Effectiveness of ischemic preconditioning for correction of neuroautonomic disorders in vibration disease
Introduction. Vibration disease, affecting the autonomic-vascular regulation at different levels, disrupts the balance of sympathetic and parasympathetic influences with the formation of vasospasm. The development of cardiac autonomic neuropathy leads to a worsening of the prognosis for the life of patients, and therefore, the search for effective methods for correcting autonomic disorders is an urgent task in the treatment of vibration disease. The aim of the study is to evaluate the effectiveness of ischemic preconditioning for the correction of neurovegetative manifestations of vibration disease. Materials and methods. A comparative assessment of the initial parameters of heart rate variability was carried out in the main group of patients with an established diagnosis of vibration disease (32 people), and in the control group (25 people who had never worked under the influence of industrial vibration). The main group of patients underwent ischemic preconditioning of the upper extremities for 4 days, followed by monitoring of heart rate variability. The Mann-Whitney criteria were used to compare two independent samples and Wilcoxon to assess the significance of changes in indicators before and after exposure. Values at p<0.05 were considered statistically reliable. Results. An initial decrease in the power level of all spectral parameters of heart rate variability in the main group with the formation of relative sympathicotonia and a decrease in the values of the approximated entropy was revealed. After ischemic preconditioning, heart rate variability significantly increases, which indicates a decrease in the severity of autonomous neuropathy and an improvement in the prognosis for life. Conclusions. In patients with vibration disease, all parts of the peripheral and central autonomic nervous system are involved in pathogenesis with the formation of persistent sympathicotonia and violation of regulatory mechanisms. Ischemic preconditioning can affect the identified disorders by inducing an adaptive vagal response.