Factors of Cardiovascular Risk in Drivers of Locomotive Crews of Railway Transport with Ventricular Arrhythmias

Abstract

AIM: This study aimed to assess cardiovascular risk factors in drivers and assistant drivers of railway engine crews with ventricular rhythm disorders. MATERIALS AND METHODS: The study included 120 patients aged 39 to 61 years (mean age M SD: 50.4 4 years), who were distributed into two groups with and without ventricular rhythm disorders. All participants underwent 12-lead daily ECG monitoring with assessment of noninvasive markers of myocardial electrical instability (circadian profile, QT interval, late ventricular potentials, T-wave alternation, rhythm variability). Traditional factors of cardiovascular risk, the employment period in the profession, and the level of personal and situational anxiety on Spielbergers state-trait anxiety inventory (STAI) were evaluated. RESULTS: In Group 1, in comparison with Group 2, significant differences were revealed in the duration of the PQ interval (during the day and at night) and the indicators of late ventricular potentials (RMS 40 and TotQRSF). When analyzing risk factors, elevated indices of total blood cholesterol were registered in both groups, and the risk on the SCORE scale was at a moderate level. In the group of workers with ventricular rhythm disorders, higher indicators of total blood cholesterol and the frequency of smoking and alcohol consumption were established. In individuals with ventricular rhythm disorders, a significant relationship was detected between the number of registered single monomorphic ventricular extrasystoles and the age of the employee (r = 0.3, р 0.05), and blood pressure level (r = 0.3, р 0.05), and the relationship between the level of anxiety and the registration of single supraventricular extrasystoles was established (r = 0.3, р 0.05). In the Group 2, a significant correlation was revealed between the number of registered single supraventricular extrasystoles and age (r = 0.2, р 0.05), the employment period in the profession of a driver (r = 0.2, р 0.05), the blood pressure level (r = 0.2, р 0.05), and the level of anxiety on the STAI (r = 0.3, р 0.05). CONCLUSIONS: Drivers of railway engine crews with ventricular rhythm disorders are characterized by a higher level of total blood cholesterol and a higher frequency of smoking and alcohol consumption. They have significant changes in the duration of the PQ interval (during the day and at night) and indicators of late ventricular potentials (RMS 40 and TotQRSF) according to Holter monitoring. The relationship of the number of ventricular rhythm disorders with age and the office values of systolic and diastolic blood pressure is noted in drivers of engine crews of railway transport.