{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T21:46:45Z","timestamp":1782251205054,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000006","name":"Office of Naval Research","doi-asserted-by":"publisher","award":["N000142312829"],"award-info":[{"award-number":["N000142312829"]}],"id":[{"id":"10.13039\/100000006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Like structural firefighting, shipboard firefighting requires extreme exertion. However, shipboard firefighting may be a unique cardiovascular stress as most sailors lack extensive firefighting experience and may complete significant work before reaching the fire scene. Several indices of acute cardiovascular impairment have been associated with the high prevalence of sudden cardiac death among structural firefighters. However, acute cardiovascular responses to shipboard firefighting have yet to be described. The aim of this study was to investigate cardiac, macrovascular and microvascular responses to simulated shipboard firefighting. Nineteen participants donned protective equipment before completing the simulated shipboard firefighting protocol (SBFFP), which included lifting, striking and pulling tasks repeated until a stopping criterion was met (maximum heart rate, volitional fatigue, breathing air supply depleted). Echocardiography, aortic and brachial blood pressure, subendocardial viability ratio (SEVR), and reactive hyperaemia index were measured before, after and 1\u00a0h after the protocol. Immediately after SBFFP, left ventricular end diastolic and systolic diameter, brachial systolic blood pressure, SEVR, and the reactive hyperaemia index decreased (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0\u2264\u00a00.0121), while ventricular fractional shortening increased (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.0001). All of these metrics returned to baseline after 1\u00a0h (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0\u2265\u00a00.0699), except SEVR, which remained decreased (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.0400). There were no changes in aortic blood pressures (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0\u2265\u00a00.0671). These data represent the cardiovascular strain and subsequent impairment expected after shipboard firefighting operations, and may be mechanisms contributing to acutely increased risk of cardiac events after firefighting.\n                  <\/jats:p>","DOI":"10.1113\/ep092779","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:21:41Z","timestamp":1773120101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute cardiovascular changes following heat exposure during simulated shipboard firefighting"],"prefix":"10.1113","author":[{"given":"Daniel K.","family":"Sweet","sequence":"first","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Lavoie","sequence":"additional","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden W.","family":"Hess","sequence":"additional","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Inglis","sequence":"additional","affiliation":[{"name":"Department of Pathology and Anatomical Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Monaco","sequence":"additional","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"},{"name":"Department of Emergency Medicine University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Luke","family":"Pryor","sequence":"additional","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7711-4001","authenticated-orcid":false,"given":"David","family":"Hostler","sequence":"additional","affiliation":[{"name":"Center for Research and Education in Special Environments, Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"},{"name":"Department of Emergency Medicine University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"9","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1097\/JOM.0000000000000507","article-title":"Electrocardiographic responses during fire suppression and recovery among experienced firefighters","volume":"57","author":"Al\u2010Zaiti S.","year":"2015","journal-title":"Journal of Occupational and Environmental Medicine"},{"issue":"1","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s12940-017-0303-8","article-title":"Cardiovascular health effects following exposure of human volunteers during fire extinction exercises","volume":"16","author":"Andersen M. H. G.","year":"2017","journal-title":"Environmental Health"},{"issue":"3","key":"e_1_2_8_4_1","first-page":"225","article-title":"Physiological responses during shipboard firefighting","volume":"66","author":"Bennett B. L.","year":"1995","journal-title":"Aviation Space and Environmental Medicine"},{"issue":"7","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1002\/oby.23175","article-title":"Cardiovascular disease risk factors by BMI and age in United States firefighters","volume":"29","author":"Bode E. D.","year":"2021","journal-title":"Obesity"},{"issue":"11","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/j.jacc.2004.08.062","article-title":"Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia","volume":"44","author":"Bonetti P. O.","year":"2004","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/10803548.2007.11076730","article-title":"Cardiovascular stress, energy expenditure and subjective perceived ratings of fire fighters during typical fire suppression and rescue tasks","volume":"13","author":"Bugajska J.","year":"2007","journal-title":"International Journal of Occupational Safety and Ergonomics"},{"issue":"11","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1097\/JOM.0b013e3182619018","article-title":"Acute cardiovascular effects of firefighting and active cooling during rehabilitation","volume":"54","author":"Burgess J. L.","year":"2012","journal-title":"Journal of Occupational and Environmental Medicine"},{"key":"e_1_2_8_9_1","unstructured":"Campbell R. Hall S. &Petrillo J.