World Trade Center Responders at Heightened Risk for Atherosclerosis, Study Says

Researchers from Mount Sinai have found that responders who experienced high levels of exposure to the initial dust cloud on Sept. 11, 2001, have a greater risk of developing arterial plaque.

In the first study using magnetic resonance imaging (MRI) to evaluate cardiovascular risk in World Trade Center (WTC) first responders, researchers from Mount Sinai School of Medicine have found that the responders who experienced high levels of exposure to the initial dust cloud on Sept. 11, 2001, demonstrate high-risk features of atherosclerosis (plaque in arteries). The data were presented at the American Heart Association's Scientific Sessions 2011 in Orlando, Fla.

Mary Ann McLaughlin, MD, MPH, associate professor of medicine, is the primary investigator for this study and has been evaluating the cardiovascular health of WTC responders since 2007. In addition to the current study, her research has shown more impaired cardiac relaxation and coronary calcification in responders at ground zero, compared with the general population.

First author, Venkatesh Mani, Ph.D., and colleagues, used MRI to evaluate the blood vessels of 19 responders exposed to the high levels of particulate matter from the dust cloud, and 12 exposed to the lower levels. They found that WTC workers who were exposed to the initial dust cloud had higher blood vessel formation in their artery plaque compared to people with lower exposure. Co-investigator, Simonette Sawit, MD, also demonstrated impaired vascular reactivity, or dysfunction of the inner lining of blood vessels, in those with higher dust exposure. This dysfunction may accelerate the progression of atherosclerosis. The Mount Sinai team discovered this association in WTC workers independent of other clinical factors.

"Using noninvasive MRI imaging, we were able to see a significant impact of the events of 9/11 on the cardiovascular health of the brave men and women who responded that day," said Zahi Fayad, Ph.D., professor of radiology and medicine in the Division of Cardiology and director of the Translational and Molecular Imaging Institute at Mount Sinai School of Medicine. "Now that we have visualized the risk and early development of vascular lesions in a subset of subjects, we look forward to studying the use of imaging in the greater patient population."

"This study defines physiologic change associated with greater exposure to the dust cloud at the WTC site," said McLaughlin said. "We are currently evaluating other predictors of cardiovascular risk in this population to gain a better understanding of the impact of particulate matter exposure on cardiovascular health."

This research was funded by Clinical and Translational Science Award, the Translational and Molecular Imaging Institute, Mount Sinai School of Medicine. The WTC Clinical Center of Excellence at Mount Sinai is a treatment and monitoring program for emergency responders, recovery workers, residents, and area workers who were affected by the terrorist attacks in New York City on 9/11. The program identifies mental and physical health problems needing timely treatment; evaluates the health of first responders; monitors the development of symptoms; and researches the effects of 9/11 through data collection and analysis.

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