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Mandaglio-Collados D, López-Gálvez R, Ruiz-Alcaraz AJ, López-García C, Roldán V, Lip GYH, Marín F, Rivera-Caravaca JM. Impact of particulate matter on the incidence of atrial fibrillation and the risk of adverse clinical outcomes: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163352. [PMID: 37023806 DOI: 10.1016/j.scitotenv.2023.163352] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is common and increases the risk of stroke and mortality. Previous studies have suggested that air pollution is an important risk factor for new-onset AF. Herein, we review the evidence regarding: 1) the association between exposure to particulate matter (PM) and new-onset AF, and 2) the risk of worse clinical outcomes in patients with pre-existent AF and their relation to PM exposure. METHODS A selection of studies between 2000 and 2023 linking PM exposure and AF was performed through searches in PubMed, Scopus, Web of Science, and Google Scholar. RESULTS 17 studies from different geographical areas demonstrated that exposure to PM was associated with an increased risk of new-onset AF, although the results were heterogeneous regarding the temporal pattern (short- or long-term) ultimately related to AF. Most of the studies concluded that the risk of new-onset AF increased between 2 %-18 % per 10 μg/m3 increment in PM2.5 or PM10 concentrations, whereas the incidence (percentage of change of incidence) increased between 0.29 %-2.95 % per 10 μg/m3 increment in PM2.5 or PM10. Evidence about the association between PM and adverse events in patients with pre-existent AF was scarce but 4 studies showed a higher risk of mortality and stroke (between 8 %-64 % in terms of hazard ratio) in patients with pre-existent AF when PM exposure was higher. CONCLUSIONS Exposure to PM (both PM2.5 and PM10) is a risk factor for AF, and a risk factor for mortality and stroke in patients who already suffer from AF. Since the relationship between PM and AF is independent of the region of the world, PM should be considered as a global risk factor for both AF and worse clinical outcomes in AF patients. Specific measures to prevent air pollution exposure need to be adopted.
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Affiliation(s)
- Darío Mandaglio-Collados
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Raquel López-Gálvez
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Antonio José Ruiz-Alcaraz
- Department of Biochemistry and Molecular Biology and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Cecilia López-García
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Vanessa Roldán
- Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Faculty of Nursing, University of Murcia, Murcia, Spain
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Garcia A, Santa-Helena E, De Falco A, de Paula Ribeiro J, Gioda A, Gioda CR. Toxicological Effects of Fine Particulate Matter (PM 2.5): Health Risks and Associated Systemic Injuries-Systematic Review. WATER, AIR, AND SOIL POLLUTION 2023; 234:346. [PMID: 37250231 PMCID: PMC10208206 DOI: 10.1007/s11270-023-06278-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
Previous studies focused on investigating particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) have shown the risk of disease development, and association with increased morbidity and mortality rates. The current review investigate epidemiological and experimental findings from 2016 to 2021, which enabled the systemic overview of PM2.5's toxic impacts on human health. The Web of Science database search used descriptive terms to investigate the interaction among PM2.5 exposure, systemic effects, and COVID-19 disease. Analyzed studies have indicated that cardiovascular and respiratory systems have been extensively investigated and indicated as the main air pollution targets. Nevertheless, PM2.5 reaches other organic systems and harms the renal, neurological, gastrointestinal, and reproductive systems. Pathologies onset and/or get worse due to toxicological effects associated with the exposure to this particle type, since it can trigger several reactions, such as inflammatory responses, oxidative stress generation and genotoxicity. These cellular dysfunctions lead to organ malfunctions, as shown in the current review. In addition, the correlation between COVID-19/Sars-CoV-2 and PM2.5 exposure was also assessed to help better understand the role of atmospheric pollution in the pathophysiology of this disease. Despite the significant number of studies about PM2.5's effects on organic functions, available in the literature, there are still gaps in knowledge about how this particulate matter can hinder human health. The current review aimed to approach the main findings about the effect of PM2.5 exposure on different systems, and demonstrate the likely interaction of COVID-19/Sars-CoV-2 and PM2.5.
