Enlargement of the aorta: An occupational disease?

Abstract

Background: Aortic dilation may critically precede progression to thoracic aortic aneurysm (TAA). Prolonged or repetitive isometric-type heavier strenuous activities resulting from the nature of some professions may be an important causative factor for TAA.

Method: The echocardiographic measurement data of middle-age subjects who were isometric-type daily strenuous activity trainers or ordinary activity trainers were retrospectively analyzed. Clinical features and echocardiographic parameters of the left ventricle and left atrium (LA), aortic root (AR) and ascending aorta (AA) were compared between the groups.

Results: AR (35.6±3.0 mm versus 33.5±1.9 mm), AA (36.8±3.0 mm versus 34.4±1.9 mm) and LA (37.4±2.2 mm versus 36.2±2.2 mm) diameters were significantly enlarged in the strenuous activity trainer group versus the ordinary activity group. Diastolic blood pressure was significantly lower (73.8±5.9 mmHg versus 78.3±6.0 mmHg) in this group. AR diameter was correlated with height (β=0.460; P=0.004) and LA diameter (β=0.280; P=0.008) while AA diameter was correlated with type of profession (β=0.309; P=0.003), left ventricular systolic diameter (β=0.500; P=0.001) and LA diameter (β=0.272; P=0.005) in regression analysis.

Conclusion: Aortic dilation and, subsequently, TAA may be an occupational disease due to nature of some professions (eg, the military, security, weight lifters, athletes, heavy workers, etc). Echocardiography is a convenient method of imaging that could be easily applied either during preparticipation screening or during periodical examination of these subjects. Earlier detection of TAA and limitation of such strenuous activities in these individuals may be initial lifesaving measures for the prevention of future cases of aortic aneurysm and dissection.

Keywords: Aortic aneurysm; Echocardiography; Occupation; Strenuous sports; Weight lifting.

Figures

Figure 1)

Representative drawing of aortic root and ascending aorta in accordance with the mean diameters and differences of measurements among groups. OAT Ordinary activity trainers; SAT Strenuous activity trainers

Figure 2)

Representative drawing of aortic root and ascending aorta exposing to expanding force of high blood pressure both at systole (A) and diastole (B)