{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:40:52Z","timestamp":1772628052586,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Occupational exposures at the WTC site after September 11, 2001 have been associated with several presumably inflammatory lower airway diseases. Pulmonary arterial enlargement, as suggested by an increased ratio of the diameter of the pulmonary artery to the diameter of the aorta (PAAr) has been reported as a computed tomographic (CT) scan marker of adverse respiratory health outcomes, including WTC\u2010related disease. In this study, we sought to utilize a novel quantitative CT (QCT) measurement of PAAr to test the hypothesis that an increased ratio is associated with FEV<jats:sub>1<\/jats:sub> below each subject's statistically determined lower limit of normal (FEV<jats:sub>1<\/jats:sub>\u00a0&lt;\u00a0LLN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a group of 1,180 WTC workers and volunteers, we examined whether FEV<jats:sub>1<\/jats:sub>\u00a0&lt;\u00a0LLN was associated with an increased QCT\u2010measured PAAr, adjusting for previously identified important covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Unadjusted analyses showed a statistically significant association of FEV<jats:sub>1<\/jats:sub>\u00a0&lt;\u00a0LLN with PAAr (35.3% vs 24.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001), as well as with height, body mass index, early arrival at the WTC disaster site, shorter WTC exposure duration, post\u2010traumatic stress disorder checklist (PCL) score, wall area percent and evidence of bronchodilator response. The multivariate logistic regression model confirmed the association of FEV<jats:sub>1<\/jats:sub>\u00a0&lt;\u00a0LLN with PAAr (OR 1.63, 95% CI 1.21, 2.20, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0015) and all the unadjusted associations, except for PCL score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In WTC workers, FEV<jats:sub>1<\/jats:sub>\u00a0&lt;\u00a0LLN is associated with elevated PAAr which, although likely multifactorial, may be related to distal vasculopathy, as has been hypothesized for chronic obstructive pulmonary disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13067","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T06:43:20Z","timestamp":1564123400000},"page":"614-623","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Increased pulmonary artery diameter is associated with reduced FEV<sub>1<\/sub> in former World Trade Center workers"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8949-9279","authenticated-orcid":false,"given":"Rafael E.","family":"de la Hoz","sequence":"first","affiliation":[{"name":"Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York New York"},{"name":"Department of Medicine Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2923-3284","authenticated-orcid":false,"given":"Yunho","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1451-3080","authenticated-orcid":false,"given":"Anthony P.","family":"Reeves","sequence":"additional","affiliation":[{"name":"School of Electrical 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