Endothelial dysfunction as a marker of thrombotic readiness in the arctic region: 611-018.74:616.1(98)

Abstract

Summary. Introduction. The harsh working conditions faced by seafarers in the Arctic due to prolonged exposure to extreme climatic and geophysical factors at high latitudes are associated with the development of the “polar stress syndrome”. In Arctic conditions, endothelial dysfunction caused by oxidative stress may be a predictor of vascular disorders and thrombotic readiness. Аim: to evaluate the changes in specific markers of endothelial dysfunction and oxidative stress as potential predictors of thrombotic readiness in sailors during a translatitudinal voyage in the Arctic. Materials and Methods. Twenty-five crew members of the vessel “Mikhail Somov” participated in a prospective clinical and laboratory study during the integrated marine research expedition TransАrctica-2019. Venous blood samples were taken at 3 points: at point 0 — at the port of departure (Arkhangelsk) before the vessel set sail; at point 1 (Heiss Island of the Franz Josef Land) on board the “Mikhail Somov” vessel (the highest latitude point of the expedition); at point 2 — when the vessel returned to the port (Arkhangelsk). The levels of vascular endothelial growth factor (VEGF-A), matrix metalloproteinase-9 (MMP-9), soluble P-selectin (sP-selectin), and total serum antioxidant capacity (TS-AOC) were quantified by enzyme immunoassay. Thrombin kinetics parameters, including lag phase time (tLag), thrombin peak formation time (tPeak), thrombin peak (Peak), and endogenous thrombin potential (AUC) were assessed using the Ceveron® alpha automatic coagulometer. Results. A gradual increase in the level of serum MMP-9 was observed at points 0, 1 and 2 (11.05 [9.71; 12.25] ng/mL, 11.35 [10.89; 12.53] ng/mL, 11.96 [11.33; 13.23] ng/mL, respectively), as along with a decrease in sP-selectin during a translatitudinal voyage. Statistical analysis revealed a significant correlation between the MMP-9 level and tobacco use (z = –2.611; p = 0.009), and alcohol consumption (z = –3.318; p = 0.0009), as well as between sP-selectin levels and alcohol consumption (df = 23; t = –3.0549; p = 0.0056). A correlation was found between the MMP-9 level and parameters of the thrombin kinetics test, including tLag (rs = 0.4654; p = 0.0190), tPeak (rs = 0.4702; p = 0.0177), Peak (rs = –0.456; p = 0.0217), and VI (rs = –0.416; p = 0.0381). These findings indicate the state of thrombotic readiness. Conclusion. Extreme Arctic conditions, as well as oxidative stress and risk factor modification, significantly impact the vascular endothelium, leading to the development of its dysfunction and an increased risk forthrombotic readiness.

For citation: Vorobyeva N.A., Vorobyeva A.I., Kashevarova M.I., Vorontsova A.S., Marusii A.A. Endothelial dysfunction as a marker of thrombotic readiness in the Arctic region. Tromboz, gemostaz i reologiya. 2023;(4):40–48. (In Russ.).

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