| About the author: |
Svitlyk H.V. |
| Heading |
CLINICAL MEDICINE |
| Type of article |
Scentific article |
| Annotation |
The article is devoted to the actual problem of nowadays - the influence of occupational hazards (OH) on people organism. The task of the work was to determine acute period of ST-elevation myocardial infarction (STEMI) in patients with occupational hazards.
We have examined 135 males with STEMI. 44 persons had been subjecting to prolonged exposure of occupational hazards (during at least 10 years) - contact with gasoline, diesel fuel, combustion products, pesticides, fertilizers, paints, varnishes, adhesives, metals, welding aerosols and others.
It was founded that the early post-infarction period in such individuals was characterized by a higher activity of systemic inflammation (in comparison with persons whose working conditions weren’t related to occupational hazards), which correlated with the more frequent occurrence of cardiovascular events. Also there was a tendency to more frequent occurrence of sustained ventricular paroxysmal tachycardia, "new" ischemia and myocardial infarction, thrombus formation in the left ventricle. In this category of patients was founded a statistically significant occurrence of ventricular extrasystoles of high gradations (p <0.0001) and formation of acute aneurysm in the left ventricle (p = 0.0412).
A deeper autonomic imbalance was revealed in these patients with a predominance of sympathetic nervous system tone that was combined with increased risk of life-threatening arrhythmias and sudden death.
We have founded weak and moderate correlation between the level of proinflammatory markers at the time of the disease onset and events that complicated its course. Thus, the parameters of interleukin-6 (IL-6), intercellular adhesion molecule (ICAM-1) and tumor necrosis factor α (TNF-α) correlated with dilatation of the cavity of the left ventricle (r = 0.20; r = 0.18; r = 0.19, respectively, p <0.05), TNF-α - with the thrombus formation in the left ventricle (r = 0.19; p <0.05).
Rhythm disturbances were correlated with C-reactive protein levels (polymorphic ventricular extrasystoles - r = 0.19; p <0.05; early ventricular extrasystoles - r = 0.31; p <0.05); IL-6 (early ventricular extrasystoles - r = 0.26; p <0.05); TNF-α (polymorphic ventricular extrasystoles - r = 0.18; p <0.05; early ventricular extrasystoles - r = 0.17; p <0.05), and conduction disorders correlated with IL-6 levels (AV-blockade of the second degree, Mobitz I - r = 0.24, p <0,05).
Direct correlation was found between the formation of acute aneurysm of the left ventricle and the levels of CRP and TNF-α in the debut of the disease (r = 0.21; r = 0.26, respectively, p <0.05).
The most optimal criterion for prediction of the occurrence of complications in the early post-infarction period was the CRP (threshold value 18.81 mg/l, sensitivity 86%, specificity 81%).
Lower (dynamically assesed at the hospital stage) levels of the heart rate variability (both low and high-frequency waves) in patients exposed to occupational hazards were considered as the result of the toxic effect of xenobiotics on the sympathetic and parasympathetic branches of the autonomic nervous system.
Important is to continue the research in this direction, as well as to do the environment more healthy and improve working conditions.
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| Tags |
ST-elevation myocardial infarction, anthropogenic xenobiotics, activity of systemic inflammation, heart rate variability, early period of ST-elevation myocardial infarction |
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| Publication of the article |
«World of Medicine and Biology» №1(63), 2018 year, 069-074 pages, index UDK 616.127-005.8-036.11-06:613.632 |
| DOI |
10.26724/2079-8334-2018-1-63-69-74 |
