MedicalResearch.com Interview with:
Maria Korre, ScD
Post-Doctoral Research Fellow
Environmental & Occupational Medicine & Epidemiology Program
Department of Environmental Health
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. It is crucial to note though, that the risk of on-duty CVD events is not evenly distributed among all firefighters, but is highly concentrated among the most susceptible individuals. Given that firefighting is an inherently dangerous occupation and many of its hazards cannot be engineered out of the job, we have concentrated our efforts on understanding what can make an individual firefighter susceptible.
As in the general population, these cardiovascular events are largely due to coronary heart disease (CHD), however, there is an increasing recognition of the role of left ventricular (LV) hypertrophy/cardiomegaly in the risk of sudden cardiac death (SCD) independent of the presence of CHD. Evidence suggests an improved prognostic value, when LV hypertrophy is based on the accurate assessment of LV mass.
LV mass is a strong predictor of CVD events and despite it’s critical prognostic significance, it’s measurement and role in clinical practice has yet to be established.
In this paper we aimed to identify the most important predictors of LV mass after indexing for height among career male firefighters as assessed by both echocardiography and cardiac magnetic resonance.
MedicalResearch.com: What are the main findings?
Response: The major finding of our study was the fact that BMI was the major driver of left ventricular mass among firefighters. In fact, a 1-unit decrease in BMI was associated with 1 unit (g/m1.7) reduction of LV mass index even after adjustment for well-known CVD risk factors.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings taken together with previous research suggest that reducing obesity will improve CVD risk profiles and decrease on-duty CVD and SCD events in the fire service. Clinicians should consider a screening echocardiography for obese firefighters, those with uncontrolled or long-standing hypertension and those with obstructive sleep apnea.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future CVD-outcome based studies are needed to provide evidence on the prognostic value of LVM for the on-duty CVD and SCD events in the fire service.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Korre M, Porto LGG, Farioli A, Yang J, Christiani DC, Christophi CA, Lombardi DA, Kovacs RJ, Mastouri R, Abbasi S, Steigner M, Moffatt S, Smith D, Kales SN, Effect of Body Mass Index on Left Ventricular Mass in Career Male Firefighters, The American Journal of Cardiology (2016), doi: 10.1016/j.amjcard.2016.08.058.
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