Cardiovascular screening and long-term outcomes in aircraft pilots

Area of Science:

• Cardiology
• Aviation Medicine
• Occupational Health

Background:

• Pilots face occupational risks impacting cardiometabolic health.
• Regulatory health screenings are mandatory for pilots.
• Limited data exists on pilot cardiometabolic risk factors and cardiac screening outcomes.

Purpose of the Study:

• To evaluate cardiac assessments in asymptomatic aircraft pilots.
• To determine the association between clinical risk factors and cardiac outcomes in pilots.

Main Methods:

• Study included asymptomatic pilots referred for cardiac assessment (1991-2023).
• Evaluated baseline characteristics, cardiac test findings, and outcomes.
• Defined Major Adverse Clinical Event (MACE) and used Kaplan-Meier methods for estimation.
• Defined significant valvular disease and aortic dilation (≥40mm) via echocardiography.

Main Results:

• 212 pilots studied; majority were white (92.9%) and male (91%), mean age 58.5 years.
• Common comorbidities included hyperlipidaemia (48%), hypertension (32%), and sleep apnoea (15%).
• Prevalence of significant valvular disease was 2.4%, and aortic dilation was 16%.
• Mean functional aerobic capacity was 109±24.6% (11.89±2.65 METs); <8% had positive exercise stress test findings.
• 15% incidence of MACE over a median follow-up of 5.15 years.

Conclusions:

• Asymptomatic pilots possess underlying cardiovascular risks but exhibit good functional capacity and long-term outcomes.
• The prevalence of aortic dilation necessitates increased attention during pilot cardiac examinations.
• Findings support continued vigilance and tailored screening protocols for pilot cardiovascular health.