Key result
Higher ambient PM2.5 exposure is linked to a ~1% faster annual decline in LVEF.
Why the study?
The effects of air pollutants on cardiac structure and function preceding clinical heart failure diagnosis are not well understood.
Does ambient air pollution exposure (PM2.5 and NO2) worsen longitudinal changes in cardiac structure and function in Hispanic/Latino adults?
Cohort (n=1,498)
Yes
Does ambient air pollution exposure (PM2.5 and NO2) worsen longitudinal changes in cardiac structure and function in Hispanic/Latino adults?
Mean Difference: -1.05 (95% CI -1.73–-0.37)
Long-term exposure to ambient air pollutants like PM2.5 and NO2 is associated with adverse longitudinal preclinical changes in cardiac structure and function, highlighting air pollution as a potential modifiable risk factor for heart failure.
Should not yet change practice; leaves open whether PM2.5 reduction slows LVEF decline in exposed adults.
BACKGROUND: The effects of air pollutants on cardiac structure and function preceding the clinical diagnosis of heart failure are not well understood. OBJECTIVES: The objective of the study was to determine if ambient pollutant concentrations are associated with longitudinal changes in cardiac structure and function. METHODS: Measures of cardiac structure and function were serially assessed by echocardiogram at visits 1 (2008-2011) and 2 (2015-2018), respectively, with a median follow-up of 4.3 years (IQR: 4.0-4.4 years). Outdoor air pollution concentrations at residence were estimated from spatio-temporal models, as mean concentrations the year prior to each visit. We determined longitudinal relationships between air pollution and each echocardiographic measure, adjusted for baseline and time-varying covariates. RESULTS: was associated with a decrease in left ventricular ejection fraction of -1.05% per year (95% CI: -1.73 to -0.37) and increase in relative wall thickness by 0.12 (95% CI: 0.05-0.19) unit. CONCLUSIONS: Our findings suggest that common air pollutant exposures are associated with longitudinal preclinical adverse changes in cardiac structure and function.
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Leiser et al. (2026) conducted a cohort in Pre-heart failure (n=1,498). Ambient air pollution (PM2.5 and NO2) vs. Lower exposure levels (per IQR increase) was evaluated on Annual change in left ventricular ejection fraction (LVEF) (MD -1.05% per year, 95% CI -1.73 to -0.37). A 4 μg/m3 increase in ambient PM2.5 exposure was associated with a longitudinal decrease in left ventricular ejection fraction of -1.05% per year and an increase in relative wall thickness.
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