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Affiliation(s)
- Amanda Garcia
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
| | - Eduarda Santa-Helena
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Anna De Falco
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Joaquim de Paula Ribeiro
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
| | - Adriana Gioda
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Departmento de Química, Rio de Janeiro, Brazil
| | - Carolina Rosa Gioda
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande - FURG, Rio Grande, RS Brazil
- Programa de Pós Graduação Em Ciências Fisiológicas, Universidade Federal do Rio Grande - FURG, Av. Itália Km 8, Campus Carreiros, Rio Grande, RS 96203-900 Brazil
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Sun T, Wang Z, Lei F, Lin L, Zhang X, Song X, Ji YX, Zhang XJ, Zhang P, She ZG, Cai J, Jia P, Li H. Long-term exposure to air pollution and increased risk of atrial fibrillation prevalence in China. Int J Cardiol 2023; 378:130-137. [PMID: 36841290 DOI: 10.1016/j.ijcard.2023.02.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common type of treated heart arrhythmia contributing to adverse cardiovascular events. The association between short-term air pollution exposure and AF episodes has been recognized. But the evidence of the association between long-term air pollution exposure and AF was limited, especially in developing countries. METHODS We performed a nationwide cross-sectional study among 1,374,423 individuals aged ≥35 years from 13 health check-up centers. Using logistic regression models, we assessed the association between long-term exposure to single air pollution and AF prevalence, including particulate matter (PM2.5 and PM10), ozone (O3) and PM2.5 compositions, which were estimated by high-resolution and high-quality spatiotemporal datasets of ground-level air pollutants for China. The quantile g-computation model was used to explore the joint effect of all exposures to air pollution and the contribution of an individual component to the mixture. RESULTS In single-pollutant models, an increase of 10 μg/m3 in PM2.5 (OR 1.031[95%CI 1.010,1.053]) and PM10 (OR = 1.021 [95%CI 1.009,1.033]) was positively associated with AF prevalence. The stratified analyses revealed that these associations were significantly stronger in females, people <65 years old, and those with hypertension and diabetes. In the further exploration of the joint effect of PM2.5 compositions (OR 1.060 [95%CI 1.022,1.101]) per quintile increase in all five PM2.5 components), we found that PM2.5 sulfate contributed the most. CONCLUSIONS These findings provide important evidence for the positive relationship between long-term exposure to air pollution and AF prevalence in China and identify sulfate particles of PM2.5 as having the highest contribution to the overall mixture effects among all PM2.5 chemical constituents.
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Affiliation(s)
- Tao Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Zhanpeng Wang
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Fang Lei
- Institute of Model Animal, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Lijin Lin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xiaohui Song
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Peng Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China; School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China; Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; Hubei Luojia Laboratory, Wuhan, China; School of Public Health, Wuhan University, Wuhan, China.
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China; Huanggang Institute of Translational Medicine, Huanggang, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
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Akhlaq S, Ara SA, Ahmad B, Fazil M, Akram U, Haque M, Khan AA. Interventions of Unani medicine for maintenance of health with special reference to air quality: an evidence-based review. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:85-96. [PMID: 34883008 DOI: 10.1515/reveh-2021-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This article aims to discuss the impact of air quality on human health, measures to achieve the goal of good indoor air quality and proposed benefits of interventions of Unani Medicine with an evidence-based approach. CONTENT The significance of air quality on the health of the community cannot be denied. Recent evidences from WHO illustrated data on severe air pollutants and their impacts on human health ranges from minor upper respiratory irritation to chronic respiratory ailments including lung carcinoma and heart disease associated with premature mortality and reduced life expectancy. In Unani Medicine, air has been included in the list of factors, which are six in number and play the central role in prevention of diseases and maintenance of health. Air is considered as the medium of most of the extrinsic factors such as chemical and biological pollutants affecting health and their exposure results in short and long-term health issues. The literature of Unani Medicine proposes many simple and effective measures, which help to improve indoor and outdoor air quality. The goal of outdoor clean air is achieved through implementation of measures to tackle the source of pollution, while indoor clean air is attained through various means e.g., fumigation with herbal drugs. Hence, an extensive literature survey on Unani reserve was conducted to collect information about the concept of air discussed under the heading of six essential factors and its implication in prevention of diseases and maintenance of health. Further, research databases such as Pub Med, Google Scholar, and Science-Direct were broadly searched for evidence on the efficacy of herbals mentioned in Unani literature for the indoor air purification and subsequent air quality improvement. SUMMARY AND OUTLOOK Recent studies showed good air quality leads to decrease in mortality, particularly of respiratory and cardiovascular deaths whereas poor air quality results in a variety of diseases. Unani scholars prescribed several regimens such as Bukhoor (Fumigation), Sa'oot (Nasal instillation) and use of Abeer (Perfumes) and Nadd (Incense) for the improvement of air quality. Likewise various herbal fumigants and sprays containing drugs like mī'a sā'ila (Liquidambar orientalis Mill.), mastagi (Pistacia lentiscus L.), mushk (Moschus moschiferus L.), loban (Styrax benzoides W. G. Craib), ābnoos (Diospyros ebenum J. Koenig ex Retz), zā'fran (Crocus sativus L.) and sirka (vinegar) etc. has been well explained and used exclusively for air purification and improvement of AQI. Therefore, in the present scenario of altered air quality, we forward certain measures described in Unani system of medicine for health promotion and protection. Scientific evidence on several drugs reveal the presence of a number of pharmacologically active substances, which may provide a new approach into the purification of air.
