Researchers Link World Trade Center Responders to Heart Disease

According to two studies conducted by Mount Sinai School of Medicine researchers, the World Trade Center (WTC) collapse has caused potentially dangerous heart problems in responders.

The first study, “First Documentation of Cardiac Dysfunction Following Exposure to the World Trade Center Disaster,” showed that WTC responders have impaired diastolic function of both the right and left ventricle, meaning their hearts do not relax normally, which can put them at risk for heart problems such as shortness of breath and heart failure. More than 50 percent of responders had abnormal relaxation of the left ventricle compared to only 7 percent of people of a similar age in the general population. Greater than 60 percent had isolated impaired diastolic function in the right ventricle of the heart, which pumps blood to the lungs.

Lori Croft, M.D., assistant professor of medicine, and colleagues suspect that debris inhaled from the WTC site may have contributed to these heart abnormalities. They caution, however, that there is no comparison data of people working in a similar urban community plagued by air pollution and life/emotional stresses who were not exposed to the WTC site.

“We know that inhaled debris may be linked to heart and lung disease,” said Croft. “While we still have work to do in determining a definitive connection between heart abnormalities and the World Trade Center collapse, these data are an exciting first step.”

The second study, “Relationship between Erectile Dysfunction and Coronary Artery Calcification in a Population of Middle-Aged Men in the World Trade Center Medical Monitoring and Treatment Program,” is the first to analyze the connection between erectile dysfunction (ED) and coronary artery calcification, or hardening, in middle-aged men (mean age 45.4).

After adjusting for risk factors like diabetes, smoking and body-mass index, Mary Ann McLaughlin, M.D., associate professor of medicine and cardiology, and her team found a significant independent association of ED with coronary artery calcification scores (CACS) in WTC workers.

The study of WTC workers showed that men with ED were 53 percent more likely to have high-risk coronary artery calcification. The hazard ratio for ED was similar to other well-known cardiovascular risk factors such as smoking and hypertension. Coronary artery calcification is a known precursor to heart disease and can eventually lead to heart attack.

“Our study is the largest to date to establish the link between ED and coronary artery calcification in middle-aged men,” said McLaughlin. “These data from WTC workers provide further evidence that erectile dysfunction is an indicator of cardiovascular disease.”

“The findings from these analyses underscore the need to have long-term monitoring of potential health effects related to the WTC disaster,” said Jacqueline Moline, M.D., vice chair of the Department of Preventive Medicine. “They also point to the need to evaluate first responders in general, to ensure that these public safety officers remain healthy and we identify what risk factors might be contributing to any potential health issues.”

Moline acted as principal investigator of the two studies and leads The World Trade Center Medical Monitoring and Treatment Program. Croft and McLaughlin conducted the analyses of 1,236 workers who participated in the program from January 2008 to June 2009.

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