Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455, Witten, Germany.
Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY, USA.
Sci Rep. 2024 May 27;14(1):12115. doi: 10.1038/s41598-024-62190-0.
Previous investigations have highlighted notable variations in cardiovascular risk indicators associated with various professional categories. However, only a few studies have examined structural and functional cardiac parameters using echocardiography within distinct occupational groups. Hence, this study endeavored to assess cardiac structural and functional parameters in three additional occupations: firefighters (FFs), police officers (POs), and office workers (OWs). This prospective study encompassed 197 male participants (97 FFs, 54 POs, and 46 OWs) from Germany. All participants underwent 2D and Doppler echocardiography in resting conditions; standard parasternal and apical axis views were employed to evaluate structural (diastolic and systolic) and functional (systolic and diastolic function, and strain) cardiac parameters. All three occupational groups exhibited a tendency towards septal hypertrophy. Notably, OWs exhibited the largest diastolic interventricular septum diameter (IVSd), at 1.33 ± 0.25 cm. IVSd significantly varied between POs and OWs (p = 0.000) and between POs and FFs (p = 0.025). Additionally, during diastole a substantially larger left ventricular posterior wall diameter (LVPWd) was observed in OWs compared to FFs (p = 0.001) and POs (p = 0.013). The left ventricular diastolic cavity diameter (LVIDd) and the left ventricular systolic cavity diameter (LVIDs) were significantly higher in POs than they were in FFs (LVIDd: p = 0.001; LVIDs: p = 0.009), and the LVIDd was notably higher in FFs (p = 0.015) and POs compared to OWs (p = 0.000). FFs exhibited significantly better diastolic function, indicated by higher diastolic peak velocity ratios (MV E/A ratio) and E/E' ratios, compared to POs (E/A ratio: p = 0.025; E/E' ratio: p = 0.014). No significant difference in diastolic performance was found between OWs and FFs. Significantly higher E'(lateral) values were noted in POs compared to FFs (p = 0.003) and OWs (p = 0.004). Ejection fraction did not significantly differ among FFs, POs, and OWs (p > 0.6). The left ventricular mass (LV Mass) was notably higher in POs than it was in FFs (p = 0.039) and OWs (p = 0.033). Strain parameter differences were notably improved in two- (p = 0.006) and four-chamber (p = 0.018) views for FFs compared to POs. Concentric remodeling was the predominant change observed in all three occupational groups. Significant differences in the presence of various forms of hypertrophy were observed in FFs, POs, and OWs (exact Fisher test p-values: FFs vs. OWs = 0.021, POs vs. OWs = 0.002). OWs demonstrated notably higher rates of concentric remodeling than FFs did (71.77% vs. 47.9%). This study underscores disparities in both functional and structural parameters in diverse occupational groups. Larger prospective studies are warranted to investigate and delineate differences in structural and functional cardiac parameters across occupational groups, and to discern their associated effects and risks on the cardiovascular health of these distinct professional cohorts.
先前的研究已经强调了与各种职业类别相关的心血管风险指标的显著差异。然而，只有少数研究使用超声心动图在不同职业群体中检查了心脏结构和功能参数。因此，本研究旨在评估另外三个职业群体的心脏结构和功能参数：消防员（FFs）、警察（POs）和办公室工作人员（OWs）。这项前瞻性研究包括来自德国的 197 名男性参与者（97 名 FFs、54 名 POs 和 46 名 OWs）。所有参与者均在静息状态下接受二维和多普勒超声心动图检查；采用标准胸骨旁和心尖轴视图评估心脏结构（舒张和收缩）和功能（收缩和舒张功能以及应变）参数。所有三个职业群体都存在室间隔肥厚的趋势。值得注意的是，OWs 的舒张室间隔厚度（IVSd）最大，为 1.33±0.25cm。POs 和 OWs 之间（p=0.000）以及 POs 和 FFs 之间（p=0.025）的 IVSd 存在显著差异。此外，在舒张期，OWs 的左心室后壁厚度（LVPWd）明显大于 FFs（p=0.001）和 POs（p=0.013）。POs 的左心室舒张腔直径（LVIDd）和左心室收缩腔直径（LVIDs）明显大于 FFs（LVIDd：p=0.001；LVIDs：p=0.009），FFs 的 LVIDd 明显高于 POs（p=0.015）和 OWs（p=0.000）。FFs 的舒张功能明显更好，表现为更高的舒张峰值速度比（MV E/A 比）和 E/E'比，与 POs 相比（E/A 比：p=0.025；E/E'比：p=0.014）。FFs 和 OWs 之间的舒张功能没有显著差异。POs 的 E'（侧壁）值明显高于 FFs（p=0.003）和 OWs（p=0.004）。FFs、POs 和 OWs 之间的射血分数没有显著差异（p>0.6）。POs 的左心室质量（LV Mass）明显高于 FFs（p=0.039）和 OWs（p=0.033）。FFs 的二维（p=0.006）和四腔（p=0.018）视图的应变参数差异明显改善。在所有三个职业群体中，以向心性重构为主。FFs、POs 和 OWs 中存在各种形式的肥厚存在显著差异（确切 Fisher 检验 p 值：FFs 与 OWs=0.021，POs 与 OWs=0.002）。OWs 的向心性重构发生率明显高于 FFs（71.77%比 47.9%）。本研究强调了不同职业群体中功能和结构参数的差异。需要进行更大规模的前瞻性研究，以调查和描绘不同职业群体中心脏结构和功能参数的差异，并了解这些不同职业群体心血管健康的相关影响和风险。
