The Effects of G-force on Echocardiographic Parameters: Two Decades of Echocardiographic Follow-Up in Air Force Pilots

Background: Very little is known about the long-term effects of sustained flight exposure among pilots, particularly across different G-force profiles. This study aims to evaluate echocardiographic variations in air-force pilots over a follow-up period of more than two decades.

Methods: A cohort of 98 consecutive air-force pilots was evaluated through serial echocardiographs conducted between the years 1990 and 2024. Echocardiographic parameters, including valvular abnormalities and pulmonary pressures, were recorded over time. Subjects were divided into those with exposure to high-performance (G-force > 3) vs. low-performance pilots.

Results: The median age was 51 years (IQR: 51–52) with a median flight experience of 28 years (IQR: 23–31). There were 63 pilots exposed to high G-force and 35 low-performance pilots. Over the follow-up period, only 2 cases of mild aortic regurgitation were observed. Additionally, 13 cases of mitral regurgitation were noted, distributed as follows: 7 (11%) in the high-performance group vs. 6 (17%) in the low-performance group (p = 0.59). No cases of elevated pulmonary artery pressure were detected during follow-up.

Conclusions: Over a long-term follow-up period exceeding two decades, only minimal valvular alterations were observed among air-force pilots. These findings suggest that valvular integrity is largely preserved despite prolonged exposure to varying G-forces.