title: Right heart pressure increases after acute increases in ambient particulate concentration.
abstract: OBJECTIVE
  We explored the association between acute changes in daily mean pulmonary artery (PA) and right ventricular (RV) pressures and concentrations of ambient fine particulate matter [PM with aerodynamic diameter < or = 2.5 microm (PM(2.5))] as an explanation for previous associations between congestive heart failure (HF) hospital admissions and PM.
  
  
  METHODS
  In the Chronicle Offers Management to Patients with Advanced Signs and Symptoms of Heart Failure (COMPASS-HF) trial, to see whether management of ambulatory HF could be improved by providing continuous right heart pressure monitoring to physicians, the Chronicle Implantable Hemodynamic Monitor (Medtronic, Inc., Minneapolis, MN, USA) continuously measured multiple right heart hemodynamic parameters, heart rate, and activity trends in subjects with moderate/severe HF. Using these trial data, we calculated daily mean pressures, using only those time intervals where the subject was not physically active (n = 5,807 person-days; n = 11 subjects). We then studied the association between mean daily PA/RV pressures and mean ambient PM(2.5) concentrations on the same day and previous 6 days.
  
  
  RESULTS
  Each 11.62-microg/m(3) increase in same-day mean PM(2.5) concentration was associated with small but significant increases in estimated PA diastolic pressure [0.19 mmHg; 95% confidence interval (CI), 0.05-0.33] and RV diastolic pressure (0.23 mmHg; 95% CI, 0.11-0.34). Although we saw considerable differences in the magnitude of response by COMPASS-HF randomization group (total data access for physicians vs. blocked clinician access), season, left ventricular ejection fraction, and obesity, these effects were not significantly different.
  
  
  CONCLUSIONS
  These pilot study findings provide a potential mechanism for previous findings of increased risk of HF associated with ambient PM. However, because of the small number of subjects, a larger study is needed for confirmation.
authors.affiliation: School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey 08854, USA. richda@umdnj.edu
authors.forename: David Q
authors.initials: DQ
authors.lastname: Rich
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Freudenberger
authors.forename: Pamela
authors.initials: P
authors.lastname: Ohman-Strickland
authors.forename: Yong
authors.initials: Y
authors.lastname: Cho
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kipen
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000494:pharmacology*; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016276:Ventricular Function / Q000187:drug effects*
chemical_list: D000393:Air Pollutants
references.citation: J Card Fail. 1995 Mar;1(2):161-8
references.pmid: 9420646
references.citation: Environ Health Perspect. 1999 Jul;107(7):521-5
references.pmid: 10378998
references.citation: N Engl J Med. 2007 Sep 13;357(11):1075-82
references.pmid: 17855668
references.citation: Circulation. 2002 Apr 2;105(13):1534-6
references.pmid: 11927516
references.citation: Epidemiology. 2005 Jan;16(1):41-8
references.pmid: 15613944
references.citation: Environ Health Perspect. 2006 Jan;114(1):120-3
references.pmid: 16393668
references.citation: Res Rep Health Eff Inst. 2005 Jun;(124):1-66; discussion 67-82, 141-8
references.pmid: 17153517
references.citation: J Am Coll Cardiol. 2008 Mar 18;51(11):1073-9
references.pmid: 18342224
references.citation: Am J Epidemiol. 2006 Sep 1;164(5):421-33
references.pmid: 16793862
references.citation: Circulation. 2002 Mar 26;105(12):1503-8
references.pmid: 11914262
references.citation: Am J Epidemiol. 2005 Jun 1;161(11):1030-6
references.pmid: 15901623
references.citation: Environ Health Perspect. 2007 Jul;115(7):1002-6
references.pmid: 17637913
references.citation: Epidemiology. 2001 Mar;12(2):193-9
references.pmid: 11246580
references.citation: Arch Environ Health. 1999 Mar-Apr;54(2):130-9
references.pmid: 10094292
references.citation: Am J Epidemiol. 1995 Jul 1;142(1):23-35
references.pmid: 7785670
references.citation: Environ Health Perspect. 2005 Aug;113(8):1032-8
references.pmid: 16079075
references.citation: Circulation. 2005 Dec 20;112(25):3930-6
references.pmid: 16365212
references.citation: Am J Respir Crit Care Med. 2007 Aug 15;176(4):395-400
references.pmid: 17446340
references.citation: Environ Health Perspect. 1998 Oct;106(10):649-53
references.pmid: 9755140
references.citation: Am J Cardiol. 2006 Feb 1;97(3):404-8
references.pmid: 16442405
references.citation: Am J Cardiol. 2006 Aug 1;98(3):423-4
references.pmid: 16860038
references.citation: J Card Fail. 2002 Apr;8(2):63-70
references.pmid: 12016628
references.citation: Environ Health Perspect. 2002 Sep;110(9):875-80
references.pmid: 12204821
references.citation: Am J Epidemiol. 2005 Jun 15;161(12):1123-32
references.pmid: 15937021
references.citation: Circulation. 2002 Aug 20;106(8):933-8
references.pmid: 12186796
references.citation: Environ Health Perspect. 2005 Aug;113(8):978-82
references.pmid: 16079066
references.citation: Am J Respir Crit Care Med. 2004 Apr 15;169(8):934-40
references.pmid: 14962820
references.citation: Stroke. 2005 Dec;36(12):2549-53
references.pmid: 16254223
references.citation: Int J Epidemiol. 2006 Oct;35(5):1347-54
references.pmid: 16844771
references.citation: Circulation. 2003 Mar 4;107(8):1202-8
references.pmid: 12615802
references.citation: Inhal Toxicol. 2004 Jun;16(6-7):363-72
references.pmid: 15204752
references.citation: Occup Environ Med. 2007 Jun;64(6):373-9
references.pmid: 17182639
references.citation: Circulation. 2001 Aug 28;104(9):986-91
references.pmid: 11524390
references.citation: Environ Health Perspect. 2002 Dec;110(12):1191-7
references.pmid: 12460797
references.citation: Epidemiology. 2003 Sep;14(5):528-35
references.pmid: 14501267
references.citation: Environ Health Perspect. 2003 Apr;111(4):402-8
references.pmid: 12676590
references.citation: Eur Respir J. 2001 Apr;17(4):604-8
references.pmid: 11401052
references.citation: Epidemiology. 2000 Jan;11(1):11-7
references.pmid: 10615837
references.citation: Am J Respir Crit Care Med. 2002 Oct 1;166(7):998-1004
references.pmid: 12359661
references.citation: Inhal Toxicol. 2004 Jun;16(6-7):353-62
references.pmid: 15204751
references.citation: Occup Environ Med. 1999 Oct;56(10):679-83
references.pmid: 10658547
references.citation: Circulation. 2001 Jun 12;103(23):2810-5
references.pmid: 11401937
references.citation: Circulation. 2000 Mar 21;101(11):1267-73
references.pmid: 10725286
references.citation: Am J Public Health. 1995 Oct;85(10):1361-5
references.pmid: 7573618
references.citation: Occup Environ Med. 2006 Sep;63(9):591-6
references.pmid: 16698809
references.citation: Am J Respir Crit Care Med. 2006 Feb 15;173(4):432-41
references.pmid: 16293802