicate an elevated mortality risk from short-term exposure to UFP. They further suggest that RRs for short-term associations of air pollution decreased as pollution control measures were implemented in Eastern Germany