Skip to main content
PMC home page
British Journal of Industrial Medicine logoLink to British Journal of Industrial Medicine
. 1988 Nov;45(11):742–746. doi: 10.1136/oem.45.11.742

Evaluation of right and left ventricular function in hard metal workers.

S F Horowitz 1, A Fischbein 1, D Matza 1, J N Rizzo 1, A Stern 1, J Machac 1, S J Solomon 1
PMCID: PMC1009691  PMID: 3203078

Abstract

Ingested cobalt has previously been associated with the development of a congestive cardiomyopathy. Despite occasional reports of cardiomyopathy after industrial exposure to cobalt, this association remains controversial. In a study of 30 cemented tungsten carbide workers with a mean duration of exposure to cobalt of 9.9 +/- 5.3 years radionuclide ventriculography was performed to study right and left ventricular ejection fractions at rest and exercise. For the entire group, rest and exercise biventricular function was normal. There was, however, a weak but significant inverse correlation between duration of exposure and resting left ventricular function (r = -0.40, p less than 0.03). Workers with abnormal chest x ray findings (9/30) had relatively lower exercise right ventricular ejection fractions (45% +/- 6 v 52% +/- 7, p less than 0.02). An inverse relation was also found between rest and exercise right ventricular ejection fraction and severity of parenchymal abnormalities on x ray examination (r = -0.44, p less than 0.01 and r = -0.41, p less than 0.02). Diminished right ventricular reserve was probably due to fibrotic lung disease and early cor pulmonale. Although overt left ventricular dysfunction was not present, prolonged exposure to industrial cobalt may be a weak cardiomyopathic agent with unknown long term significance.