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Application of smart devices in investigating the effects of air pollution on atrial fibrillation onset. NPJ Digit Med 2023; 6:42. [PMID: 36918625 PMCID: PMC10015044 DOI: 10.1038/s41746-023-00788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
Few studies have examined the link between short-term exposure to air pollutants and atrial fibrillation (AF) episodes. This study aims to examine the association of hourly criteria air pollutants with AF episodes. We employ a smart device-based photoplethysmography technology to screen AF from 2018 to 2021. Hourly concentrations of six criteria air pollutants are matched to the onset hour of AF for each participant. We adopt a time-stratified case-crossover design to capture the acute effects of air pollutants on AF episodes, using conditional logistic regression models. Subgroup analyses are conducted by age, gender, and season. A total of 11,906 episodes of AF are identified in 2976 participants from 288 Chinese cities. Generally, the strongest associations of air pollutants are present at lag 18-24 h, with positive and linear exposure-response relationships. For an interquartile range increase in inhalable particles, fine particles, nitrogen dioxide, and carbon monoxide, the odds ratio (OR) of AF is 1.19 [95% confidential interval (CI): 1.03, 1.37], 1.38 (95%CI: 1.14, 1.67), 1.60 (95%CI: 1.16, 2.20) and 1.48 (95%CI: 1.19, 1.84), respectively. The estimates are robust to the adjustment of co-pollutants, and they are larger in females, older people, and in cold seasons. There are insignificant associations for sulfur dioxide and ozone. This nationwide case-crossover study demonstrates robust evidence of significant associations between hourly exposure to air pollutants and the onset of AF episodes, which underscores the importance of ongoing efforts to further improve air quality as an effective target for AF prevention.
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Li C, Chen M, Li M, Wang H, Qiu X, Hu X, Wang Q, Sun J, Yang M, Zhu Y, Liao P, Zhou B, Chen M, Liu X, Zhao Y, Shen M, Huang J, Luo L, Wu H, Li YG. ECG Utilization Patterns of Patients With Arrhythmias During COVID-19 Epidemic and Post-SARS-CoV-2 Eras in Shanghai, China. Front Cardiovasc Med 2022; 9:829679. [PMID: 35571158 PMCID: PMC9091729 DOI: 10.3389/fcvm.2022.829679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background The COVID-19 pandemic has led to concerns around its subsequent impact on global health. Objective To investigate the health-seeking behavior, reflected by ECG utilization patterns, of patients with non-COVID-19 diseases during and after COVID-19 epidemic. Methods Taking advantage of the remote ECG system covering 278 medical institutions throughout Shanghai, the numbers of medical visits with ECG examinations during the lockdown (between January 23 and April 7, 2020), post-lockdown (between April 8 and December 31, 2020) and post-SARS-CoV-2 (between January 23 and April 7, 2021) periods were analyzed and compared against those during the same periods of the preceding years (2018 and 2019). Results Compared with the same period during pre-COVID years, the number of medical visits decreased during the lockdown (a 38% reduction), followed by a rebound post-lockdown (a 17% increase) and a fall to the baseline level in post-SARS-CoV-2 period. The number of new COVID-19 cases announced on a given day significantly correlated negatively with the numbers of medical visits during the following 7 days. Medical visit dynamics differed for various arrhythmias. Whereas medical visits for sinus bradycardia exhibited a typical decrease-rebound-fallback pattern, medical visits for atrial fibrillation did not fall during the lockdown but did exhibit a subsequent increase during the post-lockdown period. By comparison, the volume for ventricular tachycardia remained constant throughout this entire period. Conclusion The ECG utilization patterns of patients with arrhythmias exhibited a decrease-rebound-fallback pattern following the COVID-19 lockdowns. Medical visits for diseases with more severe symptoms were less influenced by the lockdowns, showing a resilient demand for healthcare.
