{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:26:02Z","timestamp":1770971162866,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,7,16]]},"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We hypothesise that there is an association between an elevated pulmonary artery\/aorta (PA\/A) and World Trade Center-Lung Injury (WTC-LI). We assessed if serum vascular disease biomarkers were predictive of an elevated PA\/A.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective case-cohort analysis of thoracic CT scans of WTC-exposed firefighters who were symptomatic between 9\/12\/2001 and 3\/10\/2008. Quantification of vascular-associated biomarkers from serum collected within 200\u2005days of exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Urban tertiary care centre and occupational healthcare centre.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Male never-smoking firefighters with accurate pre-9\/11 forced expiratory volume in 1\u2005s (FEV<jats:sub>1<\/jats:sub>) \u226575%, serum sampled \u2264200\u2005days of exposure was the baseline cohort (n=801). A subcohort (n=97) with available CT scans and serum biomarkers was identified. WTC-LI was defined as FEV<jats:sub>1<\/jats:sub>\u226477% at the subspecialty pulmonary evaluation (n=34) and compared with controls (n=63) to determine the associated PA\/A ratio. The subcohort was restratified based on PA\/A\u22650.92 (n=38) and PA\/A&lt;0.92(n=59) to determine serum vascular biomarkers that were predictive of this vasculopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>The primary outcome of this study was to identify a PA\/A ratio in a cohort of individuals exposed to WTC dust that was associated with WTC-LI. The secondary outcome was to identify serum biomarkers predictive of the PA\/A ratio using logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>PA\/A\u22650.92 was associated with WTC-LI, OR of 4.02 (95% CI 1.21 to 13.41; p=0.023) when adjusted for exposure, body mass index and age at CT. Elevated macrophage derived chemokine and soluble endothelial selectin were predictive of PA\/A\u22650.92, (OR, 95% CI 2.08, 1.05 to 4.11, p=0.036; 1.33, 1.06 to 1.68, p=0.016, respectively), while the increased total plasminogen activator inhibitor 1 was predictive of not having PA\/A\u22650.92 (OR 0.88, 0.79 to 0.98; p=0.024).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Elevated PA\/A was associated with WTC-LI. Development of an elevated PA\/A was predicted by biomarkers of vascular disease found in serum drawn within 6\u2005months of WTC exposure. Increased PA\/A is a potentially useful non-invasive biomarker of WTC-LI and warrants further study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005575","type":"journal-article","created":{"date-parts":[[2014,9,30]],"date-time":"2014-09-30T20:17:47Z","timestamp":1412108267000},"page":"e005575","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Enlarged pulmonary artery is predicted by vascular injury biomarkers and is associated with WTC-Lung Injury in exposed fire fighters: a case\u2013control study"],"prefix":"10.1136","volume":"4","author":[{"given":"Edward J","family":"Schenck","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghislaine C","family":"Echevarria","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University, School of Medicine, New York, New York, USA"},{"name":"Divisi\u00f3n de Anestesiolog\u00eda, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis G","family":"Girvin","sequence":"additional","affiliation":[{"name":"Department of Radiology, New York University Langone Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley L","family":"Comfort","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William N","family":"Rom","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"},{"name":"Department of Environmental Medicine, New York University, School of Medicine, Tuxedo Park, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Prezant","sequence":"additional","affiliation":[{"name":"Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, USA"},{"name":"Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D","family":"Weiden","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"},{"name":"Department of Environmental Medicine, New York University, School of Medicine, Tuxedo Park, New York, USA"},{"name":"Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Nolan","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, USA"},{"name":"Department of Environmental Medicine, New York University, School of Medicine, Tuxedo Park, New York, USA"},{"name":"Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,9,29]]},"reference":[{"key":"2025101814053740000_4.9.e005575.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1580"},{"key":"2025101814053740000_4.9.e005575.2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00077012"},{"key":"2025101814053740000_4.9.e005575.3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201109-1672OC"},{"key":"2025101814053740000_4.9.e005575.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-1202"},{"key":"2025101814053740000_4.9.e005575.5","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.12.2107137"},{"issue":"(2 Pt 1)","key":"2025101814053740000_4.9.e005575.6","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1164\/ajrccm.151.2.7842197","article-title":"Rapid decline in Fev1. 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