Association between Ambient Air Pollution and Cardiac Morpho-Functional Phenotypes: Insights from the UK Biobank Population Imaging Study

Nay Aung, Mihir M. Sanghvi, Filip Zemrak, Aaron M. Lee, Jackie A. Cooper, Jose M. Paiva, Ross J. Thomson, Kenneth Fung, Mohammed Y. Khanji, Elena Lukaschuk, Valentina Carapella, Young Jin Kim, Patricia B. Munroe, Stefan K. Piechnik, Stefan Neubauer, Steffen E. Petersen

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53 Citations (Scopus)


Background: Exposure to ambient air pollution is strongly associated with increased cardiovascular morbidity and mortality. Little is known about the influence of air pollutants on cardiac structure and function. We aim to investigate the relationship between chronic past exposure to traffic-related pollutants and the cardiac chamber volume, ejection fraction, and left ventricular remodeling patterns after accounting for potential confounders. Methods: Exposure to ambient air pollutants including particulate matter and nitrogen dioxide was estimated from the Land Use Regression models for the years between 2005 and 2010. Cardiac parameters were measured from cardiovascular magnetic resonance imaging studies of 3920 individuals free from pre-existing cardiovascular disease in the UK Biobank population study. The median (interquartile range) duration between the year of exposure estimate and the imaging visit was 5.2 (0.6) years. We fitted multivariable linear regression models to investigate the relationship between cardiac parameters and traffic-related pollutants after adjusting for various confounders. Results: The studied cohort was 62±7 years old, and 46% were men. In fully adjusted models, particulate matter with an aerodynamic diameter <2.5 µm concentration was significantly associated with larger left ventricular end-diastolic volume and end-systolic volume (effect size = 0.82%, 95% CI, 0.09-1.55%, P=0.027; and effect size = 1.28%, 95% CI, 0.15-2.43%, P=0.027, respectively, per interquartile range increment in particulate matter with an aerodynamic diameter <2.5 µm) and right ventricular end-diastolic volume (effect size = 0.85%, 95% CI, 0.12-1.58%, P=0.023, per interquartile range increment in particulate matter with an aerodynamic diameter <2.5 µm). Likewise, higher nitrogen dioxide concentration was associated with larger biventricular volume. Distance from the major roads was the only metric associated with lower left ventricular mass (effect size =-0.74%, 95% CI,-1.3% to-0.18%, P=0.01, per interquartile range increment). Neither left and right atrial phenotypes nor left ventricular geometric remodeling patterns were influenced by the ambient pollutants. Conclusions: In a large asymptomatic population with no prevalent cardiovascular disease, higher past exposure to particulate matter with an aerodynamic diameter <2.5 µm and nitrogen dioxide was associated with cardiac ventricular dilatation, a marker of adverse remodeling that often precedes heart failure development.

Original languageEnglish
Pages (from-to)2175-2186
Number of pages12
Issue number20
Publication statusPublished - 2018 Nov 13

Bibliographical note

Funding Information:
Drs Peterson, Neubauer, and Piechnik acknowledge the British Heart Foundation for funding the manual analysis to create a cardiovascular magnetic resonance imaging reference standard for the UK Biobank imaging resource in 5000 CMR scans (PG/14/89/31194). Dr Aung is supported by a Wellcome Trust Research Training Fellowship (203553/Z/16/Z). Drs Lee and Petersen acknowledge support from the National Institute for Health Research Barts Biomedical Research Center and from the “SmartHeart” Engineering and Physical Sciences Research Council program grant (EP/P001009/1). Drs Neubauer and Petersen are supported by the Oxford National Institute for Health Research Biomedical Research Center and the Oxford British Heart Foundation Center of Research Excellence. This project was enabled through access to the Medical Research Council eMedLab Medical Bioinformatics infrastructure, supported by the Medical Research Council (grant No. MR/L016311/1). Dr Fung is supported by The Medical College of Saint Bartholomew’s Hospital Trust, an independent registered charity that promotes and advances medical and dental education and research at Barts and The London School of Medicine and Dentistry. The UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government, and the Northwest Regional Development Agency. It has also received funding from the Welsh Assembly Government and the British Heart Foundation.

Publisher Copyright:
© 2018 Lippincott Williams and Wilkins. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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