State of cardiovascular system in servicemen of Ukraine armed forces and emergency workers of the Chornobyl accident: Comparative analysis

Abstract: Objective: To conduct a comparative analysis of cardiovascular system state in emergency workers (EW) of the accident at the Chornobyl NPP and servicemen (SM) of Ukraine Armed Forces (UAF) who took part in the fight against Russian military aggression, and to assess the role of military service factors on the development of cardiac pathology. Materials and methods: The study included 81 male EW and 161 SM of UAF, who were examined and treated in the cardiology department of NRCRMHO from 2022 to 2024. The average age of the surveyed EW was (56.0 ± 2.5) years, and SM – (45.9 ± 8.8) years. According to modern standards, clinical examination, electrocardiography, Doppler echocardiography (EchoCG) examination, and statistical analysis were performed. Results: It was found that among the examined people of both groups, who are now aged 50 to 60 years, EW at the time hypertensive heart disease (HHD) and coronary heart disease (CHD) onset were younger than SM on average of 7.5 and 5.4 years, respectively. Among EW there were more patients with HHD of stage III, angina pectoris of functional class (FC) III and heart failure (HF) of stage II according to NYHA, while among the FC there was a higher proportion of patients with HHD of stage II, FC II and HF I. In addition, 42 % EW had a history of myocardial infarction compared to 14.8 % of SM (р < 0.001), and EW had a higher proportion of patients with AV blocks (41.3% vs. 16.7%, р < 0.001). Echocardiographic parameters showed that EW compared to SM had a higher incidence of left ventricular dilatation, posterior wall and interventricular septum thickening, and, as a result, myocardial hypertrophy, particularly eccentric hypertrophy. It was found that the risk HHD developing during the war was 3.32 times higher in mobilized SM compared to the regular UAF, 2.41 times higher in SM who participated in combat, and 5.27 times higher in SM with shrapnel or bullet wounds. The risk of developing CHD was associated only with UAF staff: in mobilized SM it was 3.84 times higher than in regular officers. Conclusions: The EW group differed from SM in a more severe course of HHD, CHD and HF, they had more severe changes in the structure of left ventricular myocardium. Most likely, this is explained by the fact that the incidence of HHD and CHD occurs at a younger age, and therefore by the longer duration of these diseases, which led to more severe pathological myocardial remodeling.