(2024).Fatal Firefighter Injuries in the United States.National Fire Protection Association.Quincy MA."},{"issue":"12","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1249\/MSS.0b013e318180bc98","article-title":"Heat stress and baroreflex regulation of blood pressure","volume":"40","author":"Crandall C. G.","year":"2008","journal-title":"Medicine and Science in Sports and Exercise"},{"issue":"3","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1177\/1358863X07081134","article-title":"Indices of cardiovascular function derived from peripheral pulse wave analysis using radial applanation tonometry: A measurement repeatability study","volume":"12","author":"Crilly M.","year":"2007","journal-title":"Vascular Medicine"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ijcard.2021.02.085","article-title":"Relationship between peripheral arterial reactive hyperemia and the index of myocardial resistance in patients undergoing invasive coronary angiography","volume":"333","author":"Di Serafino L.","year":"2021","journal-title":"International Journal of Cardiology"},{"issue":"2","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1358863X11404940","article-title":"Acute effects of firefighting on arterial stiffness and blood flow","volume":"16","author":"Fahs C. A.","year":"2011","journal-title":"Vascular Medicine"},{"issue":"2","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00421-011-2033-x","article-title":"Acute effects of firefighting on cardiac performance","volume":"112","author":"Fernhall B.","year":"2012","journal-title":"European Journal of Applied Physiology"},{"issue":"2","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.3390\/nu8020085","article-title":"Cardiometabolic health in submariners returning from a 3\u2010month patrol","volume":"8","author":"Gasier H. G.","year":"2016","journal-title":"Nutrients"},{"issue":"2","key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1002\/j.2040-4603.2017.tb00750.x","article-title":"Regulation of coronary blood flow","volume":"7","author":"Goodwill A.","year":"2017","journal-title":"Comprehensive Physiology"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/eurheartj\/11.suppl_C.2","article-title":"Diastolic function and heart failure: An overview","volume":"11","author":"Grossman W.","year":"1990","journal-title":"European Heart Journal"},{"issue":"3","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s00421-021-04859-2","article-title":"Effect of live\u2010fire training on ventricular\u2010vascular coupling","volume":"122","author":"Hibner B. A.","year":"2022","journal-title":"European Journal of Applied Physiology"},{"issue":"2","key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3109\/10903127.2010.545474","article-title":"Physiological recovery from firefighting activities in rehabilitation and beyond","volume":"15","author":"Horn G. P.","year":"2011","journal-title":"Prehospital Emergency Care"},{"issue":"6","key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"681","DOI":"10.3109\/10903127.2016.1168890","article-title":"Effect of two work\u2010to\u2010rest ratios on cardiovascular, thermal, and perceptual responses during fire suppression and recovery","volume":"20","author":"Hostler D.","year":"2016","journal-title":"Prehospital Emergency Care"},{"issue":"1","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00421-011-1946-8","article-title":"The exercise dose affects oxidative stress and brachial artery flow\u2010mediated dilation in trained men","volume":"112","author":"Johnson B. D.","year":"2012","journal-title":"European Journal of Applied Physiology"},{"issue":"12","key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1056\/NEJMoa060357","article-title":"Emergency duties and deaths from heart disease among firefighters in the United States","volume":"356","author":"Kales S. N.","year":"2007","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s00421-025-05906-y","article-title":"Examination of post\u2010exercise microvascular reactivity in healthy adults","volume":"126","author":"Landers\u2010Ramos R. Q.","year":"2025","journal-title":"European Journal of Applied Physiology"},{"issue":"12","key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1519\/JSC.0000000000004577","article-title":"Evaluation of work efficiency in structural firefighters","volume":"37","author":"Langford E. L.","year":"2023","journal-title":"Journal of Strength and Conditioning Research"},{"issue":"3","key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/1358863X20987608","article-title":"Firefighter hemodynamic responses to different fire training environments","volume":"26","author":"Lefferts E. C.","year":"2021","journal-title":"Vascular Medicine"},{"issue":"11","key":"e_1_2_8_26_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.002270","article-title":"Prognostic value of flow\u2010mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: