Demiralp Nuray, Akyel Serdar, Koç Hürmüz, Öztürk Ahmet
Bozkurt Vocational School of Higher Education, Civil Defence and Firefighting Program, Kastamonu University, Kastamonu, Türkiye.
Department of Cardiology, Faculty of Medicine, Kastamonu University, Kastamonu, Türkiye.
Eur J Appl Physiol. 2025 Oct 2. doi: 10.1007/s00421-025-06008-5.
This pilot study aimed to systematically evaluate exercise-induced electrocardiographic (ECG) responses in professional firefighters and to explore the association between premature ventricular complexes (PVCs) and myocardial ischemia in this high-risk occupational group.
This pilot cross-sectional study enrolled 21 male firefighters (mean age 43.4 ± 7.18 years) from a single municipal fire department. Participants underwent comprehensive cardiovascular assessment including anthropometric measurements, biochemical analyses (lipid profile, testosterone), submaximal exercise testing (Bruce protocol), and 24-h Holter ECG monitoring. Statistical analyses included Mann-Whitney U tests and effect size calculations.
No exercise-induced ST-segment changes indicative of myocardial ischemia were observed. However, PVCs were detected in 33% of participants (7/21), with exercise testing revealing 18 simple and 2 multiform PVCs, while Holter monitoring recorded 25 simple and 1 multiform PVC. PVC-positive firefighters were significantly older (median 49 vs. 40 years, p = 0.019, r = 0.514). Mean exercise capacity was 12.45 METs, with 81% achieving moderate fitness levels. Post-exercise heart rate recovery (HRR1: 24 ± 11.5 bpm; HRR2: 35.4 ± 11.5 bpm) showed normal patterns.
The findings of this pilot study indicate the need for larger-scale investigations, supported by advanced diagnostic modalities, to clarify the clinical relevance of exercise-induced premature ventricular complexes (PVCs) in firefighters. Although no ischemic changes were observed, the presence of subclinical coronary artery disease cannot be definitively excluded. These results provide a meaningful preliminary foundation for developing targeted screening approaches to improve early cardiovascular risk detection in high-physical-demand occupational groups.
本初步研究旨在系统评估职业消防员运动诱发的心电图（ECG）反应，并探讨这一高危职业群体中室性早搏（PVC）与心肌缺血之间的关联。
本初步横断面研究纳入了来自单一市消防部门的21名男性消防员（平均年龄43.4±7.18岁）。参与者接受了全面的心血管评估，包括人体测量、生化分析（血脂谱、睾酮）、次极量运动试验（布鲁斯方案）和24小时动态心电图监测。统计分析包括曼-惠特尼U检验和效应量计算。
未观察到提示心肌缺血的运动诱发ST段改变。然而，33%的参与者（7/21）检测到PVC，运动试验发现18个单形性和2个多形性PVC，而动态心电图监测记录到25个单形性和1个多形性PVC。PVC阳性的消防员年龄显著更大（中位数49岁对40岁，p = 0.019，r = 0.514）。平均运动能力为12.45代谢当量，81%达到中等健康水平。运动后心率恢复（HRR1：24±11.5次/分；HRR2：35.4±11.5次/分）显示正常模式。
本初步研究结果表明，需要在先进诊断方式支持下进行更大规模的调查，以阐明消防员运动诱发室性早搏（PVC）的临床相关性。虽然未观察到缺血性改变，但不能明确排除亚临床冠状动脉疾病的存在。这些结果为制定有针对性的筛查方法以改善对高体力需求职业群体的早期心血管风险检测提供了有意义的初步基础。