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Affiliation(s)
- Cheng Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mu Chen
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mohan Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haicheng Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiangjun Qiu
- Shanghai Siwei Medical Co. Ltd., Shanghai, China
| | - Xiaoliang Hu
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qunshan Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Sun
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mei Yang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuling Zhu
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peng Liao
- School of Public Health, Fudan University, Shanghai, China
| | - Baohong Zhou
- Shanghai Siwei Medical Co. Ltd., Shanghai, China
| | - Min Chen
- Shanghai Siwei Medical Co. Ltd., Shanghai, China
| | - Xia Liu
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuelin Zhao
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mingzhen Shen
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinkang Huang
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai, China
| | - Hong Wu
- Shanghai Health Commission, Shanghai, China
| | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Medical Information Telemonitoring Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Yi-Gang Li
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Yang L, Zhang Y, Qi W, Zhao T, Zhang L, Zhou L, Ye L. Adverse effects of PM 2.5 on cardiovascular diseases. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:71-80. [PMID: 33793141 DOI: 10.1515/reveh-2020-0155] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
As an air pollutant, fine particulate matter with a diameter ≤ 2.5 μm (PM2.5) can enter the body through the respiratory tract and cause adverse cardiovascular effects. Here, the effects of PM2.5 on atherosclerosis, hypertension, arrhythmia, myocardial infarction are summarized from the perspective researches of human epidemiology, animal, cell and molecule. The results of this review should be proved useful as a scientific basis for the prevention and treatment of cardiovascular disease caused by PM2.5.
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Affiliation(s)
- Liwei Yang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Yuezhu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Wen Qi
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Tianyang Zhao
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Lele Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Liting Zhou
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Lin Ye
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
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Pallikadavath S, Vali Z, Patel R, Mavilakandy A, Peckham N, Clegg M, Sandilands AJ, Ng GA. The Influence of Environmental Air Pollution on Ventricular Arrhythmias: A Scoping Review. Curr Cardiol Rev 2022; 18:e160422203685. [PMID: 35430968 PMCID: PMC9893149 DOI: 10.2174/1573403x18666220416203716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Exposure to air pollution is a recognised risk factor for cardiovascular disease and has been associated with supraventricular arrhythmias. The effect of air pollution on ventricular arrhythmias is less clear. This scoping review assessed the effects of particulate and gaseous air pollutants on the incidence of ventricular arrhythmias. METHODS MEDLINE and EMBASE databases were searched for studies assessing the effects of air pollutants on ventricular tachycardia and ventricular fibrillation. These pollutants were particulate matter (PM) 2.5, PM10, Nitrogen Dioxide (NO2), Carbon Monoxide (CO), Sulphur Dioxide (SO2), and Ozone (O3). RESULTS This review identified 27 studies: nine in individuals with implantable cardioverter defibrillators, five in those with ischaemic heart disease, and 13 in the general population. Those with ischaemic heart disease appear to have the strongest association with ventricular arrhythmias in both gaseous and particulate pollution, with all three studies assessing the effects of PM2.5 demonstrating some association with ventricular arrythmia. Results in the general and ICD population were less consistent. CONCLUSION Individuals with ischaemic heart disease may be at an increased risk of ventricular arrhythmias following exposure to air pollution.
