Updated: 2025-12-07
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0219U003596, 0116U003576 , R & D reports
The determination of gender difference in course of the most common circulatory system diseases in clean-up workers of the accident at the Chernobyl nuclear power plant taking in account myocardium structural and functional changes, rs966221 polymorphism of PDE4D gene and impact of radiation factor
Belyi David, Abramenko Irina,
29-01-2019
State institution "National research centеr for radiation medicine of the National academy of medical sciences of Ukraine "
А subject of the study was 515 men involved as clean-up workers (CW) of the accident at the Chernobyl Nuclear Power Plant (CNPP) and 145 women-CW, as well as 162 men and 120 women who did not expose to radiation (control groups). The goal of this work is to optimize the approaches to diagnosis of the most common circulatory system diseases in CW at the ChNPP, depending on the gender of patients based on the study of structural and functional changes in the myocardium, the PDE4D gene polymorphism rs966221 and the effect of ionizing radiation. Methods: conventional clinical examination, analysis of radiation and other risk factors, blood pressure measurements, electrocardiography (ECG), daily ECG monitoring and heart rate variability, echo- and doppler cardiography, polymerase chain reaction, statistical analysis. Hypertensive heart disease (HHD) and coronary heart disease (CHD) in male clean-up workers (CW-m) developed earlier than in female CW (CW-f). In the first middle age of HHD and CHD onset was 48.7 and 56.4 years, they were younger than their controls at 7.4 and 4.8 years respectively. CW-f developed HHD and CHD being 50.7 and 61.4 years old and 3.4 and 2.2 years earlier than in patients from control group. The significant risk of HHD development during the first 10 years after the accident was revealed in military officers and policemen who had in Pripyat and / or at the CNPP non-shiftwork. The risk of CHD development was higher in an engineering staff who worked in the 30-km zone, if compare with other CW-m. The risk of HHD development in CW-f during the first 10 years after the accident was higher among representatives of any profession, excluding those who worked in the service sector, medical staff and CW f of other professional categories who worked by shiftwork had the highest risk of CHD development during the first 15 years after the accident. The risk of myocardial infarction (MI) earlier development was 3.3 times higher in men than in women. Those who were 1 year older, had a 0.982 time (or on 1.8%) lower risk compared with younger ones. The 5 years age difference reduced this risk by 8.7%, and 10 years - by 16.6%. In carriers of TT genotype, males and females, CW and non-irradiated control, the risk of MI was higher in 2.369 times (or on 137%) compared with carriers of CC and CT genotype. In CW-m compared with CW-f there was significantly higher frequency of myocardial irritability as ventricular and supraventricular extrasystoles (ES), myocardial conductivity as complete blockade of His' bundle legs and AB blockade grade 1, the disorders in myocardial repolarization and the presence of focal and diffuse cardiosclerosis. In CW-m over 65, the frequency of paired and group ventricular ES was significantly higher than that of CW-f having corresponding age, whereas CW-f less than 65 years of age were more likely to have paired supraventricular ES and supraventricular tachycardia. A decrease of statistical and spectral parameters of heart rate variability (HRV) in all frequency bands with relative advantage of sympathetic influences was determined in CW-m and men control group. More significant changes of HRV relate to women and men with TT genotype, which are associated with the development of significant sympathetic influence due to essentially reduced parasympathetic activity. In men and women with HHD and CHD, both CW and non-irradiated controls, thickening of the left ventricular wall (LV) was the main factor that led to an increased myocardium mass and, consequently, the development of LV hypertrophy (LVH). CW-f more likely have more increased thickness of LV posterior wall and interventricular septum (IVS) from the admissible norm and more relative number of patients with IVS hypertrophy than CW-m. CW-f are characterized by more frequent concentric LVH, especially among those women who had obesity, so most of CW-f in comparison with CW-m were at the risk of dangerous CHD complications. TT genotype carriage of polymorphism rs966221 PDE4D gene in CW-m associated with the development of eccentric, and the genotypes CC and CT carriage - with a concentric LVH. The duration of ST segment horizontal depression more than 60 minutes during a day, SDNN-I less than 30 ms, myocardial mass index more than 122 g / m2 for women and 149 g / m2 for men are predicted adverse course for HHD and CHD.The results are submitted in 37 publications, including 10 articles, 3 chapters in a monography, 24 theses, materials were presented at 14 reports. Field of application: radiation medicine, therapy, cardiology.
Абраменко І.В.
Білий Д.О.
Білоус Н.І.
Базика Д. О.
Габулавічене Ж. М.
Ковальов О. С.
Круглова В.О.
Курсіна Н. В.
Макаревич О. М.
Настіна О.М.
Садова С.В.
Сидоренко Г.В.
2020-04-02
Updated: 2025-12-07
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