Objectives To investigate pre-clinical adverse effects of ambient particulate air pollution and nitrogen oxides in patients with heart failure.
Methods A cohort of 132 non-smoking patients resident in Aberdeen, Scotland, with stable chronic heart failure were enrolled in a repeated measures panel study. Patients with atrial fibrillation or pacemakers were excluded. Participants were studied for 3 days every two months for up to a year with monitoring of pollutant exposure and concurrent measurements of patho-physiological responses. Measurements included daily area PM10, particle number concentration (PNC) and nitrogen oxides, daily estimated personal PM2.5 and PNC exposures and 3-day cumulative personal nitrogen dioxide (NO2) measurements. Concurrent meteorologic data were recorded. Blood was taken at the end of each 3-day block for assays of markers of endothelial activation, inflammation and coagulation. Cardiac rhythm was monitored by ambulatory Holter monitor during the final 24 hours of each block.
Results The average 24-hour background ambient PM10 ranged from 7.4-68 μg.m-3 and PNC from 454-11,283 particles.cm-3. No associations were demonstrated between the incidence of arrhythmias, heart rate variability or haematological/biochemical measures and any variations in pollutant exposures at any lags.
Conclusions Assuming that low level pollution affects the parameters measured, these findings may suggest a beneficial effect of modern cardioprotective therapy which may modify responses to external risk factors. Widespread use of such drugs in susceptible populations may in future reduce the adverse effects of air pollution on the heart.
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