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Affiliation(s)
- Susil Pallikadavath
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Zakariyya Vali
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Roshan Patel
- Leicester Medical School, College of Life Sciences, University of Leicester, UK
| | - Akash Mavilakandy
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Nicholas Peckham
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Matt Clegg
- Department of Geography, University of Birmingham, Birmingham, UK
| | - Alastair J. Sandilands
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - G. André Ng
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
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Francisco-Pascual J, Cantalapiedra-Romero J, Pérez-Rodon J, Benito B, Santos-Ortega A, Maldonado J, Ferreira-Gonzalez I, Rivas-Gándara N. Cardiac monitoring for patients with palpitations. World J Cardiol 2021; 13:608-627. [PMID: 34909127 PMCID: PMC8641003 DOI: 10.4330/wjc.v13.i11.608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/27/2021] [Accepted: 10/31/2021] [Indexed: 02/06/2023] Open
Abstract
Palpitations are one of the most common reasons for medical consultation. They tend to worry patients and can affect their quality of life. They are often a symptom associated with cardiac rhythm disorders, although there are other etiologies. For diagnosis, it is essential to be able to reliably correlate the symptoms with an electrocardiographic record allowing the identification or ruling out of a possible rhythm disorder. However, reaching a diagnosis is not always simple, given that they tend to be transitory symptoms and the patient is frequently asymptomatic at the time of assessment. In recent years, electrocardiographic monitoring systems have incorporated many technical improvements that solve several of the 24-h Holter monitor limitations. The objective of this review is to provide an update on the different monitoring methods currently available, remarking their indications and limitations, to help healthcare professionals to appropriately select and use them in the work-up of patients with palpitations.
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Affiliation(s)
- Jaume Francisco-Pascual
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Javier Cantalapiedra-Romero
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
| | - Jordi Pérez-Rodon
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Begoña Benito
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Alba Santos-Ortega
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Jenson Maldonado
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
| | - Ignacio Ferreira-Gonzalez
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Nuria Rivas-Gándara
- Unitat d'Arritmies, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid 28029, Spain
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10
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Fang Y, Cheng H, Li X, Xu Y, Xu H, Chen Z, Cai W, Liu C, Cao J. Short-term exposure to ambient air pollution and atrial fibrillation hospitalization: A time-series study in Yancheng, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 228:112961. [PMID: 34773847 DOI: 10.1016/j.ecoenv.2021.112961] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
Atrial fibrillation (AF) is an important cardiovascular disease that causes a great burden of disease. However, there is limited evidence of a link between air pollution exposure and AF. This study aimed to explore the short-term association between air pollution and AF. We obtained daily hospitalization of AF in two major hospitals of Yancheng, China from May, 2015 to May, 2020. Generalized additive models with quasi-Poisson regression were used to assess the associations between six criteria air pollutants and AF hospitalization. We explored the lag patterns, and visualized the concentration-response relationships. The robustness of the association was tested by two-pollutant model, and we explored potential effect modification by age, sex and season. A total of 15,171 inpatients from two hospitals were collected in this study with an average daily count of eight patients. We observed consistent and significant associations between six air pollutants and AF on lag 0-4 days. A 10 ug/m3 increase in PM2.5 was associated with 2.81% (95%CI: 1.44%, 4.20%) changes in AF, and the effect estimate was 1.67% (95%CI: 0.77%, 2.59%) for PM10, 4.90% (95%CI: 1.69%, 8.22%) for NO2, 6.81% (95%CI: 0.46%, 13.57%) for SO2, 1.82% (95%CI: 0.60%, 3.06%) for O3; a 0.1 mg/m3 increase in CO was associated with 2.55% (95%CI: 0.91%, 4.21%) increments in AF. Associations of PM2.5 and PM10 were robust after adjusting for SO2, NO2, CO, and O3, but not vice versa. Female patients and those aged less 70 years had larger risk of AF associated with air pollution exposure. The concentration-response curves of the six pollutants were almost linear and increasing with no obvious thresholds. This time-series study in Yancheng demonstrated increased risk of AF and a delayed effect over lag 0-4 days. Our findings suggested need of prevention and protection against these environmental risk factors for AF in health departments.