A systematic review and meta\u2010analysis","volume":"4","author":"Matsuzawa Y.","year":"2015","journal-title":"Journal of the American Heart Association"},{"issue":"26","key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1093\/eurheartj\/eht565","article-title":"Central blood pressure: Current evidence and clinical importance","volume":"35","author":"McEniery C. M.","year":"2014","journal-title":"European Heart Journal"},{"issue":"5","key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1161\/01.CIR.85.5.1743","article-title":"Altered myocardial force\u2010frequency relation in human heart failure","volume":"85","author":"Mulieri L. A.","year":"1992","journal-title":"Circulation"},{"issue":"8","key":"e_1_2_8_29_1","first-page":"1289","article-title":"Noninvasive microvascular indices reveal peripheral vascular abnormalities in patients with suspected coronary microvascular dysfunction","volume":"36","author":"Nardone M.","year":"2019","journal-title":"The Canadian journal of cardiology"},{"issue":"3","key":"e_1_2_8_30_1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/1358863X15571447","article-title":"Effect of aspirin on acute changes in peripheral arterial stiffness and endothelial function following exertional heat stress in firefighters: The factorial group results of the enhanced firefighter rehab trial","volume":"20","author":"Olafiranye O.","year":"2015","journal-title":"Vascular Medicine"},{"issue":"4","key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1161\/hy1001.096106","article-title":"Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform","volume":"38","author":"Pauca A. L.","year":"2001","journal-title":"Hypertension"},{"issue":"3","key":"e_1_2_8_32_1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1152\/jappl.1964.19.3.531","article-title":"A new weighting system for mean surface temperature of the human body","volume":"19","author":"Ramanathan N. L.","year":"1964","journal-title":"Journal of Applied Physiology"},{"issue":"7","key":"e_1_2_8_33_1","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.3390\/healthcare11071032","article-title":"Comparison of acute arterial responses following a rescue simulation and maximal exercise in professional firefighters","volume":"11","author":"Santos V.","year":"2023","journal-title":"Healthcare"},{"issue":"5","key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1249\/MSS.0000000000001191","article-title":"Heat strain is exacerbated on the second of consecutive days of fire suppression","volume":"49","author":"Schlader Z. J.","year":"2017","journal-title":"Medicine and Science in Sports and Exercise"},{"issue":"6","key":"e_1_2_8_35_1","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1161\/01.HYP.0000223013.60612.72","article-title":"Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise","volume":"47","author":"Sharman J. E.","year":"2006","journal-title":"Hypertension"},{"issue":"3","key":"e_1_2_8_36_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1249\/JES.0000000000000081","article-title":"Cardiovascular strain of firefighting and the risk of sudden cardiac events","volume":"44","author":"Smith D. L.","year":"2016","journal-title":"Exercise and Sport Sciences Reviews"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaf584"},{"issue":"1","key":"e_1_2_8_38_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1358863X241288139","article-title":"Changes in the reactive hyperemia index after continuous and interval exercise","volume":"30","author":"Sweet D. K.","year":"2025","journal-title":"Vascular Medicine"},{"issue":"1","key":"e_1_2_8_39_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0735-1097(00)01054-8","article-title":"Age\u2010predicted maximal heart rate revisited","volume":"37","author":"Tanaka H.","year":"2001","journal-title":"Journal of the American College of Cardiology"},{"issue":"8","key":"e_1_2_8_40_1","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.70340","article-title":"Association between peripheral and coronary microvascular function and the impact of myocardial bridging","volume":"13","author":"Toya T.","year":"2025","journal-title":"Physiological Reports"},{"issue":"2","key":"e_1_2_8_41_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0895-7061(98)00280-5","article-title":"Heart rate and the rate\u2010pressure product as determinants of cardiovascular risk in patients with hypertension","volume":"12","author":"White W.","year":"1998","journal-title":"American Journal of Hypertension"},{"issue":"7","key":"e_1_2_8_42_1","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1093\/milmed\/usae483","article-title":"Fire at sea: A 70\u2010year review of fire\u2010related mass casualty events on U.S. aircraft carriers","volume":"190","author":"Wickard A. S.","year":"2025","journal-title":"Military Medicine"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP092779","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/full-xml\/10.1113\/EP092779","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP092779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:21:48Z","timestamp":1773120108000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/EP092779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":41,"alternative-id":["10.1113\/EP092779"],"URL":"https:\/\/doi.org\/10.1113\/ep092779","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"EP092779"}}