Association of low-moderate urine arsenic and QT interval: Cross-sectional and longitudinal evidence from the Strong Heart Study. (September 2018)

• Record Type: Journal Article
• Authors: Moon, Katherine A.; Zhang, Yiyi; Guallar, Eliseo; Francesconi, Kevin A.; Goessler, Walter; Umans, Jason G.; Best, Lyle G.; Howard, Barbara V.; Devereux, Richard B.; Okin, Peter M.; Navas-Acien, Ana
• Is Part Of: Environmental pollution. Volume 240(2018)
• Page Start: 894
• Page End: 902
• Publication Date: 2018-09
• Subjects: Arsenic -- QT interval -- Electrocardiology -- Ventricular repolarization -- Cardiovascular disease -- Longitudinal cohort; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2018.04.129
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: Epidemiologic studies suggest that chronic exposure to arsenic is related to cardiovascular disease (CVD), but the pathophysiological link remains uncertain. We evaluated the association of chronic low-moderate arsenic exposure and arsenic metabolism with baseline difference and annual change in ECG measures (QT interval, JT interval, PR interval, QRS duration, and QT dispersion) using linear mixed models in the Strong Heart Study main cohort (N = 1174, median age 55 years) and family study (N = 1695 diabetes-free, median age 36 years). At baseline, arsenic exposure was measured as the sum of inorganic and methylated species in urine (ΣAs) and arsenic metabolism was measured as the relative percentage of arsenic species. Median ΣAs and Bazett heart rate-corrected QT interval (QTc) were 8.6 μg/g creatinine and 424 ms in the main cohort and 4.3 μg/g and 414 ms in the family study, respectively. In the main cohort, a comparison of the highest to lowest ΣAs quartile (>14.4 vs. <5.2 μg/g creatinine) was associated with a 5.3 (95% CI: 1.2, 9.5) ms higher mean baseline QTc interval but no difference in annual change in QTc interval. In the family study, a comparison of the highest to lowest quartile (>7.1 vs. <2.9 μg/g creatinine) was associated with a 3.2 (95% CI: 0.6, 5.7) ms higher baseline QTc interval and a 0.6 (95% CI: 0.04, 1.2) ms larger annual increase in QTc interval. Associations with JTc interval were similar but stronger in magnitude compared to QTc interval. Arsenic exposure was largely not associated with PR interval, QRS duration or QT dispersion. Similar to arsenic exposure, a pattern of lower %MMA and higher %DMA was associated with longer baseline QTc interval in both cohorts and with a larger annual change in QTc interval in the family study. Chronic low-moderate arsenic exposure and arsenic metabolism were associated with prolonged ventricular repolarization. Graphical abstract: Image 1 Highlights: Chronic low-moderate arsenic exposure was measured at baseline in urine. Arsenic was associated with longer baseline QT interval. Arsenic was associated with higher annual change in QT interval in the family study. Arsenic metabolism was also associated with QT interval. Chronic low-moderate arsenic exposure may increase ventricular repolarization. Abstract : Chronic low-moderate arsenic exposure and arsenic metabolism were associated with prolonged ventricular repolarization.