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Affiliation(s)
- Yan Fang
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Hongyi Cheng
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xu Li
- Department of Cardiology, the Yancheng School of Clinical Medicine of Nanjing Medical University and Yancheng Third People 's Hospital, Yancheng 224006, China
| | - Yifan Xu
- Department of Radiology, the Fourth Affiliated Hospital of Nantong University, Yancheng 224006, China; Department of Radiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Hang Xu
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Neurology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Zhichao Chen
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Weixin Cai
- Department of Hematology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Hematology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
| | - Jingyan Cao
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China.
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11
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Zhao C, Li Q, Cui Z, Wang J, Sun L, Yin Y. Impact of ambient fine particulate matter on emergency department admissions for circulatory system disease in a city in Northeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:62839-62852. [PMID: 34218380 DOI: 10.1007/s11356-021-15222-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
The cardiovascular impact of fine particles has caused great concern worldwide. However, evidences on the impact of fine particulate matter (PM2.5) on emergency department (ED) admissions for circulatory system disease in Northeast China is limited. We assessed the acute, lag, cumulative, and harvesting effects of PM2.5 on ED admissions for circulatory system diseases and their exposure-response relationship. A total of 26,168 ED admissions, including those for hypertension, ischemic heart disease (IHD), arrhythmia, heart failure (HF), and cerebrovascular events (CVE), were collected from the Shenyang Emergency Center from 1 January 2017 to 31 December 2018. The relationship between PM2.5 and ED admissions for circulatory system disease was estimated using a distributed lag non-linear model and a generalized additive quasi-Poisson model. We stratified the analyses by temperature. Air pollution was positively correlated with daily ED admissions for circulatory system disease or other cause-specific diseases under different lag structures. For every 10-μg/m3 increase in the PM2.5 concentration, the relative risk of daily ED admissions for circulatory system disease was 1.007 [95% confidence interval (CI), 1.001-1.013] in lag0, 1.007 (95%CI, 1.000-1.013) in lag1, and 1.011 (95%CI, 1.002-1.021) in lag03. A lag effect was found in IHD, a cumulative effect was found in CVE, and both lag and cumulative effects were found in hypertension and arrhythmia. A harvesting effect was observed in daily ED admissions for circulatory system disease and HF. We found no interaction between pollutants and temperature. We observed a monotonic and almost linear exposure-response relationship between PM2.5 and circulatory system disease with no threshold effect.PM2.5 contributes to obvious acute, lag, cumulative, and harvesting effects on circulatory system disease. PM2.5 was associated with the risk of daily ED admissions for circulatory system disease, hypertension, IHD, arrhythmia, HF, and CVE. Therefore, air quality management must be strengthened.
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Affiliation(s)
- Chenkai Zhao
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang, 110122, Liaoning, China
| | - Qidian Li
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang, 110122, Liaoning, China
| | - Zhongming Cui
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110000, Liaoning, China
| | - JunLong Wang
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110000, Liaoning, China
| | - Li Sun
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110000, Liaoning, China
| | - Yan Yin
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110000, Liaoning, China.
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12
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Wang F, Ahat X, Liang Q, Ma Y, Sun M, Lin L, Li T, Duan J, Sun Z. The relationship between exposure to PM 2.5 and atrial fibrillation in older adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 784:147106. [PMID: 34088062 DOI: 10.1016/j.scitotenv.2021.147106] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Fine particle matter (PM2.5) is recognized as atrial fibrillation (AF) risk factor, especially for older adults. However, studies on the relationship between PM2.5 and AF were inconsistent. Herein, we present a systematic review to further assess the correlation between PM2.5 and AF in older adults (average age > 50 years old). A comprehensive search was conducted with the keywords in PubMed (675 records), Web of Science (1130 records), Embase (82 records), and the Cochrane Library (42 records). Using Stata12.0 software to test the heterogeneity between studies, and select the corresponding model to calculate the comprehensive effect value, odds ratio (OR, odds ratio), the pooled %-change (percentage change) and its 95% confidence interval (CL, confidence interval). A total of 16 observational studies were included, involving 10,580,394 participants, the results showed that PM2.5 had an adverse effects on AF in older adults. An association was found between exposure to PM2.5 (per 10 μg/m3 increase) and AF in older adults, with the corresponding pooled OR (1.11, 95% CI: 1.03-1.19) and pooled %-change (1.01%, 95% CI: 0.14%-1.88%). Our study indicated that PM2.5 exposure was significantly related to increased incidence of AF in older adults. Both the pooled OR and %-change value were higher in areas with higher levels of PM2.5(≥25 μg/m3).
