State of cardiovascular system in employees with chronic obstructive pulmonary disease in combination with arterial hypertension in terms of exposure to toxic games

Abstract

Objective. Identification of the features of the cardiovascular system damage in chronic obstructive pulmonary disease (COPD) combined with arterial hypertension (AH) in workers exposed to toxic gases (TG).

Materials and methods. 132 house painters and paint production workers of the Novosibirsk aviation enterprise were included in 3 strata and examined: I-COPD and TG; II-COPD in combination with AH when exposed to TG; III – COPD in combination with AH without exposure to TG. Employees of all strata were divided by length of service less than 10 and more than 10 years. The selection of workers in groups was carried out by a continuous method.

Results. The most pronounced changes on the ECG, regardless of the length of service, were observed in workers with COPD in combination with hypertension and contact with TG (levogram and metabolic changes in the myocardium). When exposed to TG for more than 10 years, hypertrophy of the left parts of the heart was also detected. Among workers with COPD in combination with hypertension exposed to TG, the indicators of average pulmonary artery pressure (APAP) and pulmonary vascular resistance (PVR) elevated with increasing work experience; changes in the structure and function of the right and left parts of the heart and signs of remodeling of large vessels were also revealed. The same workers showed more pronounced changes in the daily blood pressure profile (DBPP) of AP with the prevalence of Non-dippers and Night-pickers.

Conclusions. Among workers suffering from comorbid pathology, with increasing duration of TG exposure over 10 years, there were observed the most pronounced ECG changes (deviation of electrical axis to the left, metabolic changes in the myocardium, hypertrophy of the left heart); increased APAP and PVR 1.21 and 1.10 times; changes in the structure and function of the right and left chambers of the heart, remodeling of large vessels; increase in the frequency of variants of the DBPP of Non-dippers and Night-pickers.

Keywords

chronic obstructive pulmonary disease / arterial hypertension / toxic gases / daily blood pres-sure profile

References

[1] Vertkin A. L., Kovacova N.O. Comorbidity is the new pathology. Technologies of its prevention and treatment. Arhiv vnutrennej mediciny 2013; 4: 12 (in Russian).

[2] Верткин А.Л., Ховасова Н.О. Коморбидность – новая патология. Технологии её профилактики и лечения. Архив внутренней медицины 2013; 4: 12.

[3] Shpagin I.S., Kotova O.S., Pospelova T.I., Gerasimenko O.N., Shpagina L.A., Ermakova M.A. Chronic obstructive pulmonary disease in combination with essential arterial hypertension: clinical and functional and molecular genetic features. Vestnik sovremennoj klinicheskoj mediciny 2016; 9 (4): 56–65 (in Russian).

[4] Шпагин И.С., Котова О.С., Поспелова Т.И., Герасименко О.Н., Шпагина Л.А., Ермакова М.А. Хроническая обструктивная болезнь легких в сочетании с эссенциальной артериальной гипертензией: клинико-функциональные и молекулярно-генетические особенности. Вестник современной клинической медицины 2016; 9 (4): 56–65.

[5] Global Strategy for the Diagnosis, Management and Prevention of Chronic obstructive pulmonary disease (GOLD). Updated 2016; 80.

[6] Malysh E.Y., Drobysheva E.S., Chernov A.V. Chronic obstructive pulmonary disease and damage the cardiovascular system. Molodoj uchenyj 2014; 5 (64): 145–148.

[7] Malysh E.Y., Drobysиheva E.S., Chernov A.V. Chronic obstructive pulmonary disease and damage the cardiovascular system. Molodoj uchenyj 2014; 5 (64): 145–148.

[8] Trofimenko I.N., Chernyak B.A., Bukina L.A. Influence of comorbid pathology on the course of COPD. Tezisy XXV Nacional'nogo kongressa po boleznjam organov dyhanija, Moscow 2015; 356 (in Russian).

[9] Трофименко И.Н., Черняк Б.А., Букина Л.А. Влияние коморбидной патологии на течение ХОБЛ. Тезисы XXV Национального конгресса по болезням органов дыхания. М. 2015; 356.

[10] Klester K.V., Klester E.B., Bessonova A.S. Comorbidity and mortality risk assessment in COPD: a prognostic analysis. Tezisy XXV Nacional'nogo kongressa po boleznjam organov dyhanija, Moscow 2015; 220 (in Russian).

[11] Клестер К.В., Клестер Е.Б., Бессонова А.С. Коморбидность и оценка риска летальности при ХОБЛ: прогностический анализ. Тезисы ХХV Национального конгресса по болезням органов дыхания. М. 2015; 220.

[12] Kochetova E.V. Assessment of total cardiovascular risk and comorbidity index in patients with COPD. Tezisy XXV Nacional'nogo kongressa po boleznjam organov dyhanija, Moscow 2015: 215–216 (in Russian)

[13] Кочетова Е.В. Оценка суммарного сердечно-сосудистого риска и индекса коморбидности у больных ХОБЛ. Тезисы ХХV Национального конгресса по болезням органов дыхания. М. 2015; 215–216.

[14] Lahousse L., Loth D.W., Joos G.F., Hofman A., Leufkens H.G., Brusselle G.G., Stricker B.H. Pulm Statins, systemic inflammation and risk of death in COPD: The Rotterdam study. Pulm Pharmacol Ther 2013; 26: 212–217.

