Advertisement

Effect of Obesity on Acute Hemostatic Responses to Live-Fire Training Drills

Published:September 14, 2014DOI:https://doi.org/10.1016/j.amjcard.2014.08.046
      The objective of this study was to evaluate the impact of obesity and firefighting activities on coagulation and fibrinolytic activity in relatively young, apparently healthy firefighters. Firefighters performed simulated firefighting activities for 18 minutes in a live-fire training structure. Blood samples were obtained at baseline, before firefighting, and within a few minutes of completing the activity. Nearly all markers of coagulation and fibrinolytic activity increased immediately after firefighting with an overall shift toward a procoagulatory profile. Obese firefighters exhibited lower levels of tissue plasminogen activator activity (0.98 vs 0.63 IU/ml) and higher levels of plasminogen activator inhibitor-1 activity (2.2 vs 4.5 ng/ml) at baseline compared with normal-weight firefighters, suggesting that fibrinolytic activity was lower in obese firefighters. There were few interactions between body mass index and firefighting activity, thus our findings suggest that obese firefighters did not exhibit a greater procoagulatory response to live firefighting compared with normal-weight firefighters. Acute live firefighting produced increases in both fibrinolytic and coagulatory responses; although obesity was associated with a reduced fibrinolytic profile at baseline, the changes produced by acute firefighting were similar in obese and nonobese firefighters.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Geibe J.R.
        • Holder J.
        • Peeples L.
        • Kinney A.M.
        • Burress J.W.
        • Kales S.N.
        Predictors of on-duty coronary events in male firefighters in the United States.
        Am J Cardiol. 2008; 101: 585-589
        • Holder J.D.
        • Stallings L.A.
        • Peeples L.
        • Burress J.W.
        • Kales S.N.
        Firefighter heart presumption retirements in Massachusetts 1997-2004.
        J Occup Environ Med. 2006; 48: 1047-1053
        • Mertens I.
        • Van Gaal L.F.
        Obesity, haemostasis and the fibrinolytic system.
        Obes Rev. 2002; 3: 85-101
        • Mertens I.
        • Van der Planken M.
        • Corthouts B.
        • Wauters M.
        • Peiffer F.
        • De Leeuw I.
        • Van Gaal L.
        Visceral fat is a determinant of PAI-1 activity in diabetic and non-diabetic overweight and obese women.
        Horm Metab Res. 2001; 33: 602-607
        • Szymanski L.M.
        • Durstine J.L.
        • Davis P.G.
        • Dowda M.
        • Pate R.R.
        Factors affecting fibrinolytic potential: cardiovascular fitness, body composition, and lipoprotein(a).
        Metabolism. 1996; 45: 1427-1433
        • Morris P.J.
        • Packianathan C.I.
        • Van Blerk C.J.
        • Finer N.
        Moderate exercise and fibrinolytic potential in obese sedentary men with metabolic syndrome.
        Obes Res. 2003; 11: 1333-1338
        • Van Guilder G.P.
        • Hoetzer G.L.
        • Smith D.T.
        • Irmiger H.M.
        • Greiner J.J.
        • Stauffer B.L.
        • DeSouza C.A.
        Endothelial t-PA release is impaired in overweight and obese adults but can be improved with regular aerobic exercise.
        Am J Physiol Endocrinol Metab. 2005; 289: E807-813
        • Fahs C.A.
        • Smith D.L.
        • Horn G.P.
        • Agiovlasitis S.
        • Rossow L.M.
        • Echols G.
        • Heffernan K.S.
        • Fernhall B.
        Impact of excess body weight on arterial structure, function, and blood pressure in firefighters.
        Am J Cardiol. 2009; 104: 1441-1445
        • Smith D.L.
        • Fehling P.C.
        • Frisch A.
        • Haller J.M.
        • Winke M.
        • Dailey M.W.
        The prevalence of cardiovascular disease risk factors and obesity in firefighters.