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Affiliation(s)
- Fenghong Wang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China; Sinopharm North Hospital, Baotou 014040, PR China
| | - Xapkat Ahat
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Qingqing Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Yuexiao Ma
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
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13
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Zhu C, Maharajan K, Liu K, Zhang Y. Role of atmospheric particulate matter exposure in COVID-19 and other health risks in human: A review. ENVIRONMENTAL RESEARCH 2021; 198:111281. [PMID: 33961825 PMCID: PMC8096764 DOI: 10.1016/j.envres.2021.111281] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 05/04/2023]
Abstract
Due to intense industrialization and urbanization, air pollution has become a serious global concern as a hazard to human health. Epidemiological studies found that exposure to atmospheric particulate matter (PM) causes severe health problems in human and significant damage to the physiological systems. In recent days, PM exposure could be related as a carrier for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus transmission and Coronavirus disease 2019 (COVID-19) infection. Hence, it is important to understand the adverse effects of PM in human health. This review aims to provide insights on the detrimental effects of PM in various human health problems including respiratory, circulatory, nervous, and immune system along with their possible toxicity mechanisms. Overall, this review highlights the potential relationship of PM with several life-limiting human diseases and their significance for better management strategies.
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Affiliation(s)
- Chengyue Zhu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Kannan Maharajan
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Kechun Liu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Yun Zhang
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China.
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14
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Olier I, Ortega-Martorell S, Pieroni M, Lip GYH. How machine learning is impacting research in atrial fibrillation: implications for risk prediction and future management. Cardiovasc Res 2021; 117:1700-1717. [PMID: 33982064 PMCID: PMC8477792 DOI: 10.1093/cvr/cvab169] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/11/2021] [Indexed: 02/01/2023] Open
Abstract
There has been an exponential growth of artificial intelligence (AI) and machine learning (ML) publications aimed at advancing our understanding of atrial fibrillation (AF), which has been mainly driven by the confluence of two factors: the advances in deep neural networks (DeepNNs) and the availability of large, open access databases. It is observed that most of the attention has centred on applying ML for dvsetecting AF, particularly using electrocardiograms (ECGs) as the main data modality. Nearly a third of them used DeepNNs to minimize or eliminate the need for transforming the ECGs to extract features prior to ML modelling; however, we did not observe a significant advantage in following this approach. We also found a fraction of studies using other data modalities, and others centred in aims, such as risk prediction, AF management, and others. From the clinical perspective, AI/ML can help expand the utility of AF detection and risk prediction, especially for patients with additional comorbidities. The use of AI/ML for detection and risk prediction into applications and smart mobile health (mHealth) technology would enable ‘real time’ dynamic assessments. AI/ML could also adapt to treatment changes over time, as well as incident risk factors. Incorporation of a dynamic AI/ML model into mHealth technology would facilitate ‘real time’ assessment of stroke risk, facilitating mitigation of modifiable risk factors (e.g. blood pressure control). Overall, this would lead to an improvement in clinical care for patients with AF.
