Left ventricular hypertrophy and linked cardiovascular risk factors among Congolese licensed civilian aircrew

Abstract

Objective: To assess the prevalence of left ventricular hypertrophy (LVH) and linked cardiovascular risk factors in civilian aircrew.
Methods: Cardiovascular risk factors were assessed among flight and cabin crew undergoing routine clinical and biological evaluation for initial or renewal of aeromedical license. The evaluation also included a standard 12-lead ECG and echocardiography. Echo-based LVH was LVM ≥ 49 g/m2.7 (men) or ≥ 45 g/m2.7 (women). LVH was categorized as mild (men: 49-55 g/m2.7; women: 45-51 g/m2.7), moderate (men: 56-63 g/m2.7; women: 52-58 g/m2.7), or severe (men: ≥ 64 g/m2.7; women: ≥ 59g/m2.7) according to Lang’s report.
Results: Among the 379 aircrew members (70.4% men; 23% Caucasians; 62.5% flight crew; mean age 40.6 ± 12.8 years), LVH was present in 36 individuals (9.5%) with mild, moderate and severe pattern observed respectively in 19.4%, 33.3% and 47.2% of the cases. The rate of LVH amounted to 16.7% in normotensive subjects, 25.0% in those with prehypertension, and 58.3% among hypertensive individuals. In addition to age of 40-59y (OR: 8.48; 95% CI: [2.23-12.23]; p = .002) or more (4.22 [1.57-11.35]; p = .004), hypertension (3.55 [1.50 - 8.41]; p = .004), overweight/obesity (5.33 [1.14 - 25.05]; p = .034) and hyperuricemia (5.05 [2.11 - 12.09]; p = .001), all well-known constituents of the metabolic syndrome, were the main factors significantly associated with LVH.
Conclusion: The frequency and link of LVH to the components of the metabolic syndrome highlights the need for a comprehensive approach to the management of cardiovascular risk factors in civilian aircrew.