Risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry

Abstract

Introduction. In the coal industry, 78.7% of employees work in places with harmful working conditions, which play a leading role in the development of not only professional, but also industrial diseases, the leading of which are diseases of the cardiovascular system. The identification of preclinical systolic dysfunction of the left ventricle and the assessment of the role of traditional and professionally determined risk factors for the development of systolic dysfunction of the left ventricle in workers of the main professions of the coal industry is of scientific interest. The study aims to assess the risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry. Materials and methods. The study included 101 employees of the main professions of the coal industry and 80 employees of the paramilitary mine rescue unit. The subjects had no somatic pathology, which could lead to structural and functional changes of the heart. The scientists performed echocardiographic and ultrasound examinations of the main arteries according to standard methods and assessed the generally accepted risk factors for the development of cardiovascular pathology (smoking, abdominal obesity, body mass index, total cholesterol, triglycerides, high and low density lipoprotein cholesterol, glycated hemoglobin). Results. The researchers revealed systolic dysfunction of the left ventricle significantly in miners more often in the form of a decrease in longitudinal deformation (27.7% of miners versus 7.6% of paramilitary rescuers, p=0.0005), while its average value is also significantly lower in miners and has a value below the established norm (–17.2±0.044 and –19.3±0.03, p=0.0005). The authors found no significant differences in the frequency of commonly accepted risk factors: abdominal obesity, smoking, atherosclerosis of the main arteries, dyslipidemia and the level of glycated hemoglobin in miners and workers of the mine rescue unit, as well as in miners, depending on the index of longitudinal deformation of the left ventricle. Conclusion. The obtained results indicate the need for a prenosological diagnosis of systolic dysfunction of the left ventricle, studying it in dynamics and simultaneously expanding the search for risk factors, which will allow early prevention of this complication in workers in harmful working conditions. Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Association "Ethical Principles of Scientific Medical Research with Human Participation" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order of the Ministry of Health of the Russian Federation dated 01.04.2016 No. 200n. The subjects signed an informed consent to participate in the study.