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Affiliation(s)
- Ivan Olier
- School of Computer Science and Mathematics, Liverpool John Moores University, 3 Byrom Street, Liverpool L3 3AF, UK.,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Sandra Ortega-Martorell
- School of Computer Science and Mathematics, Liverpool John Moores University, 3 Byrom Street, Liverpool L3 3AF, UK.,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Mark Pieroni
- School of Computer Science and Mathematics, Liverpool John Moores University, 3 Byrom Street, Liverpool L3 3AF, UK.,Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK.,Liverpool Heart and Chest Hospital, Liverpool, UK
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15
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Yue C, Yang F, Li F, Chen Y. Association between air pollutants and atrial fibrillation in general population: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111508. [PMID: 33142159 DOI: 10.1016/j.ecoenv.2020.111508] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with several risk factors. Recent studies have suggested that the exposure to air pollutants may increase the prevalence of AF, we evaluated those studies systematically to better elucidate the correlation between exposure to air pollution and AF. METHOD We conducted a systematic review of publications using PubMed, Embase, the Cochrane library and Web of Science to explore the association between air pollutants and AF within the general population. The chosen studies were published until 7 July 2020. According to different study designs, we divided the outcomes into "short-term-exposure group" and "long-term-exposure group" for each pollutant. We used I2 statistics and Q-test to examine statistical heterogeneity, and sensitivity analysis to exclude the heterogeneous study. Fixed or random-effect model was used to combine the effects. Final result was presented as the OR and 95% CI of AF prevalence for every 10 μg/m3 increase in the concentration of PM2.5 and PM10;10 ppb increase in the concentration of SO2 ,NO2 ,O3; and 1 ppm increase in the CO concentration. RESULTS Our analysis contain 18 studies. Underlying short-term exposure effect, for each increment of 10 μg/m3 in the PM2.5 concentration, the combined OR of AF prevalence was 1.01(1.00-1.02), for PM10 was 1.03(1.01-1.05). For a 10 ppb increment in the concentration of SO2, NO2, and O3 was 1.05(1.01-1.09), 1.03(1.01-1.04), and 1.01(0.97-1.06), respectively, for a 1 ppm increase of CO concentration was 1.02(0.99-1.06). Underlying long-term-exposure effect for each increment of 10 μg/m3 in the PM2.5 concentration; the combined OR of AF prevalence was 1.07(1.04-1.10) and that for PM10 was 1.03(1.03-1.04) For a 10 ppb increment in the NO2 concentration was 1.02(1.00-1.04). CONCLUSION Our meta-analysis indicated that all air pollutants exposure had an adverse effect on AF prevalence in general population.
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Affiliation(s)
- Chao Yue
- Department of Thoracic Surgery, Beijing Aerospace General Hospital, Wanyuan North Road, Beijing 100076, China
| | - Fan Yang
- Department of Pediatric intensive care unit, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, North Lishi Road, Beijing 100037, China
| | - Fengwei Li
- Department of Thoracic Surgery, Beijing Aerospace General Hospital, Wanyuan North Road, Beijing 100076, China
| | - Yingtai Chen
- Department of Thoracic Surgery, Beijing Aerospace General Hospital, Wanyuan North Road, Beijing 100076, China.
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16
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Yang H, Zhu H, Fu H. Numerical calculation and analysis of filtration performance of an effective novel structural fiber for PM2.5. PLoS One 2020; 15:e0240941. [PMID: 33091026 PMCID: PMC7580886 DOI: 10.1371/journal.pone.0240941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
In this study, a novel fiber with slit-crescent-shaped cross-section is proposed to enhance the filtration performance of PM2.5 in fibrous filtration. The collection efficiency of this fiber is simulated by using a Brownian dynamics simulation technique, and its filtration pressure drop is obtained by numerically solving Navier-Stokes equation with Fluent software. A parametric study is performed to improve the optimum filtration performance of the slit-crescent-shaped fiber via adjusting its structural parameters (dimensionless center-to-center spacing and slit width). Results indicate that at the optimal condition, i.e., when dimensionless slit width ranges from 0.2 to 0.4, collection efficiency is enhanced by 13.1%–101.1% relative to the circular fiber for particles ranging from 0.1μm to 2.5μm for the slit-crescent-shaped fiber under various dimensionless center-to-center spacing, and filtration pressure drop is reduced by up to 14.4%. In addition, quality factor is introduced to evaluate the comprehensive filtration performance of the slit-crescent-shaped fiber with different structural parameters, and results show that large dimensionless slit width and small dimensionless center-to-center spacing lead to a much higher quality factor than the circular fiber, especially for particles lager than 0.5μm. The numerical results obtained in this work are conducive to designing high efficiency fibrous filters.
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Affiliation(s)
- Hui Yang
- College of Environmental Science and Engineering, Donghua University, Shanghai, China
- College of Energy and Building Environment, Guilin University of Aerospace Technology, Guilin, China
| | - Hui Zhu
- College of Energy and Building Environment, Guilin University of Aerospace Technology, Guilin, China
| | - Haiming Fu
- College of Environmental Science and Engineering, Donghua University, Shanghai, China
- * E-mail:
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