{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:43:31Z","timestamp":1771551811045,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"16","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2015,5,11]]},"published-print":{"date-parts":[[2015,8,15]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Fine particulate matter (PM<jats:sub>2.5<\/jats:sub>) air pollution and variations in ambient temperature have been linked to increased cardiovascular morbidity and mortality. However, no large-scale study has assessed their effects on directly measured aerobic functional capacity among high-risk patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using a cross-sectional observational design, we evaluated the effects of ambient PM<jats:sub>2.5<\/jats:sub> and temperature levels over 7\u2005days on cardiopulmonary exercise test results performed among 2078 patients enrolling into a cardiac rehabilitation programme at the University of Michigan (from January 2003 to August 2011) using multiple linear regression analyses (controlling for age, sex, body mass index).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Peak exercise oxygen consumption was significantly decreased by approximately 14.9% per 10 \u03bcg\/m<jats:sup>3<\/jats:sup> increase in ambient PM<jats:sub>2.5<\/jats:sub> levels (median 10.7 \u03bcg\/m<jats:sup>3<\/jats:sup>, IQR 10.1 \u03bcg\/m<jats:sup>3<\/jats:sup>) (lag days 6\u20137). Elevations in PM<jats:sub>2.5<\/jats:sub> were also related to decreases in ventilatory threshold (lag days 5\u20137) and peak heart rate (lag days 2\u20133) and increases in peak systolic blood pressure (lag days 4\u20135). A 10\u00b0C increase in temperature (median 10.5\u00b0C, IQR 17.5\u00b0C) was associated with reductions in peak exercise oxygen consumption (20.6\u201327.3%) and ventilatory threshold (22.9\u201329.2%) during all 7 lag days. In models including both factors, the outcome associations with PM<jats:sub>2.5<\/jats:sub> were attenuated whereas the effects of temperature remained significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Short-term elevations in ambient PM<jats:sub>2.5<\/jats:sub>, even at low concentrations within current air quality standards, and\/or higher temperatures were associated with detrimental changes in aerobic exercise capacity, which can be linked to a worse quality of life and cardiovascular prognosis among cardiac rehabilitation patients.<\/jats:p>\n               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