Researchers from Mount Sinai School of Medicine are presenting more than 20 ground-breaking studies at the American College of Cardiology (ACC) 59th annual scientific session (ACC.10) in Atlanta. Their research includes data showing that the World Trade Center (WTC) collapse has caused potentially dangerous heart problems in responders on-site.
Jacqueline Moline, MD, Vice Chair, Department of Preventive Medicine, Mount Sinai School of Medicine leads The World Trade Center Medical Monitoring and Treatment Program. The Program provided federal funding for two WTC heart studies, of which Dr. Moline is the primary investigator. Lori Croft, MD, Assistant Professor of Medicine and Mary Ann McLaughlin, MD, Associate Professor, Medicine and Cardiology, conducted the analyses of 1,236 workers who participated in the program from January 2008 to June 2009.
Dr. Croft's study, "First Documentation of Cardiac Dysfunction Following Exposure to the World Trade Center Disaster," showed that 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 had abnormal relaxation of the left ventricle compared to only seven 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.
Dr. Croft and her colleagues suspect that debris inhaled from the WTC site may have contributed to these heart abnormalities, however, caution that there is no comparison data of people working in a similar urban community plagued by air pollution and life and emotional stresses who were not exposed to the WTC.
"We know that inhaled debris may be linked to heart and lung disease," said Dr. 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."
Dr. McLaughlin's 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, Dr. McLaughlin's 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 Dr. 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 Dr. Moline. "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."
Dr. Croft's data was presented at ACC.10 on Monday, March 15, 2010. McLaughlin's data is presented on Tuesday, March 16, 2010 from 9:30 a.m. to 12:30 p.m.
The World Trade Center Medical Monitoring and Treatment Program's Mount Sinai-coordinated Consortium of Clinical Centers of Excellence have medically screened nearly 27,000 WTC rescue and recovery workers and volunteers in all 50 states since the program kicked off in July of 2002. The Program has also provided more than 53,000 medical monitoring exams and is federally funded and supported through a grant administered by the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control.
About The World Trade Center Medical Monitoring and Treatment Program
The World Trade Center Medical Monitoring and Treatment Program, with funding from the federal government, offers free, confidential medical and mental health evaluation, long-term monitoring and treatment for eligible WTC rescue, recovery and clean-up workers, including volunteers, who responded to the Sept. 11th, 2001 terrorist attacks in New York. Medical screening and periodic medical monitoring examinations, as well as both out- and in-patient treatment services as may be needed for World Trade Center-related medical and mental health conditions is being offered at a number of NY/NJ metro-area occupational medicine clinical centers and nationwide. Mount Sinai Center for Occupational & Environmental Medicine has taken a lead in developing the program that stands as the federal government's principal public health response to 9/11, Mount Sinai continues to coordinate a NY-NJ Consortium of occupational medicine providers of program services.
The Program also maintains data through two Data and Coordination Centers, one coordinated by Mount Sinai (School of Medicine) and one by the FDNY, complementing the latter agency's matching service program for current and retired NYC Fire Dept. employees. Non-identifying data is periodically pooled and analyzed across the programs to expand the scientific understanding of health impacts resultant from WTC exposures, assure best practices of care for responders in need, and help inform future health response to such emergencies.
About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai Hospital is one of the nation's oldest, largest and most-respected voluntary hospitals. Founded in 1852, Mount Sinai today is a 1,171-bed tertiary-care teaching facility that is internationally acclaimed for excellence in clinical care. Last year, nearly 60,000 people were treated at Mount Sinai as inpatients, and there were nearly 450,000 outpatient visits to the Medical Center.
Mount Sinai School of Medicine is internationally recognized as a leader in groundbreaking clinical and basic science research, as well as having an innovative approach to medical education. With a faculty of more than 3,400 in 38 clinical and basic science departments and centers, Mount Sinai ranks among the top 20 medical schools in receipt of National Institute of Health (NIH) grants. For more information, please visit www.mountsinai.org.