Detection of hidden coronary insufficiency in persons ensuring the safety of train traffic on the Trans-Baikal Railway

The aim of the study. To conduct preclinical diagnosis of ischemic heart disease and to identify latent coronary insufficiency in persons involved in traffic safety in railway transport.

Materials and methods. A cross-sectional study of 108 working male railway workers whose duty is ensuring the safety of railway traffic was conducted. These patients were selected as having high-grade arrhythmias (56.2 %) or non-specific disorders of repolarization processes on the ECG (43.8 %), which was an indication for coronary angiography. All patients underwent echocardiography, ECG, Holter monitoring with the study of heart rate variability, lipid spectrum and coronary angiography. Statistical processing was carried out in the Statistica 10 program.

Results and discussion. During coronary angiography, coronary artery stenosis of various severity were detected in 57 (52.8 %) patients. In the group of patients with  stenosis, total cholesterol was 9.7 % higher (p = 0.0054), left ventricular myocardial mass index was 18.6 % higher compared to the group without stenosis (p = 0.0012). In the presence of stenosis, standard deviation of normal heartbeat index was 103.3 ± 31.3 ms, without stenosis – 134.0 ± 48.2 ms (p = 0.0019). The duration of arterial hypertension in the group with stenosis was two times longer (p = 0.0036).

Conclusion. 52.8 % of the examined patients had coronary artery stenoses, more than half of these stenoses were hemodynamically significant. Positive correlations were found between the presence of coronary artery stenosis and the duration of hypertension, the presence of hypertrophy and diastolic dysfunction of the left ventricle, left ventricular myocardial mass index, and complaints of shortness of breath during exercise.

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