Distant ischemic preconditioning and the regulation of vascular tone in miners with vibration disease combined with ischemic heart disease

Introduction. There is a adverse trend in increasing prevalence of cardiovascular diseases among miners, especially those with an established diagnosis of occupational disease, which in combination aggravates the risk of permanent loss of working capacity. The similarity of some pathogenetic mechanisms of development of vibration disease (VD) and ischemic heart disease (IHD) determines the possibility of their early general prevention. Objective of the investigation was to study the effect of distant ischemic preconditioning on the regulation of microcirculation in patients with VD associated with IHD. Material and methods. The study involved twenty two male 42 to 54 years miners with a proven diagnosis of VD in combination with IHD; work experience was more than 15 years. The features of autonomic regulation were assessed using spectral analysis of heart rate variability, microcirculation indices and tissue blood perfusion were detected by laser Doppler flowmetry before and after a course of distant ischemic preconditioning according to the elaborated technique. Results. In the examined miners with VD in combination with IHD, a decrease in heart rate variability was initially detected, indicating a violation of the autonomic regulation of the heart and being an unfavourable marker of the risk of sudden cardiac death. After a course of ischemic preconditioning, an increase in variability was observed, statistically significant in the low and very low frequency ranges of the spectrum. A tendency towards an increase in the microcirculation index was also revealed, which reflects an improvement in tissue perfusion with blood. Limitations. The study is limited to the number of long-term labour experience miners with a proven diagnosis of VD in combination with IHD, without heart rhythm disturbances and implantable devices affecting the heart rhythm, and those who underwent an in-depth medical examination in the Clinic of the Research Institute for Complex Problems of Hygiene and Occupational Diseases. Conclusion. The results obtained give grounds to continue studying the role of distant ischemic preconditioning as a method of correcting autonomic disorders in vibration disease in patients with ischemic heart disease.