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Multicenter Study
. 2014 May 1;189(9):1093-100.
doi: 10.1164/rccm.201312-2298OC.

Traffic-related air pollution and the right ventricle. The multi-ethnic study of atherosclerosis

Peter J Leary  1 , Joel D Kaufman, R Graham Barr, David A Bluemke, Cynthia L Curl, Catherine L Hough, Joao A Lima, Adam A Szpiro, Victor C Van Hee, Steven M Kawut
Affiliations
Multicenter Study

Traffic-related air pollution and the right ventricle. The multi-ethnic study of atherosclerosis

Peter J Leary et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Right heart failure is a cause of morbidity and mortality in common and rare heart and lung diseases. Exposure to traffic-related air pollution is linked to left ventricular hypertrophy, heart failure, and death. Relationships between traffic-related air pollution and right ventricular (RV) structure and function have not been studied.

Objectives: To characterize the relationship between traffic-related air pollutants and RV structure and function.

Methods: We included men and women with magnetic resonance imaging assessment of RV structure and function and estimated residential outdoor nitrogen dioxide (NO2) concentrations from the Multi-ethnic Study of Atherosclerosis, a study of individuals free of clinical cardiovascular disease at baseline. Multivariable linear regression estimated associations between NO2 exposure (averaged over the year prior to magnetic resonance imaging) and measures of RV structure and function after adjusting for demographics, anthropometrics, smoking status, diabetes mellitus, and hypertension. Adjustment for corresponding left ventricular parameters, traffic-related noise, markers of inflammation, and lung disease were considered in separate models. Secondary analyses considered oxides of nitrogen (NOx) as the exposure.

Measurements and main results: The study sample included 3,896 participants. In fully adjusted models, higher NO2 was associated with greater RV mass and larger RV end-diastolic volume with or without further adjustment for corresponding left ventricular parameters, traffic-related noise, inflammatory markers, or lung disease (all P < 0.05). There was no association between NO2 and RV ejection fraction. Relationships between NOx and RV morphology were similar.

Conclusions: Higher levels of NO2 exposure were associated with greater RV mass and larger RV end-diastolic volume.

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Figures

Figure 1.
Figure 1.
Representative map of Winston-Salem showing coarse and fine details of nitrogen dioxide predictions in parts per billion (ppb) from the spatiotemporal model including approximate Multi-ethnic Study of Atherosclerosis participant locations (jittered for privacy).
Figure 2.
Figure 2.
Multivariable nonparametric smoothed relationship between nitrogen dioxide (NO2) in parts per billion (ppb) and right ventricular (RV) parameters with adjustment for age, sex, race/ethnicity, height, weight, city, education, income, smoking status, pack-years, hypertension, diabetes, cholesterol, and impaired glucose tolerance (black lines). Gray lines represent 95% confidence bounds.
Figure 3.
Figure 3.
Relationship between the number of years a participant lived in their neighborhood and the difference in right ventricular (RV) mass or end-diastolic volume (EDV) per interquartile increase in nitrogen dioxide (NO2): a sliding time window analysis of the full model. *P ≤ 0.05.
See this image and copyright information in PMC

Comment in

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