Full text

PDF
743

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BECH A. O., KIPLING M. D., HEATHER J. C. Hard metal disease. Br J Ind Med. 1962 Oct;19:239–252. doi: 10.1136/oem.19.4.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barborik M., Dusek J. Cardiomyopathy accompaning industrial cobalt exposure. Br Heart J. 1972 Jan;34(1):113–116. doi: 10.1136/hrt.34.1.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bonenfant J. L., Miller G., Roy P. E. Quebec beer-drinkers' cardiomyopathy: pathological studies. Can Med Assoc J. 1967 Oct 7;97(15):910–916. [PMC free article] [PubMed] [Google Scholar]
  4. Brent B. N., Berger H. J., Matthay R. A., Mahler D., Pytlik L., Zaret B. L. Physiologic correlates of right ventricular ejection fraction in chronic obstructive pulmonary disease: a combined radionuclide and hemodynamic study. Am J Cardiol. 1982 Aug;50(2):255–262. doi: 10.1016/0002-9149(82)90174-6. [DOI] [PubMed] [Google Scholar]
  5. Chew C., Ziady G. M., Raphael M. J., Oakley C. M. The functional defect in amyloid heart disease. The "stiff heart" syndrome. Am J Cardiol. 1975 Oct 6;36(4):438–444. doi: 10.1016/0002-9149(75)90891-7. [DOI] [PubMed] [Google Scholar]
  6. Cohen M., Horowitz S. F., Machac J., Mindich B. P., Fuster V. Response of the right ventricle to exercise in isolated mitral stenosis. Am J Cardiol. 1985 Apr 1;55(8):1054–1058. doi: 10.1016/0002-9149(85)90745-3. [DOI] [PubMed] [Google Scholar]
  7. Ellis J. H., Jr, Kirch D., Steele P. P. Right ventricular ejection fraction in severe chronic airway obstruction. Chest. 1977 Feb;71(2 Suppl):281–282. doi: 10.1378/chest.71.2_supplement.281. [DOI] [PubMed] [Google Scholar]
  8. Hartz A. J., Anderson A. J., Brooks H. L., Manley J. C., Parent G. T., Barboriak J. J. The association of smoking with cardiomyopathy. N Engl J Med. 1984 Nov 8;311(19):1201–1206. doi: 10.1056/NEJM198411083111901. [DOI] [PubMed] [Google Scholar]
  9. Kesteloot H., Roelandt J., Willems J., Claes J. H., Joossens J. V. An enquiry into the role of cobalt in the heart disease of chronic beer drinkers. Circulation. 1968 May;37(5):854–864. doi: 10.1161/01.cir.37.5.854. [DOI] [PubMed] [Google Scholar]
  10. Kesteloot H., Terryn R., Bosmans P., Joossens J. V. Alcoholic perimyocardiopathy. Acta Cardiol. 1966;21(3):341–357. [PubMed] [Google Scholar]
  11. LIQUIER-MILWARD J. Evidence of a complex compound of cobalt with a purine base (adenine). Nature. 1951 Jun 30;167(4261):1068–1069. doi: 10.1038/1671068b0. [DOI] [PubMed] [Google Scholar]
  12. McDermott P. H., Delaney R. L., Egan J. D., Sullivan J. F. Myocardosis and cardiac failure in men. JAMA. 1966 Oct 17;198(3):253–256. [PubMed] [Google Scholar]
  13. Morin Y., Daniel P. Quebec beer-drinkers' cardiomyopathy: etiological considerations. Can Med Assoc J. 1967 Oct 7;97(15):926–928. [PMC free article] [PubMed] [Google Scholar]
  14. Morin Y., Têtu A., Mercier G. Cobalt cardiomyopathy: clinical aspects. Br Heart J. 1971;33(Suppl):175–178. doi: 10.1136/hrt.33.suppl.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rodeheffer R. J., Gerstenblith G., Becker L. C., Fleg J. L., Weisfeldt M. L., Lakatta E. G. Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate. Circulation. 1984 Feb;69(2):203–213. doi: 10.1161/01.cir.69.2.203. [DOI] [PubMed] [Google Scholar]
  16. Rona G. Experimental aspects of cobalt cardiomyopathy. Br Heart J. 1971;33(Suppl):171–174. doi: 10.1136/hrt.33.suppl.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. SCHEPERS G. W. The biological action of tungsten carbide and cobalt; studies on experimental pulmonary histopathology. AMA Arch Ind Health. 1955 Aug;12(2):140–146. [PubMed] [Google Scholar]
  18. Sandusky G. E., Crawford M. P., Roberts E. D. Experimental cobalt cardiomyopathy in the dog: a model for cardiomyopathy in dogs and man. Toxicol Appl Pharmacol. 1981 Sep 15;60(2):263–278. doi: 10.1016/0041-008x(91)90230-c. [DOI] [PubMed] [Google Scholar]
  19. Soter N. A., Wasserman S. I., Austen K. F. Cold urticaria: release into the circulation of histamine and eosinophil chemotactic factor of anaphylaxis during cold challenge. N Engl J Med. 1976 Mar 25;294(13):687–690. doi: 10.1056/NEJM197603252941302. [DOI] [PubMed] [Google Scholar]
  20. Sullivan J., Parker M., Carson S. B. Tissue cobalt content in "beer drinkers' myocardiopathy". J Lab Clin Med. 1968 Jun;71(6):893–911. [PubMed] [Google Scholar]
  21. TAYLOR D. M. The absorption of cobalt from the gastrointestinal tract of the rat. Phys Med Biol. 1962 Jan;6:445–451. doi: 10.1088/0031-9155/6/3/308. [DOI] [PubMed] [Google Scholar]
  22. WEBB M. The biological action of cobalt and other metals. III. Chelation of cations by dihydrolipoic acid. Biochim Biophys Acta. 1962 Nov 19;65:47–65. doi: 10.1016/0006-3002(62)90148-8. [DOI] [PubMed] [Google Scholar]
  23. Wiberg G. S., Munro I. C., Morrison A. B. Effect of cobalt ions on myocardial metabolism. Can J Biochem. 1967 Aug;45(8):1219–1223. doi: 10.1139/o67-142. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Industrial Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES