Structural and functional changes of the left ventricle in the aluminum industry workers

Abstract

Introduction. Identification of early signs of left ventricular dysfunction even before the development of their clinical manifestations will allow to identify patients at risk of heart failure for its timely prevention. The study aims to evaluate the structural and functional changes of the left ventricle in workers of the main professions of the aluminum industry. Material and methods. The study included 87 employees of the main professions of aluminum production - the main group and 69 employees of the Ministry of Emergency Situations - the comparison group. The average age of the main group was 48.49±0.51 years, the comparison group was 47.15±0.57 years (p=0.082). All of them underwent echocardiography according to modern recommendations for the quantitative assessment of the structure and function of the chambers of the heart. Results. In the main group, we have detected concentric remodeling of the left ventricle in 40% of people with arterial hypertension and in 10.3% with normal blood pressure (p=0.0019), diastolic dysfunction with impaired relaxation of the left ventricle in 73.3% and 43.6%, respectively (p=0.0056). Early echocardiographic indicators of left ventricular systolic dysfunction - GLS, S - had not only significant differences in the main group depending on the presence of hypertension but were also significantly lower in the main group in subjects with normal blood pressure than in the comparison group. In the main group, the researchers have identified a decrease in the longitudinal deformation of the left ventricle in 58.5% of people with arterial hypertension and in 28.2% with normal blood pressure (p=0.0063). In the studied groups without arterial hypertension, we have found a decrease in longitudinal deformation significantly more often in aluminum industry workers (p=0.001). Limitations. This study is limited to a sample of employees of the main professions of the aluminum industry undergoing periodic medical examination at the Research Institute of Complex Hygiene Problems and Occupational Diseases. Conclusion. Arterial hypertension in workers of the main professions of the aluminum industry leads to concentric remodeling, reduction of longitudinal deformation and development of diastolic dysfunction of the left ventricle. In aluminum production workers without arterial hypertension, the researchers have identified a violation of the systolic function of the left ventricle in the form of a decrease in the longitudinal deformation of the left ventricle and the systolic peak of the mitral ring movement at the level of the interventricular septum and the lateral wall of the left ventricle. Ethics. We have conducted the study 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 Clinical Practice in the Russian Federation", approved by Order of the Ministry of Health of the Russian Federation No. 266 dated 06.19.2003. All the subjects signed an informed consent to participate in the study.