Effects of air pollution in pulmonary pressures in patients with a CardioMEMS sensor
C Ferrero Molina, P Codina Verdaguer, E Rodenas-Alesina, G Urio-Garmendia, M Ruiz Cueto, M Domingo Teixidor, E Santiago Vacas, A Borrellas Martin, C Badia Molins, A Bayes- GenisAbstract
Introduction
Air pollution is associated with heart failure (HF) morbidity and mortality, but its immediate hemodynamic effects remain poorly characterized. Continuous pulmonary artery pressure (PAP) monitoring using CardioMEMS™ HF System offers a unique opportunity to evaluate short-term physiological responses to environmental exposures in ambulatory HF patients.
Purpose
To assess the association between short-term ambient air pollution exposure and daily changes in diastolic pulmonary artery pressure (dPAP) in patients with chronic HF monitored using a CardioMEMS sensor.
Methods
We conducted a single-center, observational longitudinal study including ambulatory HF patients implanted with a CardioMEMS PAP sensor and followed between March 2024 and February 2025. Daily outpatient dPAP measurements were linked to daily mean concentrations of nitrogen dioxide (NO₂), ozone (O₃), and PM₁₀ obtained from a local urban background monitoring station. Associations between pollutants and dPAP were evaluated using linear mixed-effects models with patient-specific random intercepts, adjusting for temperature, seasonality, and prior-day dPAP to account for temporal autocorrelation.
Results
Twenty-four patients (median age 76 years; 57% female) contributed 6565 daily dPAP measurements. At the population level, none of the evaluated pollutants showed a significant association with dPAP. Estimated effects per unit increase were –0.006 mmHg for NO₂ (95% CI –0.013 to 0.001; p=0.084), 0.002 mmHg for O₃ (95% CI –0.003 to 0.006; p=0.428), and –0.089 mmHg per log-unit increase in PM₁₀ (95% CI –0.264 to 0.086; p=0.318). Substantial interindividual variability in pollutant–pressure relationships was observed.
Conclusions
In ambulatory patients with chronic HF monitored with CardioMEMS, short-term exposure to low-to-moderate levels of ambient air pollution was not associated with consistent or clinically relevant changes in dPAP. These findings suggest that the adverse cardiovascular effects of air pollution in HF may not be mediated by acute increases in pulmonary filling pressures.For image description, please refer to the figure legend and surrounding text.