Air pollution may promote cardiac arrhythmias in healthy teenagers

Research highlights:

• The first-of-its-kind study looking at the effects of air pollution on healthy teenagers found that air pollution can induce cardiac arrhythmias within two hours of exposure.
• Reducing the risk of arrhythmias, known as arrhythmias, during adolescence may help reduce the risk of developing sudden cardiac death or heart disease in adulthood.
• Wearing a face mask and avoiding strenuous physical activity may be justified on high-pollution days, especially early in the morning, the researchers said.

Embargoed until Wednesday, September 14, 2022 at 4:00 AM CT/5:00 AM ET

DALLAS, Sept. 14, 2022 — Air pollution of breathing particulate matter (that is, small particles suspended in the air) can cause irregular heart rhythms (arrhythmia) in healthy teens, according to a new study published today in American Heart Association Journalan open access, peer-reviewed journal of the American Heart Association.

while being negative Cardiovascular Effects of Air Pollution Although adult studies are already established, this study is the first to assess the impact of air pollution on teenagers in the general population.

“While relatively rare, irregular heart rhythms are sudden cardiac death otherwise healthy adolescents and young adults. Our findings linking air pollution and arrhythmias suggest that particulate matter may contribute to the risk of sudden cardiac death in young people.” State Medical College, Hershey, Pennsylvania. “Because cardiovascular disease in childhood and adolescence can be followed into adulthood and influence the risk of major cardiovascular disease later in life, it is important to understand the potential for arrhythmias that can cause sudden cardiac death in adolescents.” Identifying modifiable risk factors should be of great public interest.”

This study examined the effects of fine particulate matter respiration on heart rhythm in adolescents. fine particles (PM_2.5) is less than 2.5 microns in size and can easily be inhaled deep into the lungs and even enter the bloodstream. Particles smaller than 2.5 microns are typically associated with burning fuels, such as those from automobile exhaust and wildfires. Once inhaled, pollutants irritate the blood vessels around the lungs and heart, and previous research suggests that pollutants increase arterial disease processes over time.

Researchers analyzed the effects of respiratory particulate matter contamination on two types of arrhythmias. premature contraction of the myocardium, often described as “skipped heartbeats”. In premature atrial contraction (PAC), the heartbeat originates from the atria (the upper chambers of the heart). Although this usually causes no symptoms or harm, frequent premature atrial contractions are associated with an increased risk of: atrial fibrillation – A severe arrhythmia, in which the upper cavity trembles instead of effectively beating, thereby increasing the risk of blood clots and stroke. A premature ventricular contraction (PVC) occurs when a heartbeat originates from one of the ventricles (chambers under the heart). They also increase the risk of later heart attack, stroke, heart failure, or sudden cardiac death.

If premature contractions do not cause symptoms, they are not treated. However, if they occur frequently and cause frequent skipping, rapid heartbeats, or pounding hearts, treatment with drugs, implanted devices, or procedures may be recommended.

Researchers analyzed health data from 322 adolescents (mean age 17 years, 56% male, 79% non-Hispanic white teens) living in central Pennsylvania. In this study, conducted from 2002 to her 2006, first he recruited children aged 6 to her 12 years. The data analyzed in this study were a review of the results of the follow-up assessment approximately 7.5 years later (2010-2013). Children in this group were considered to be at low risk of arrhythmias without major cardiovascular disease. In a follow-up study, researchers tracked each teen’s exposure to particulate matter in the air they breathe through a small wearable device called a Holter monitor (using a device called a nephelometer). EKG traces of the heart rhythm of each teenager were measured at the same time as the 24-hour measurements. .

Average PM_2.5 The concentration measured in this study is approximately 17 micrograms of particulate matter per cubic meter of air (µg/m³This is well below the health-based air quality standard of 35 µg/m3.³ Established by the US Environmental Protection Agency (EPA).

