Effect of Body Mass Index on Left Ventricular Mass in Career Male Firefighters.
Left ventricular (LV) mass is a strong predictor of cardiovascular disease (CVD) events; increased LV mass is common among US firefighters and plays a major role in firefighter sudden cardiac death. We aim to identify significant predictors of LV mass among firefighters. Cross-sectional study of 400 career male firefighters selected by an enriched randomization strategy. Weighted analyses were performed based on the total number of risk factors per subject with inverse probability weighting. LV mass was assessed by echocardiography (ECHO) and cardiac magnetic resonance, and normalized (indexed) for height. CVD risk parameters included vital signs at rest, body mass index (BMI)-defined obesity, obstructive sleep apnea risk, low cardiorespiratory fitness, and physical activity. Linear regression models were performed. In multivariate analyses, BMI was the only consistent significant independent predictor of LV mass indexes (all, p <0.001). A 1-unit decrease in BMI was associated with 1-unit (g/m1.7) reduction of LV mass/height1.7after adjustment for age, obstructive sleep apnea risk, and cardiorespiratory fitness. In conclusion, after height-indexing ECHO-measured and cardiac magnetic resonance-measured LV mass, BMI was found to be a major driver of LV mass among firefighters. Our findings taken together with previous research suggest that reducing obesity will improve CVD risk profiles and decrease on-duty CVD and sudden cardiac death events in the fire service. Our results may also support targeted noninvasive screening for LV hypertrophy with ECHO among obese firefighters.
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts.
Maria
M
Korre
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Faculty of Physical Education, Cardiovascular Laboratory of the Faculty of Medicine, University of Brasilia, Brasilia, Brazil.
Luiz Guilherme G
LG
Porto
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts; Department of Medical and Surgical Sciences, University of Bologna, Italy.
Andrea
A
Farioli
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Justin
J
Yang
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
David C
DC
Christiani
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
Costas A
CA
Christophi
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts.
David A
DA
Lombardi
Department of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
Richard J
RJ
Kovacs
Department of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
Ronald
R
Mastouri
Department of Cardiology, Providence Veteran Affairs Medical Center, Cardiovascular Institute of the Alpert Medical School of Brown University, Providence, Rhode Island.
Siddique
S
Abbasi
Heart & Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts.
Michael
M
Steigner
Public Safety Medical, Indianapolis, Indiana.
Steven
S
Moffatt
Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, New York, New York.
Denise
D
Smith
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts. Electronic address: skales@hsph.harvard.edu.
Stefanos N
SN
Kales
D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004452:Echocardiography; D061388:Firefighters; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D018570:Risk Assessment; D012307:Risk Factors; D016277:Ventricular Function, Left
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