Key result
Flight inaptitude in senior pilots is linked to a ~193% higher prevalence of enlarged heart chambers.
Why the study?
Cardiac remodeling is an important element of the cardiovascular continuum and a key mechanism for cardiovascular disease progression, with echocardiography serving as the main method for its assessment.
Cross-Sectional (n=1,189)
No
Absolute Event Rate: 9.8% vs 3.35%
p-value: p=<0.0001
The structural- functional changes of heart chambers (changes in size, volume, shape and function of the heart) are the basis of the cardiac remodeling — an important element of the cardiovascular continuum, which is a key mechanism for the progression of the main cardiovascular diseases. Echocardiography is the main and available method for its assessment. Material and methods . 1189 civil aviation pilots aged 54–68 who underwent routine in-patient examination at the Central Clinical Hospital of Civil Aviation were examined on a regular basis with further medical assessment at the Central Medical Flight Expert Commission of Civil Aviation of the Russian Federation in 2009–2010. The average age was 56.75 ± 0.07. Transthoracic echocardiography was performed for evaluation of the structural-functional indicators of the cardiovascular system in 1170 of flight personnel (98.4%). Results . Enlarged size of the heart chambers was minor and moderate without heart failure and was detected in 4.8% of civil aviation pilots of senior age group. Abnormal geometry of left ventricular (LV) was revealed in 61.7% of the examined civil aviation pilots of senior age group: left ventricular hypertrophy (LVH) — in 1% of pilots (concentric LVH — 0.6 % and eccentric LVH — 0.4% cases), concentric remodeling of the LV — in 60.7% pilots. The decrease in LV ejection fraction was observed only in one pilot with EF— 53%. Pilots inapt for flying had enlarged chambers more often than pilots with fitness to fly (9.8% vs 3.35% pilots; p < 0,0001) and LVH (2.9% vs 0.45%; p < 0,001). Conclusions . Echocardiography is an important method for cardiac chambers evaluation, including determination of type LVH geometry. It can be used in the medical assessment of civil aviation pilots of the senior age group.
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Kuzmina et al. (2020) conducted a cross-sectional in Civil aviation pilots (n=1,189). Inapt for flying status vs. Fitness to fly status was evaluated on Enlarged heart chambers (p=<0.0001). Echocardiography in senior civil aviation pilots revealed abnormal left ventricular geometry in 61.7%, with enlarged chambers significantly more common in pilots inapt for flying (9.8% vs 3.35%; p<0.0001).
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