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Air pollution and heart failure: Relationship with the ejection fraction
Alberto Dominguez-Rodriguez, Javier Abreu-Afonso, Sergio Rodríguez, Ruben A Juarez-Prera, Eduardo Arroyo-Ucar, Yenny Gonzalez, Pedro Abreu-Gonzalez, Pablo Avanzas
Alberto Dominguez-Rodriguez, Ruben A Juarez-Prera, Eduardo Arroyo-Ucar, Department of Cardiology, Hospital Universitario de Canarias, E-38320 Santa Cruz de Tenerife, Spain
Alberto Dominguez-Rodriguez, Universidad Europea de Canarias, Facultad de Ciencias de la Salud, E-38300 Santa Cruz de Tenerife, Spain
Alberto Dominguez-Rodriguez, Instituto Universitario de Tecnologías Biomédicas, E-38320 Santa Cruz de Tenerife, Spain
Javier Abreu-Afonso, Department of Applied Physics, Universidad de Valencia, E-46900 Valencia, Spain
Sergio Rodríguez, Yenny Gonzalez, Center for Atmospheric Research Izaña, AEMET-CSIC, E-38071 Santa Cruz de Tenerife, Spain
Pedro Abreu-Gonzalez, Department of Physiology, Universidad de la Laguna, E-38320 Santa Cruz de Tenerife, Spain
Pablo Avanzas, Department of Cardiology, Hospital Universitario Central de Asturias, E-33006 Oviedo, Spain
Author contributions: Dominguez-Rodriguez A and Rodríguez S had contributed to the conception, design, analysis and interpretation of data, drafting and final approval of the manuscript submitted; Abreu-Afonso J, Jaurez-Prera RA, Arroyo-Ucar E and Gonzalez Y had contributed to the analysis and interpretation of data, drafting and final approval of the manuscript submitted; Abreu-Gonzalez P and Avanzas P had contributed to the drafting of the manuscript, revising it critically for important intellectual content and final approval of the manuscript submitted.
Supported by The framework of one research projects funded by the Spanish Society of Cardiology (Daiichi-Sankyo project 2011)
Correspondence to: Alberto Dominguez-Rodriguez, MD, PhD, FESC, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n La Cuesta, E-38320 La Laguna, Santa Cruz de Tenerife, Spain. adrvdg@hotmail.com
Telephone: +34-922-679040 Fax: +34-922-678460
Received: December 4, 2012
Revised: December 7, 2012
Accepted: January 17, 2013
Published online: March 26, 2013
Processing time: 112 Days and 12.8 Hours
AIM: To study whether the concentrations of particulate matter in ambient air are associated with hospital admission due to heart failure in patients with heart failure with preserved ejection fraction and reduced ejection fraction.
METHODS: We studied 353 consecutive patients admitted into a tertiary care hospital with a diagnosis of heart failure. Patients with ejection fraction of ≥ 45% were classified as having heart failure with preserved ejection fraction and those with an ejection fraction of < 45% were classified as having heart failure with reduced ejection fraction. We determined the average concentrations of different sizes of particulate matter (< 10, < 2.5, and < 1 μm) and the concentrations of gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone) from 1 d up to 7 d prior to admission.
RESULTS: The heart failure with preserved ejection fraction population was exposed to higher nitrogen dioxide concentrations compared to the heart failure with reduced ejection fraction population (12.95 ± 8.22 μg/m3vs 4.50 ± 2.34 μg/m3, P < 0.0001). Multivariate analysis showed that nitrogen dioxide was a significant predictor of heart failure with preserved ejection fraction (odds ratio ranging from (1.403, 95%CI: 1.003-2.007, P = 0.04) to (1.669, 95%CI: 1.043-2.671, P = 0.03).
CONCLUSION: This study demonstrates that short-term nitrogen dioxide exposure is independently associated with admission in the heart failure with preserved ejection fraction population.
