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Echocardiography is an important method for non-invasive evaluation of the structural and functional indicators of the cardiovascular system, which is valuable in early detection of the cardiovascular pathology, especially in older people, because, the prevalence of the most cardiovascular diseases significantly increases with age. Material and methods. 1189 civil aviation pilots aged 54–68 years who underwent routine in-patient examination at the Central Clinical Hospital of Civil Aviation on a regular basis were examined 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 in 1170 flight personnel (98.4%) for evaluation of the structural and functional indicators of the cardiovascular system. Results. Echocardiography abnormalities were detected in 95.7% of pilots of the senior age group, 14.1% of these changes were in mixt form. Signs of atherosclerosis of the thoracic aorta were most common — 94% of cases. Left ventricle diastolic dysfunction of type I was noted in 60.3% of pilots. Structural and/or functional changes of the heart valves were noted in 18.2% of the subjects, most of them were localized in the aortic valves: 16% of cases. Dilation of the heart chambers were detected in 4.8% of the examined. LVH was found in 1% of pilots of the senior age group, and signs of LV concentric remodeling — in 60.7% of individuals. The decrease in LV myocardial contractility was detected only in one pilot with EF 53%. Small heart abnormalities were identified only in 0.6% of cases. Conclusions. Echocardiography abnormalities are quite common in pilots of the senior age group, however, «gross» echocardiographic changes are much less common than in the population, which is natural, because these individuals undergo initial medical screening and subsequent follow-up. The use of this method for screening in civil aviation pilots of senior age groups is reasonable, because the prevalence of cardiovascular disease in this group is increasing.

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Введение. Ранняя доклиническая диагностика бессимптомно протекающего атеросклероза в различных сосудистых бассейнах, включая основной сосуд, -аорту, имеет важное значение для клинической практики и особенно актуальна для авиационной медицины в целях медицинского обеспечения безопасности полетов, особенно у лиц старшей возрастной группы. Цель исследования: оценить состояние грудного и брюшного отделов аорты у пилотов гражданской авиации (ГА) старшей возрастной группы по данным ультразвукового исследования (УЗИ). Материал: обследовано 1189 пилотов гражданской авиации в возрасте 54-68 лет, проходивших плановое стационарное обследование в Центральной клинической больнице гражданской авиации на регулярной основе по достижении возраста 55 лет. Средний возраст -56,75 ± 0,07 лет. Методы: для скрининга ранней диагностики атеросклероза аорты проводилось УЗИ грудного и брюшного отделов аорты. Результаты: по данным УЗИ только у 4,7% пилотов старшей возрастной группы отсутствовали изменения в брюшном и грудном отделах аорты. У подавляющего большинства обследованных имелись атеросклеротические поражения стенки аорты, которые встречались чаще в грудном (93,8%), чем в брюшном, отделах (22,1%). Однако наибольшую клиническую и экспертную значимость имели изменения, выявленные в брюшном отделе аорты. В двух случаях (0,2%) имелись признаки нестабильной атеросклеротической бляшки в брюшном отделе аорты. Еще у двух обследованных (0,2%) впервые была диагностирована аневризма брюшного отдела аорты. И в одном случае (0,1%) диагностирован атеросклеротический сочетанный аортальный порок. Выводы: по результатам проведенного обследования пять пилотов (0,5%) были признаны негодными и еще 44 обследованных (3,7%) нуждались в более тщательном динамическом наблюдении в связи с выявленными изменениями (расширение грудного отдела аорты -у 31 пилота, брюшного отдела аорты -у двух лиц, наличие атеросклеротических бляшек в брюшном отделе аорты -у 11 человек). Учитывая полученные результаты, считаем целесообразным проведение скрининга атеросклероза аорты у пилотов старшей возрастной группы не только в грудном, но и брюшном отделах.

Prevalence, structure and clinical significance of conduction disturbances was studied according to the electrocardiography findings in 1189 older pilots in aged 55 years and older, who were to the Central Civil Aviation Hospital (Moscow) and examined on the regular bases. Resting electrocardiogram was recorded in all subjects according to generally accepted methods. Heart conduction disorders were detected in 16,9% of pilots of the older age group. More common were intraventricular conduction disturbances - 13,7% of cases, atrioventricular conduction disturbances were recorded less often- 1,8% of cases, and their combination was even less common - 0,6% of cases. Cardiac conduction abnormalities as part of another electrocardiogram syndromes were noted in 10 (0,8%) peoples. Older civil aviation pilots are characterized a lower frequency of electrocardiogram changes compared to a general population of the same age in the Russian Federation. The signs of cardiac conduction disturbances on the electrocardiogram in civil aviation pilots did not always lead to unfitness to fly. The evaluation of fitness to flight in some electrocardiogram deviations is depend of the presence or absence of cardiovascular disease, functional condition of the cardiovascular system and the data of additional examination methods. Diagnosis of heart rhythm and conduction disorders is important in assessing the state of the circulatory system, especially in flight personnel. Timely detection of cardiac conduction disorders in civil aviation pilots is essential for maintaining medical safety, especially in older people. Electrocardiography is performed as an initial method for assessing the state of the conducting heart system in civil aviation pilots.