Endothelial dysfunction as a new concept of early prevention of diseases of the cardiorespiratory system in workers of dust occupations

Abstract

Introduction. The development of ferruginous quartzites of the Kursk magnetic anomaly basin is accompanied by the release of dust, which affects miners. Identification of markers of preclinical pathology of the cardiorespiratory system (CRS) is relevant. Objective is to identify markers of endothelial dysfunction (ED) (endothelin-1 (ET-1), brain natriuretic peptide (BNP), changes in the elastic properties of blood vessels) at the preclinical stage of the development of pathology of the cardiovascular system and pathology of the respiratory organs in workers of dust occupations with different experience. Material and methods: Medical documentation (812 persons, the period from 2008 to 2015), systematized and statistically processed. ET-1 and BNP were determined by enzyme immunoassay. The central hemodynamics was studied by the method of volumetric compression oscillometry. Results. A significant correlation was established between the prevalence of diseases of the cardiovascular system (CCC), work experience in harmful conditions, and the peculiarities of the production process, r = 0.36-0.44; r = 0.48-0.64; the development of respiratory pathology with the production process and experience, r = 0.52-0.61, r = 0.41-0.47. The structure of morbidity is mainly formed by respiratory diseases - from 5.7 % to 40%; the third rank place (7.8-10.0%) is occupied by CCC diseases. A number of the examined patients have combined cardiorespiratory pathology (CRP) - 42.4%. The changes are more typical for highly trained workers. The study revealed: an increase in the pulse wave velocity (p = 0.037); linear blood flow velocity (p = 0.029), a decrease in arterial compliance (p = 0.031) with an increase in peripheral vascular resistance (p = 0.031), signs of ED (increase in ET-1, BNP). Discussion. Changes in ET-1, BNP, elastic-elastic properties of the main vessels more often developed in highly trained workers. They manifested by the development of ED, occurring as an unfavourable factor in the early appearance and progression of bronchial obstruction followed by the formation of a chronic pulmonary heart, remodelling of the main vessels. Conclusion. The study of ED is an urgent problem for studying with the subsequent optimization of therapeutic and preventive measures at mining enterprises.