Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Effect of shift work on endothelial function in young cardiology trainees

Auteur     Pierpaolo Tarzia
Auteur     Maria Milo
Auteur     Antonino Di Franco
Auteur     Antonio Di Monaco
Auteur     Alessandro Cosenza
Auteur     Marianna Laurito
Auteur     Gaetano Antonio Lanza
Auteur     Filippo Crea
Résumé     BACKGROUND Long-term shift work (SW) is associated with an increase in cardiovascular disease (CVD). Previous studies have shown that prolonged SW is associated with endothelial dysfunction, suggesting that this abnormality may contribute to the SW-related increase in cardiovascular risk. The immediate effect of SW on endothelial function in healthy subjects, however, is unknown. DESIGN We studied endothelial function and endothelium-independent function in 20 healthy specialty trainees in cardiology at our Institute, without any cardiovascular risk factor (27.3 ± 1.9 years, nine males), at two different times: (1) after a working night (WN), and (2) after a restful night (RN). The two test sessions were performed in a random sequence. METHODS Endothelial function was assessed by measuring brachial artery dilation during post-ischaemic forearm hyperaemia (flow-mediated dilation, FMD). Endothelium-independent function in response to 25 µg of sublingual glyceryl trinitrate (nitrate-mediated dilation, NMD) was also assessed. RESULTS FMD was 8.02 ± 1.4% and 8.56 ± 1.7% after WN and RN, respectively (p = 0.025), whereas NMD was 10.5 ± 2.1% and 10.4 ± 2.0% after WN and RN, respectively (p = 0.48). The difference in FMD between WN and RN was not influenced by the numbers of hours slept during WN (<4 vs >4 hours) and by the duration of involvement of specialty trainees in nocturnal work (<12 vs >12 months). CONCLUSIONS Our study shows that in healthy medical residents, without any cardiovascular risk factor, FMD is slightly impaired after WN compared to RN. Disruption of physiological circadian neuro-humoral rhythm is likely to be responsible for this adverse vascular effect.
Publication     European journal of preventive cardiology
Volume     19
Numéro     5
Pages     908-913
Date     Oct 2012

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