Myocardial deformation and parameters of diastolic function of the left ventricle in workers of coal mining enterprises in the South of Kuzbass with arterial hypertension

Abstract

Introduction. Long-term persistent hypertension can lead to heart failure. The study of its early markers, which include diastolic dysfunction of the left ventricle and reduction of longitudinal myocardial deformation, is of importance for workers engaged in harmful and dangerous working conditions.The aim of the study is to evaluate the parameters of myocardial deformation and diastolic function of the left ventricle, as well as their interrelation with arterial hypertension in workers of the coal mining industry in the South of Kuzbass.Materials and methods. 384 people were examined (men), including 266 workers of coal mines in the South of Kuzbass (drifters, stope miners, operators of rock removing machines) and 118 persons who were not employed in the coal industry, aged from 40 to 55 years. Arterial hypertension was detected according to the clinical recommendations for the diagnosis and treatment of arterial hypertension in 2019. The structural and functional state of the heart was studied by echocardiography with evaluation of the longitudinal deformation of the left ventricle by 2D-strain method and its diastolic function using pulse-wave and tissue dopplerography.Results. The prevalence of persons with arterial hypertension in the group of workers employed in the coal industry was established: 43.2% against 26.3% in the comparison group (p=0.002). Longitudinal deformation of the left ventricular myocardium in all subjects was significantly less in the presence of high blood pressure: -21.0±0.18 vs. -19.2±0.22% (p<0.001) in the main group and -21.54±0.22 vs. -19.84±0.38% (p<0.001) in the comparison group. It should also be noted that there is a tendency to differ in subgroups of subjects without arterial hypertension towards a greater reduction in longitudinal myocardial deformation in coal miners (-21.54±0.22 and -21.0±0.18%, p=0.062). In miners, diastolic left ventricular dysfunction was significantly more common than in the group without occupational hazards: 52.5 and 39.3%, respectively, p=0.021. Its presence in the cohort of coal miners with arterial hypertension was detected significantly more often (58.9%) than in individuals with normal blood pressure (25.9%), p<0.0001. In turn, in the group of people not employed in the coal industry, diastolic dysfunction of the left ventricle was also more common in the presence of arterial hypertension: in 42.6 and 13.9% of cases, respectively (p<0.001).Conclusions. The incidence of arterial hypertension among coal miners was significantly higher than in people who do not work at coal mining enterprises. In all patients with arterial hypertension, the longitudinal deformation of the left ventricular myocardium with the preserved ejection fraction was lower than in those with normal blood pressure. Diastolic myocardial dysfunction of the left ventricle was significantly more common among those examined with underground working conditions, especially in the group of people with arterial hypertension.The authors declare no conflict of interests.