Investigation on the effect of myocardial bridge on ventricular repolarization in civil pilots
10.3760/cma.j.cn113854-20221228-00158
- VernacularTitle:民航飞行员心肌桥对心室复极影响的调查
- Author:
Zhiqin YANG
1
;
Rui WAN
;
Fang LEI
;
Junhua YANG
Author Information
1. 中国南方航空股份有限公司航空卫生中心，广州 510406
- Publication Type:Journal Article
- Keywords:
Ventricular premature complexes;
Coronary diseases;
Exercise test;
Ventricular repolarization;
Civil pilots
- From:
Chinese Journal of Aerospace Medicine
2023;34(2):90-96
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the detection of myocardial bridge in civil aviation pilots and whether there is abnormal ventricular repolarization in the pilots with myocardial bridge, and to explore the effect of myocardial bridge on ventricular repolarization.Methods:Retrospective study was used to analyze the data of submaximal treadmill exercise test in 2019 for the civil aviation pilots aged ≥40. Pilots with cardiovascular diseases affecting ventricular repolarization were excluded. The resting electrocardiogram before exercise and 1 min QT interval after exercise were measured, and the QT dispersion (QT d) was calculated. The pilots were divided into myocardial bridge group and control group according to whether myocardial bridge was detected. The positive rate of treadmill exercise test and the incidence of ventricular extrasystole were compared between the pilots in myocardial bridge group and control group. The QT/RR slope was statistically analyzed in the pilots received 24 h electrocardiogram monitoring. Results:A total of 243 pilots were enrolled, including 242 males and 1 female. Among the 243 cases, 27 cases of myocardial bridge pilots were detected, and the myocardial bridge was mainly found in the anterior descending branch of left coronary artery (25/27, 92.6%). The 24 h dynamic electrocardiogram was examined in 17 cases, 6 cases were in the myocardial bridge group and 11 cases were in the control group. The total flying hours of the myocardial bridge group was longer than that of the control group ( Z=2.29, P=0.022); the positive rate or suspected positive rate of submaximal treadmill exercise test and the incidence of ventricular extrasystole in the myocardial bridge group were higher than those in the control group, and the differences were significant ( χ2=52.74, 5.78, P<0.001, =0.016); the 1 min QT d in the convalescent phase of the treadmill exercise test in the myocardial bridge group was longer than that in the control group, and the difference was significant ( Z=-2.20, P=0.028). The average frequency of 24 h ventricular extrasystole, QT e/RR slope and QT a/RR slope in the myocardial bridge group were higher than those in the control group, and the differences were significant ( t=2.37, 4.26, 2.51, P=0.034, <0.001, =0.024). Conclusions:Pilots with myocardial bridge may have prolonged ventricular repolarization and are prone to ventricular arrhythmias. In order to ensure flight safety, attention should be paid to the physical examination and flight adaptability evaluation of the pilots with myocardial bridge, especially to strengthen daily health management of the pilots with ventricular repolarization abnormalities.
