The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death Among On-duty Professional Firefighters.
The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death Among On-duty Professional Firefighters.
复制标题
DOI：
10.1097/jcn.0000000000000165
复制
发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Carey MG
中科院分区：
文献类型：
--
作者：
Al-Zaiti SS;Carey MG
消防员的心血管死亡人数是警察的两倍，是紧急医疗救援人员的四倍。这种高患病率的病因仍不清楚。心电图（ECG）是一种广泛使用的筛查高危人群的工具，但目前还没有可用的值班高分辨率心电图（ECG）记录。我们试图评估在12导联心电图霍尔特监测和运动负荷试验中，在职专业消防员的临床和心电图危险因素的患病率。消防员从调查和评估消防员健身和心电图（SAFFE）研究中招募。这项描述性研究招募了来自纽约西部地区7个消防站的消防员，他们都完成了值班，24小时霍尔特心电图监测和标准运动负荷试验。所有分析均由对所有临床数据设盲的审查员完成。112名消防员（年龄44±8岁，大多数为白色男性）完成了这项研究。尽管所有的消防员都处于正常的窦性心律，但他们中超过一半的人至少存在一种高危心电图风险因素，包括交感神经张力异常（心率升高，54%），复极异常（宽QRS-T角，25%），心肌瘢痕（QRS碎片，24%）和心肌缺血（ST段压低，24%）。此外，大多数消防员对跑步机运动负荷试验耐受良好（代谢当量任务11.8 ± 2.5），然而，近三分之一的消防员负荷试验异常，需要进一步评估以排除亚临床冠状动脉疾病。在值班的专业消防员中，致命心脏事件的高风险心电图标志物和需要进一步评估的异常压力测试结果很普遍。每年例行的12导联心电图体检可以识别那些可能受益于预防性心血管服务的人。
Firefighters have twice as many cardiovascular deaths as police officers and four times as many as emergency medical responders. The etiology for this high prevalence remains unknown. The electrocardiogram (ECG) is a widely used tool to screen populations at risk, but yet there are no available on-duty, high-resolution electrocardiographic (ECG) recordings. We sought to evaluate the prevalence of clinical and ECG risk factors among on-duty professional firefighters during 12-lead ECG holter monitoring and exercise stress testing. Firefighters were recruited from Surveying and Assessing Firefighters Fitness and ECG (SAFFE) study. This descriptive study recruited firefighters from 7 firehouses across Western New York area, who all completed on-duty, 24-hour Holter ECG monitoring and a standard exercise stress test. All analyses were completed by a reviewer blinded to all clinical data. 112 firefighters (age 44±8 years, mostly white males) completed the study. Even though all firefighters were in normal sinus rhythm, over half of them had at least one high risk ECG risk factor present, including abnormal sympathetic tone (elevated heart rate, 54%), abnormal repolarization (wide QRS-T angle, 25%), myocardial scaring (fragmented QRS, 24%), and myocardial ischemia (ST depression, 24%). In addition, most firefighters tolerated the treadmill exercise stress test well (metabolic equivalent tasks 11.8+2.5), however, almost one third had abnormal stress tests that require further evaluation to rule out subclinical coronary artery disease. Among on-duty professional firefighters, high risk ECG markers of fatal cardiac events and abnormal stress test results that warrant further evaluation are prevalent. Annual physical checkups with routine 12-lead ECG can identify those who might benefit from preventive cardiovascular services.