空气污染对SPECT心肌灌注成像的临床影响

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2025-03-22 DOI:10.1016/j.envint.2025.109406

Océane Bouchot , Stephan Gabet , Loïc Djaileb , Aurélia Robin , Nicolas De Leiris , Julie Roux , Laurent Riou , Gerald Vanzetto , Daniel Fagret , Catherine Ghezzi , Rémy Slama , Gilles Barone-Rochette

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引用次数: 0

摘要

背景：空气污染会导致心血管疾病死亡。空气污染对心血管功能的影响有非侵入性和侵入性影像学评估，但从未报道过对心肌灌注的影响。本研究旨在描述空气污染暴露与心肌灌注成像（MPI）的关系。方法2017 - 2020年前瞻性纳入单光子发射计算机断层扫描（SPECT）患者。通过SPECT评估心肌缺血程度。中度至重度缺血定义为 >； 10 %缺血心肌。通过10米分辨率空气污染物扩散模型和空气质量监测系统数据，对家庭住址的颗粒物（PM2.5和PM10）和二氧化氮暴露进行了表征。通过多变量回归评估暴露与闪烁成像参数的关系，并调查性别和BMI的潜在修改效应。结果共纳入1585名参与者（平均年龄67.7 ± 11.6 岁，男性63.3 %）；148例（9.3 %）患者出现中重度缺血。在多因素分析中，中度至重度缺血的几率增加，调整后的比值比（ORa）为1.39[95 %可信区间（95 % CI）： 1.07-1.80；p = 0.013],1.33(95 % CI: 1.01-1.75；p = 0.042),1.22(95 % CI: 0.96-1.57；p = 0.10),PM2.5、PM10和NO2暴露每增加一个四分位数范围（IQR分别等于3.3、4.3和10.0 µg/m3）。进一步调整心血管代谢疾病和症状后，只有与PM2.5的相关性仍然具有统计学意义：每增加1个iqr， ORa为1.34（95 % CI: 1.03-1.75, p = 0.031）。与PM10和PM2.5的相关性在女性中更强（相互作用p值分别为0.11和0.077）。结论我们对空气颗粒污染影响心血管风险的机制提供了新的见解。暴露于PM与中度至重度缺血有关，特别是在女性中。

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Clinical impact of air pollution on SPECT myocardial perfusion imaging

Background

Air pollution contributes to cardiovascular morbimortality. Air pollution effects on cardiovascular function assessed from non-invasive and invasive imaging have been reported but never on myocardial perfusion. This study aimed to characterize relations of air pollution exposure to myocardial perfusion imaging (MPI).

Methods

Patients referred to SPECT (single-photon emission computed tomography) MPI were prospectively enrolled between 2017 and 2020. Myocardial ischemia was assessed from the SPECT. Moderate-to-severe ischemia was defined as a > 10 % ischemic myocardium. Exposures to particulate matter (PM_2.5 and PM₁₀) and NO₂ at the home address were characterized via a 10-meter resolution air pollutant-dispersion model and air quality monitoring system data. Associations of exposures with scintigraphy parameters were assessed through multivariable regressions, and potential modifying effects by sex and BMI were investigated.

Results

A total of 1,585 participants were prospectively included (mean age 67.7 ± 11.6 years, 63.3 % male); 148 (9.3 %) patients presented a moderate-to-severe ischemia. In multivariate analysis, the odds of moderate-to-severe ischemia was increased, with adjusted odds-ratio (ORa) of 1.39 [95 % confidence interval (95 % CI): 1.07–1.80; p = 0.013], 1.33 (95 % CI: 1.01–1.75; p = 0.042), and 1.22 (95 % CI: 0.96–1.57; p = 0.10) for each increase of one Interquartile Range (IQR) in PM_2.5, PM₁₀ and NO₂ exposure, respectively (IQR equal to 3.3, 4.3 and 10.0 µg/m³, respectively). With further adjustment for cardiometabolic diseases and symptoms, only the association with PM_2.5 remained statistically significant: ORa 1.34 (95 % CI: 1.03–1.75, p = 0.031) for each one-IQR increase. Associations with PM₁₀ and PM_2.5 tended to be stronger in women (interaction p-value equal to 0.11 and 0.077, respectively).

Conclusion

We provide new insights into a mechanism by which particulate air pollution may influence cardiovascular risk. Exposure to PM was associated with moderate-to-severe ischemia, particularly in women.

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.