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Geometric indexes of heart rate variability in healthy individuals exposed to long-term air pollution


The aim of this study was to investigate the autonomic modulation of heart rate in healthy individuals exposed to long-term air pollution through geometric methods. We analyzed data from 109 healthy adults aged 18 to 49, divided into three groups according to the exposure time: period 0 to 15 years of exposure (n = 29), more than 15 years of exposure (n = 31), and control group (n = 49). For the analysis of heart rate variability (HRV), heart rate was recorded beat-to-beat for 20 min in the sitting position. The RR intervals were transformed into geometric indexes, and from them, we calculated the RRTri (triangular index), TINN (triangle interpolation of histogram of intervals NN), and Poincaré plot (SD1, SD2, and SD1/SD2). Significantly lower values were observed in the group of individuals exposed to air pollution for more than 15 years compared with the group of individuals exposed to air pollution for a period of 0–15 years and those not exposed for the RRTri (11.5 vs 13.8 vs 14.0), SD1 (16.4 vs 20.5 vs 20.6), SD2 (60.5 vs 68.1 vs 72.5), and SD1/SD2 (0.27 vs 0.34 vs 0.31), with the effect of this difference being considered large (RRTri), medium (SD1, SD1/SD2), and small (SD2). TINN was not significantly different among groups (198.2 vs 223.1 vs 233.6). Healthy individuals exposed to air pollution for more than 15 years present an autonomic imbalance, characterized by lower parasympathetic modulation and overall HRV.

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The authors thank Professor Dr. Luiz Carlos Vanderlei for assisting on HRV analysis; PhD Cand. Fernando Rocha Oliveira for assisting on statistical analysis; MS Luis Henrique Base, MS Laura Cristina Pereira Maia, and PhD Cand. Jennifer Yohanna Ferreira de Lima Antão for helping on data collection; and the Laboratório de Escrita Cientifica of Faculdade de Medicina do ABC for supplying Polar RS800Cx wristwatch.

Author information

Correspondence to Juliana Regis da Costa e Oliveira.

Ethics declarations

The project was submitted and approved by the Research Ethics Committee of the Universidade Federal de São Paulo — Escola Paulista de Medicina (protocol number 1.113.059) and followed the resolution 466/12 of the National Health Council 12/12/2012 (Brazil) and the Principles of the Declaration of Helsinki.

Competing interests

The authors declare that they have no competing interests.

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Study association

This article is part of the thesis of doctorate submitted by Juliana Régis da Costa e Oliveira, from Escola Paulista de Medicina/Universidade Federal de São Paulo.

Responsible editor: Philippe Garrigues

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Regis da Costa e Oliveira, J., Base, L.H., Maia, L.C.P. et al. Geometric indexes of heart rate variability in healthy individuals exposed to long-term air pollution. Environ Sci Pollut Res 27, 4170–4177 (2020).

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  • Environmental pollution
  • Air pollution
  • Cardiovascular system
  • Autonomic nervous system