Survey results:

• Seventy-nine percent of participants had at least one arrhythmia during the 24-hour study period. Of that group, 40% had only premature atrial beats, 12% had only premature ventricular beats, and 48% had both.

• A 5% increase in the number of premature ventricular contractions within 2 hours of exposure was observed for each 10 µg/m increase.³ In the afternoon_2.5.
• No association was found between particulate matter concentration and the number of premature atrial contractions.

“It is alarming that we were able to observe a significant effect of air pollution on cardiac arrhythmias, even though the air quality fell within health standards established by the EPA. Adolescents living in highly polluted areas may be at even higher risk,” he said.

The results were consistent with data previously obtained in adults using similar methods by these and others, but the increase in premature ventricular contractions was even higher in adults. According to the authors, reducing the risk of arrhythmias in adolescence may reduce the risk of developing heart disease in adulthood.

“Our study found that air pollution increases the risk of cardiovascular disease and sudden cardiac death, even among healthy adolescents,” he said. “On days with high concentrations of particulate matter, especially during the early morning rush hour, protective measures such as wearing a mask and avoiding strenuous physical activity may be necessary.”

The most effective way to reduce everyone’s exposure to air pollution is to support stronger national air quality regulations, says a volunteer expert at the American Heart Association and Wayne State University in Detroit. said Robert D. Brooke, MD, Ph.D., professor of medicine at the FAHA. Brooke has co-authored several American Heart Association scientific statements on air pollution.

“afternoon_2.5 Levels dropped dramatically in the 1970s and 80s due to regulation undoubtedly associated with improved health effects and life expectancy. Did. Personal Protective Measures Against Exposure to Air Pollution from Particulate Matter, Strategies and activity or behavioral changes that may reduce exposure to pollution, such as portable air purifiers, face masks, respirators, and exercise during off-peak hours. However, no studies have shown that these measures can actually prevent adverse clinical health effects such as heart attacks. ”

according to 2020 American Heart Association Policy Statement quoting global study, ambient air pollution is widely recognized as a significant cause of cardiovascular disease and mortality. In 2017, exposure to particulate air pollution was estimated to be associated with more than 7 million premature deaths worldwide and 147 million healthy life expectancy losses. The association recommends further development of evidence-based policy approaches, continued investment in research, expansion of innovation, and transformative partnerships to reduce the cardiovascular burden of air pollutants in the United States. increase.

“The most interesting and important aspect of this study is that the results were seen in healthy young adolescents,” Brooke said. It supports the concern that the_2.5 Exposure levels within the 24-hour National Ambient Air Quality Standards established by the EPA. The findings may help explain the potential reasons for the timing of arrhythmia onset and even the causes of sudden death in susceptible young people. ”

Dr. He and colleagues are currently assessing the effects of air pollution on other markers of cardiac electrical activity.

This study is limited by the inability to analyze the effects of air pollution on different subtypes of ventricular extrasystole, and it may be of interest to cardiologists to better understand how pollution affects cardiac function. may be useful for The results of this study in adolescents may not generalize to younger children.

Co-authored by Jeff D. Yanosky, Sc.D. Dr. Julio Fernandez-Mendoza. Dr. Vernon M. Chinchilli. Dr. Laila Al Shahr. Alexandros N. Vgonzas, MD. Dr. Edward O. Bixler. and Duanping Liao, MD, Ph.D.

This study was funded by the National Heart, Lung, and Blood Institute at the National Institutes of Health and the Pennsylvania State Institute of Clinical and Translational Sciences.

Research published in the American Heart Association scientific journal is peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the policy or position of the Society. The Society makes no representations or warranties as to their accuracy or reliability. The association receives funding primarily from individuals. Foundations and companies (including pharmaceuticals, device manufacturers, and other companies) also make donations to fund specific programs and events of the association. The Society has strict policies to prevent these relationships from affecting the content of science. Income from pharmaceutical companies, biotech companies, device manufacturers, health insurers, and the association’s overall financial information are available. here.

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