Association of smoking and physical inactivity with MRI derived changes in cardiac function and structure in cardiovascular healthy subjects.
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ABSTRACT:
SUBMITTER: Schafnitzel A
PROVIDER: S-EPMC6901589 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
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Association of smoking and physical inactivity with MRI derived changes in cardiac function and structure in cardiovascular healthy subjects.
Schafnitzel Anina A Lorbeer Roberto R Bayerl Christian C Patscheider Hannah H Auweter Sigrid D SD Meisinger Christa C Heier Margit M Ertl-Wagner Birgit B Reiser Maximilian M Peters Annette A Bamberg Fabian F Hetterich Holger H
Scientific reports 20191209 1
We aimed to investigate the association of smoking and physical exercise on ventricular function and structure, determined by cardiac magnetic resonance imaging (CMR), in subjects without known cardiovascular diseases. A total of 381 participants (median age 57 years) of the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort underwent CMR. The participants' smoking and sporting habits were measured by a questionnaire. Physical inactivity was associated with a reduction of le ...[more]
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Project description:BackgroundThe benefit of cardiovascular magnetic resonance Imaging (CMR) in assessing occupational risk is unknown. Pilots undergo frequent medical assessment for occult disease, which threatens incapacitation or distraction during flight. ECG and examination anomalies often lead to lengthy restriction, pending full investigation. CMR provides a sensitive, specific assessment of cardiac anatomy, tissue characterisation, perfusion defects and myocardial viability. We sought to determine if CMR, when added to standard care, would alter occupational outcome.MethodsA retrospective review was conducted of all personnel attending the RAF Aviation Medicine Consultation Service (AMCS) for assessment of a cardiac anomaly, over a 2-year period. Those undergoing standard of care (history, examination, exercise ECG, 24?h-Holter and transthoracic echocardiography), and those undergoing a CMR in addition, were identified. The influence of CMR upon the final decision regarding flying restriction was determined by comparing the diagnosis reached with standard of care plus CMR vs. standard of care alone.ResultsOf the ~?8000 UK military aircrew, 558 personnel were seen for cardiovascular assessment. Fifty-two underwent CMR. A normal TTE did not reliably exclude abnormalities subsequently detected by CMR. Addition of CMR resulted in an upgraded occupational status in 62% of those investigated, with 37% returning to unrestricted duties. Only 8% of referrals were undiagnosed following CMR. All these were cases of borderline chamber dilatation and reduction in systolic function in whom diagnostic uncertainty remained between physiological exercise adaptation and early cardiomyopathy.ConclusionsCMR increases the likelihood of a definitive diagnosis and of return to flying. This study supports early use of CMR in occupational assessment for high-hazard occupations.
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