[15] Caillaud D., Lemoigne F., Carré P., Escamilla R., Chanez P., Burgel P.-R., Court-Fortune I., Jebrak G., Pinet C., Perez T., Brinchault G., Paillasseur J.-L., Roche N. Association between occupational exposure and the clinical characteristics of COPD. BMC Public Health 2012; 12: 302.

[16] Vasilyeva O.S., Gusakov A.A., Gushchina E.E., Kravchenko N.Yu. Chronic obstructive pulmonary disease from exposure to industrial aerosols. Pul'monologija 2013; 3: 49–55 (in Russian).

[17] Васильева О.С., Гусаков А.А., Гущина Е.Е., Кравченко Н.Ю. Хроническая обструктивная болезнь легких от воздействия производственных аэрозолей. Пульмонология 2013; 3: 49–55.

[18] Kraïm–Leleu M., Lesage F.X., Drame М., Lebargy F., Deschamps F. Occupational Risk Factors for COPD: A Case–Control Study. PLoS One 2016; 11 (8): e0158719.

[19] Mazitova N.N. Occupational risk factors for chronic obstructive pulmonary disease: results of a cohort study. Ka-zanskij medicinskij zhurnal 2011; 4: 537–541 (in Russian).

[20] Мазитова Н.Н. Профессиональные факторы риска хронической обструктивной болезни легких: результаты когортного исследования. Казанский медицинский журнал 2011; 4: 537–541.

[21] Vasilyeva O.S., Kravchenko N.Yu. Chronic obstructive pulmonary dis-ease as an occupational disease: risk factors and the problem of medical and social rehabilitation of patients. Rossijskij medicinskij zhurnal 2015; 2: 22–26 (in Russian)

[22] Васильева О.С., Кравченко Н.Ю. Хроническая обструктивная болезнь легких как профессиональное заболевание: факторы риска и проблема медико-социальной реабилитации больных. Российский медицинский журнал 2015; 2: 22–26.

[23] Shpagina L.A., Kotova O.S., Karmanovskaya S.A., Kuznetsova G.V. Chronic obstructive pulmonary disease formed under the action of toxic aerosol: biomarkers. Medicina truda i promyshlennaja jekologija 2015; 9: 159 (in Russian).

[24] Шпагина Л.А., Котова О.С., Кармановская С.А., Кузнецова Г.В. Хроническая обструктивная болезнь легких, сформировавшаяся в условиях действия токсического аэрозоля: биомаркеры. Медицина труда и промышленная экология 2015; 9: 159.

[25] R 2.2.2006-05. Occupational health. Guidelines for the hygienic assessment of factors of the working environment and the labor process. Criteria and classification of working conditions. Moscov 2005 (in Russian).

[26] Р 2.2.2006-05. Гигиена труда. Руководство по гигиенической оценке факторов рабочей среды и трудового процесса. Критерии и классификация условий труда. М. 2005.

[27] GN 2.2.5.1313-03. Maximum permissible concentrations (MPC) of harmful substances in the air of the working area. Approved by the Chief State Sanitary Doctor of the Russian Federation on April 27, 2003. Moscow 2003 (in Russian).

[28] ГН 2.2.5.1313-03. Предельно допустимые концентрации (ПДК) вредных веществ в воздухе рабочей зоны. Утв. Главным государственным санитарным врачом РФ 27 апреля 2003 г. М. 2003.

[29] GOLD 2017: Global Strategy for the Diagnosis, Management and Prevention of COPD, available at: http://goldcopd.org/gold 2017

[30] Mancia G., Fagard R., Narkiewicz К., Redón J., Zanchetti A., Böhm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F. ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the Euro-pean Society of Cardiology (ESC). Journal of Hypertension 2013; 31: 1281–1357.

[31] Mancia G., Fagard R., Narkiewicz К., Redón J., Zanchetti A., Böhm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F. ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension 2013; 31: 1281–1357.

[32] Howard L.S., Grapsa J., Dawson D., Bellamy M., Chambers J.B., Masani N.D., Nihoyannopoulos P., Simon R., Gibbs J. Echocardiographic assessment of pulmonary hypertension: standard operating procedure. Eur Respir Rev 2012; 21 (125): 239–248.

[33] Neklyudova G.V., Naumenko Zh.K. Echocardiography in the diagnosis of pulmonary hypertension. Prakticheskaja pul'monologija 2015; 2: 48–56 (in Russian)

[34] Неклюдова Г.В., Науменко Ж.К. Эхокардиография при диагностике легочной гипертензии. Практическая пульмонология 2015; 2: 48–56.

[35] Rogoza A.N., Nikolsky V.P., Oshchepkova E.V., Epifanova O.N., Runikhina N.K., Dmitriev V.V. Daily monitoring of arterial pressure in hypertension. Methodological issues. Rossijskij kardiologicheskij nauchno-proizvodstvennyj kompleks MZ RF. Moscow 2004; 36 (in Russian).

[36] Рогоза А.Н., Никольский В.П., Ощепкова Е.В., Епифанова О.Н., Рунихина Н.К., Дмитриев В.В. Суточное мониторирование артериального давления при гипертонии. Методические вопросы. Российский кардиологический научно-производственный комплекс МЗ РФ. М. 2004; 36.

[37] Rebrova O.Yu. Statistical analysis of medical data. Application of the STATISTICA application software package. Moscow: MediaSfera 2002; 312 (in Russian).

[38] Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ Statistica. М.: МедиаСфера 2002; 312.

RIGHTS & PERMISSIONS

Panacheva L.A., Shpagina L.A.