Carter Dan, Pokroy Russell, Azaria Bella, Matetzky Shlomi, Prokopetz Alex, Barenboim Erez, Harpaz David, Goldstein Liav
Israel Aeromedical Center, IAF, Tel Hashomer, Israel.
Cardiology. 2007;108(2):124-7. doi: 10.1159/000096024. Epub 2006 Oct 4.
Bicuspid aortic valve (BAV) is a common congenital cardiac malformation. The major complications are aortic stenosis (AS), aortic regurgitation (AR), infectious endocarditis and aortic dissection. This paper aims to assess the hemodynamic importance of incidentally-found BAV in military aviators and evaluate the effect of high G-force on disease progression.
Aviators with BAV were detected by reviewing all cardiac assessment records between 1987 and 2005. All aviators underwent annual flight surgeon examination. Echocardiography was performed as recommended by our cardiologists and flight surgeons.
Eight newly diagnosed cases of BAV were found. All of the aviators continued active aviation throughout the study period. Repeat echocardiography demonstrated progressive widening of the aortic diameter in five of the eight aviators. No worsening of valve dysfunction was seen in those with mild aortic regurgitation at diagnosis. Left ventricular dimensions and function did not deteriorate. No new valve complications, including infectious endocarditis, were seen. The age at diagnosis strongly correlated with the root diameter change; both total (r = 0.74, p = 0.02) and annualized (r = 0.78, p = 0.02) change. Over a mean follow-up period of 12.1 years, no difference was seen in the progression of BAV in high-performance as compared to low-performance aviators.
Exposure to G-force and anti-G maneuvers does not appear to worsen cardiac and valve function in aviators with BAV.
二叶式主动脉瓣（BAV）是一种常见的先天性心脏畸形。主要并发症包括主动脉狭窄（AS）、主动脉瓣反流（AR）、感染性心内膜炎和主动脉夹层。本文旨在评估军事飞行员中偶然发现的BAV的血流动力学重要性，并评估高G值对疾病进展的影响。
通过回顾1987年至2005年间所有心脏评估记录来检测患有BAV的飞行员。所有飞行员均接受年度飞行医生检查。按照我们的心脏病专家和飞行医生的建议进行超声心动图检查。
发现8例新诊断的BAV病例。在整个研究期间，所有飞行员都继续活跃飞行。重复超声心动图显示，8名飞行员中有5名主动脉直径逐渐增宽。诊断时患有轻度主动脉瓣反流的患者，瓣膜功能障碍未加重。左心室大小和功能没有恶化。未出现包括感染性心内膜炎在内的新的瓣膜并发症。诊断时的年龄与根部直径变化密切相关；总变化（r = 0.74，p = 0.02）和年化变化（r = 0.78，p = 0.02）均如此。在平均12.1年的随访期内，高性能飞行员与低性能飞行员的BAV进展没有差异。
对于患有BAV的飞行员，暴露于G值和抗G动作似乎不会使心脏和瓣膜功能恶化。
