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

by Umans, Jason G; Howard, Barbara V.
Citation: Environmental Pollution. 240:894-902, 2018 May 21..Journal: Environmental pollution (Barking, Essex : 1987).Published: 2018ISSN: 0269-7491.Full author list: Moon KA; Zhang Y; Guallar E; Francesconi KA; Goessler W; Umans JG; Best LG; Howard BV; Devereux RB; Okin PM; Navas-Acien A.UI/PMID: 29793197.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.envpol.2018.04.129 (Click here) Abbreviated citation: Environ Pollut. 240:894-902, 2018 May 21.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 (SIGMAAs) and arsenic metabolism was measured as the relative percentage of arsenic species. Median SIGMAAs and Bazett heart rate-corrected QT interval (QTc) were 8.6mug/g creatinine and 424ms in the main cohort and 4.3mug/g and 414ms in the family study, respectively. In the main cohort, a comparison of the highest to lowest SIGMAAs quartile (>14.4 vs. <5.2mug/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. <2.9mug/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.Abstract: Copyright (c) 2018 Elsevier Ltd. All rights reserved.

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