Background

Previous studies have reported adverse health effects of indoor air pollutants especially particulate matter (PM) and black carbon (BC). Patients with chronic obstructive pulmonary disease (COPD) have been shown to be more likely with cardiovascular comorbidities in which cardiac autonomic dysfunction plays an important role. However, there is little evidence for the effect of indoor PM and BC exposures on cardiac autonomic function in COPD patients.

Objectives

To evaluate the association between exposure to indoor size-fractioned PM and BC and changes in HRV and HR in COPD patients.

Methods

Forty-three doctor diagnosed, stable COPD patients were recruited and measured for 24-h HRV and HR. Real-time indoor size-fractioned PM and BC were monitored on the day before and the day of performing health measurements. Mixed-effects models were used to estimate the associations between indoor PM and BC and HRV indices and HR after controlling for potential confounders.

Results

Increasing levels of size-fractioned PM and BC were associated with decreased HRV indices and increased HR. An IQR (3.14 μg/m³) increase in 8-h BC moving average and an IQR (20.72 μg/m³) increase in 5-min PM_0.5 moving average concentrations were associated with declines of 7.45% (95% CI: − 10.89%, − 3.88%) and 16.40% (95% CI: − 21.06%, − 11.41%) in LF, respectively. The smaller the particles size, the greater effects on HRV indices and HR. Patients' BMI modified the associations between size-fractioned PM and BC and their HRV and HR. For an IQR increase in PM_0.5, there was decline in HF of 34.85% (95% CI: − 39.08%, − 30.33%) in overweight patients, compared to a 2.01% (95% CI: − 6.44%, 11.19%) increase in normal-weight patients.

Conclusions

Exposures to indoor PM and BC were associated with altered cardiac autonomic function in COPD patients, and the associations for HRV measures of parasympathetic activity (e.g., HF) were more apparent in overweight patients.

中文翻译：

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室内尺寸分级的颗粒物和黑碳对COPD患者心脏自主神经功能的短期影响

背景

先前的研究报告了室内空气污染物，特别是颗粒物（PM）和黑碳（BC）对健康的不利影响。慢性阻塞性肺疾病（COPD）患者已显示出合并心血管疾病的可能性更大，其中心脏自主神经功能障碍起着重要的作用。但是，很少有证据表明室内PM和BC暴露对COPD患者的心脏自主神经功能有影响。

目标

要评估室内暴露于大小分级的PM和BC与COPD患者的HRV和HR变化之间的关联。

方法

招募了43位经医生诊断，稳定的COPD患者，并对其24小时HRV和HR进行了测量。在进行健康测量的前一天和当天，实时监测室内按大小划分的PM和BC。在控制潜在的混杂因素之后，使用混合效应模型来估计室内PM和BC与HRV指数和HR之间的关联。

结果

大小分级的PM和BC水平升高与HRV指数降低和HR升高有关。一个IQR（3.14微克/米³）增加BC 8-H移动平均和IQR（20.72微克/米³）在5分钟的PM增加_0.5移动平均浓度与7.45％（95％CI的下降相关联： - LF中分别为10.89％，-3.88％）和16.40％（95％CI：-21.06％，-11.41％）。颗粒尺寸越小，对HRV指数和HR的影响越大。患者的BMI改变了大小分级的PM和BC与他们的HRV和HR之间的关联。IQR增加PM _0.5时，超重患者的HF下降34.85％（95％CI：− 39.08％，− 30.33％），而2.01％（95％CI：− 6.44％，11.19％）体重正常的患者增加。

结论

在COPD患者中，室内PM和BC暴露与心脏自主神经功能改变有关，在超重患者中，HRV测量副交感神经活动（例如HF）的关联更为明显。