Abstract 9899: Effects of Ambient Air Pollutants on Progression of Cardiac Structure and Function in the Echocardiographic Study of Latinos (Echo-SOL)

Abstract

Background: Air pollutants may affect cardiac function; effects preceding clinical diagnosis of heart failure are not understood. We assessed longitudinal associations between fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ) and cardiac structure and function among 1,660 participants in the Echocardiographic Study of Latinos, in the Hispanic Community Health Study/Study of Latinos. Hypothesis: Air pollution is associated with longitudinal changes in subclinical structure/function. Methods: Left ventricular (LV) mass index, relative wall thickness, average global longitudinal strain (GLS), LV ejection fraction, e’, left atrial (LA) volume index, E/e’ ratio, and diastolic function grades were assessed by echocardiogram. Air pollution concentrations were estimated from validated spatio-temporal models at home locations, as mean concentrations of PM 2.5 and NO 2 for the year prior to clinical visit 1 (V1, 2008-2011) and 2 (V2, 2015-2018). A mixed effects model was used to jointly model cross-sectional and longitudinal relationships between time-varying air pollution and continuous measures of CF, adjusted for baseline physical activity, gender, education, age, BMI, SBP, DBP, statin use, diabetes, and hypertension status and time-varying smoking and alcohol use, with random intercepts for clinical center and primary sampling unit. Results: Participants’ mean age was 56.4 years at V1; mean follow-up was 6.52 years. Mean PM 2.5 was 10.3 μg/m 3 at V1 and 8.8 μg/m 3 at V2. Mean NO 2 was 17.4 ppb at V1 and 14.3 at V2. Per interquartile range of pollutant, higher PM 2.5 and NO 2 were associated with a 0.52% (95% CI -0.16, 1.11) and 0.98% (95% CI 0.13, 1.23) increase in GLS, respectively. NO 2 was associated with -1.07% (95% CI -2.24, 0.10) decrease in LV ejection fraction. PM 2.5 was associated with a 0.75 (95% CI 0.39, 1.12) increase in e’ and a 1.25 (95% -1.95, -0.56) decrease in E/e’ ratio. No other associations with air pollution and echo measures were found. Conclusion: These findings suggest that air pollution is associated with longitudinal changes in GLS, LV ejection fraction, e’, and E/e’ ratio in a US Hispanic/Latino cohort, an important understudied population. Air pollution may represent a modifiable risk factor in the development of clinical heart failure.