{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:06:29Z","timestamp":1777907189342,"version":"3.51.4"},"reference-count":43,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["BAA Contract 200-2011-39405"],"award-info":[{"award-number":["BAA Contract 200-2011-39405"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,21]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Obstructive sleep apnoea (OSA) is often linked to cardiovascular disease. A limited number of studies have reported an association between OSA and left ventricular diastolic dysfunction (LVDD). However, prior studies were performed on small patient populations. Studies have shown a high prevalence of OSA among first responders to the 9\/11 World Trade Center (WTC) terrorist attack. We investigated the relationship between OSA and LVDD in a large population of WTC responders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      One-time screening programme as part of the WTC-CHEST Study (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT10466218\">NCT10466218<\/jats:ext-link>\n                      ), performed at a quaternary medical centre in New York City, from November 2011 to June 2014.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 1007 participants with mean age of 51 years of mostly non-Hispanic white men were evaluated. Patients from the WTC Health Program-Clinical Center of Excellence, who were over the age of 39 years, were eligible to participate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Evaluation of those without OSA diagnosis showed no significant association with LVDD when comparing those screened (Berlin Questionnaire) as OSA high risk versus OSA low risk (p=0.101). Among those diagnosed with LVDD, there was a significant association when comparing those with and without patient-reported OSA (OR 1.50, 95% CI 1.13 to 2.00, p=0.005), but the significance was not maintained after adjusting for pertinent variables (OR 1.3, 0.94 to 1.75, p=0.119). Notably, comparing those with OSA diagnosis and those low risk of OSA, the OR for LVDD was significant (1.69, 1.24 to 2.31, p=0.001), and after adjusting for waist\u2013hip ratio, diabetes and coronary artery calcium score percentile, the relationship remained significant (OR 1.45, 1.03 to 2.04, p=0.032).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The strong association of OSA with LVDD in this population may inform future guidelines to recommend screening for LVDD in high-risk asymptomatic patients with OSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-058366","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T12:23:02Z","timestamp":1650370982000},"page":"e058366","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Obstructive sleep apnoea and left ventricular diastolic dysfunction among first responders to the 9\/11 World Trade Center terrorist attack: a cross-sectional study"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct10466218","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct10466218","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5013-3694","authenticated-orcid":false,"given":"Rupa Lakshmi","family":"Iyengar-Kapuganti","sequence":"first","affiliation":[{"name":"Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynara S","family":"Maceda","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori B","family":"Croft","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simonette T","family":"Sawit","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Medical City, Pasig City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura E","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health, Icahn Shcool of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[{"name":"Department of Medicine, The George Institute of Global Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Department of Medicine, The George Institute of Global Health, Imperial College 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