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Title: Effect of Body Mass Index on Left Ventricular Mass in Career Male Firefighters
Authors: Korre, Maria 
Porto, Luiz Guilherme Grossi 
Farioli, Andrea 
Yang, Justin 
Christiani, David C. 
Christophi, Costas A. 
Lombardi, David A. 
Kovacs, Richard J. 
Mastouri, Ronald 
Abbasi, Siddique A. 
Steigner, Michael L. 
Moffatt, Steven 
Smith, Denise Louise 
Kales, Stefanos N. 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Left ventricular mass;Cardiovascular disease;Cardiac death
Issue Date: 1-Dec-2016
Source: American Journal of Cardiology, 2016, vol. 118, no.11, pp.1769-1773
Volume: 118
Issue: 11
Start page: 1769
End page: 1773
Journal: The American Journal of Cardiology 
Abstract: 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/height1.7 after 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.
ISSN: 0002-9149
DOI: 10.1016/j.amjcard.2016.08.058
Rights: © Elsevier
Type: Article
Affiliation : Connecticut Department of Public Health 
Alma Mater Studiorum Universita di Bologna 
Massachusetts General Hospital and Harvard Medical School 
Cyprus University of Technology 
Krannert Institute Cardiology 
Brigham and Women's Hospital 
Universidade do Porto 
Public Safety Medical Services 
Skidmore College 
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