Obstructive Sleep Apnoea and Left Ventricular Diastolic Dysfunction Among First Responders to the 9/11 World Trade Center Terrorist Attack: A Cross-Sectional Study

Details

• Personal Author:
  Croft LB ; Crowley LE ; Iyengar-Kapuganti RL ; Maceda CS ; McLaughlin MA ; Sawit ST ; Woodward M
• Description:
  Objectives: Obstructive sleep apnoea (OSA) is often linked to cardiovascular disease. A limited number of studies have reported an association between OSA and left ventricular diastolic dysfunction (LVDD). However, prior studies were performed on small patient populations. Studies have shown a high prevalence of OSA among first responders to the 9/11 World Trade Center (WTC) terrorist attack. We investigated the relationship between OSA and LVDD in a large population of WTC responders. Design: Cross-sectional study. Setting: One-time screening programme as part of the WTC-CHEST Study (NCT10466218), performed at a quaternary medical centre in New York City, from November 2011 to June 2014. Participants: A total of 1007 participants with mean age of 51 years of mostly non-Hispanic white men were evaluated. Patients from the WTC Health Program-Clinical Center of Excellence, who were over the age of 39 years, were eligible to participate. Results: Evaluation of those without OSA diagnosis showed no significant association with LVDD when comparing those screened (Berlin Questionnaire) as OSA high risk versus OSA low risk (p=0.101). Among those diagnosed with LVDD, there was a significant association when comparing those with and without patient-reported OSA (OR 1.50, 95% CI 1.13 to 2.00, p=0.005), but the significance was not maintained after adjusting for pertinent variables (OR 1.3, 0.94 to 1.75, p=0.119). Notably, comparing those with OSA diagnosis and those low risk of OSA, the OR for LVDD was significant (1.69, 1.24 to 2.31, p=0.001), and after adjusting for waist-hip ratio, diabetes and coronary artery calcium score percentile, the relationship remained significant (OR 1.45, 1.03 to 2.04, p=0.032). Conclusion: The strong association of OSA with LVDD in this population may inform future guidelines to recommend screening for LVDD in high-risk asymptomatic patients with OSA. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Emergency Responders Occupational Health Safety September 11 Terrorist Attacks Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  World Trade Center; WTC; Emergency responders; Sleep disorders; Cardiac function; Cardiovascular system disorders; Cross sectional studies
• DOI:
  https://doi.org/10.1136/bmjopen-2021-058366
• ISSN:
  2044-6055
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  12
• Issue:
  4
• NIOSHTIC Number:
  nn:20065331
• Citation:
  BMJ Open 2022 Apr; 12(4):e058366
• Contact Point Address:
  Dr Rupa Lakshmi Iyengar-Kapuganti, Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, New York, USA
• Email:
  rupa.iyengar@mssm.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20110701
• Source Full Name:
  BMJ Open
• End Date:
  20140630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:30685b2efce5b556da3eae1f5c6572e399acce2cb6760699e2f8b234d32418b374d79e050354d47ef80e034c6816fcf6b3c238968a924eec4de25c374f139a69
• Download URL:
  https://stacks.cdc.gov/view/cdc/248939/cdc_248939_DS1.pdf
• File Type:
  [PDF - 309.89 KB ]