        J Obes. 2012; : 908267
        • Tsismenakis A.J.
        • Christophi C.A.
        • Burress J.W.
        • Kinney A.M.
        • Kim M.
        • Kales S.N.
        The obesity epidemic and future emergency responders.
        Obesity. 2009; 17: 1648-1650
        • Dill D.
        • Costill D.
        Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration.
        J Appl Physiol. 1974; 37: 247-248
        • Smith D.L.
        • Petruzzello S.J.
        • Goldstein E.
        • Ahmad U.
        • Tangella K.
        • Freund G.G.
        • Horn G.P.
        Effect of live-fire training drills on firefighters' platelet number and function.
        Prehosp Emerg Care. 2011; 15: 233-239
        • Smith D.L.
        • Horn G.P.
        • Petruzzello S.J.
        • Fahey G.
        • Woods J.
        • Fernhall B.
        Clotting and fibrinolytic changes following firefighting activities.
        Med Sci Sports Exerc. 2014; 46: 448-454
        • DeSouza C.A.
        • Jones P.P.
        • Seals D.R.
        Physical activity status and adverse age-related differences in coagulation and fibrinolytic factors in women.
        Arterioscler Thromb Vasc Biol. 1998; 18: 362-368
        • Darvall K.A.
        • Sam R.C.
        • Silverman S.H.
        • Bradbury A.W.
        • Adam D.J.
        Obesity and thrombosis.
        Eur J Vasc Endovasc Surg. 2007; 33: 223-233
        • Singh A.
        • Foster G.D.
        • Gunawardana J.
        • McCoy T.A.
        • Nguyen T.
        • Vander Veur S.
        • Komaroff E.
        • Rao A.K.
        Elevated circulating tissue factor procoagulant activity, factor VII, and plasminogen activator inhibitor-1 in childhood obesity: evidence of a procoagulant state.
        Br J Haematol. 2012; 158: 523-527
        • Fernhall B.
        • Fahs C.A.
        • Horn G.
        • Rowland T.
        • Smith D.
        Acute effects of firefighting on cardiac performance.
        Eur J Appl Physiol. 2012; 112: 735-741
        • Horn G.P.
        • Gutzmer S.
        • Fahs C.A.
        • Petruzzello S.J.
        • Goldstein E.
        • Fahey G.C.
        • Fernhall B.
        • Smith D.L.
        Physiological recovery from firefighting activities in rehabilitation and beyond.
        Prehosp Emerg Care. 2011; 15: 214-225
        • Smith D.L.
        • Manning T.S.
        • Petruzzello S.J.
        Effect of strenuous live-fire drills on cardiovascular and psychological responses of recruit firefighters.
        Ergonomics. 2001; 44: 244-254
        • Baynard T.
        • Miller W.C.
        • Fernhall B.
        Effects of exercise on vasodilatory capacity in endurance- and resistance-trained men.
        Eur J Appl Physiol. 2003; 89: 69-73
        • Smith D.T.
        • Hoetzer G.L.
        • Greiner J.J.
        • Stauffer B.L.
        • DeSouza C.A.
        Effects of ageing and regular aerobic exercise on endothelial fibrinolytic capacity in humans.
        J Physiol. 2003; 546: 289-298
        • Halleux C.M.
        • Declerck P.J.
        • Tran S.L.
        • Detry R.
        • Brichard S.M.
        Hormonal control of plasminogen activator inhibitor-1 gene expression and production in human adipose tissue: stimulation by glucocorticoids and inhibition by catecholamines.
        J Clin Endocrinol Metab. 1999; 84: 4097-4105
        • Fernhall B.
        • Baynard T.
        • Collier S.R.
        • Figueroa A.
        • Goulopoulou S.
        • Kamimori G.H.
        • Pitetti K.H.
        Catecholamine response to maximal exercise in persons with down syndrome.
        Am J Cardiol. 2009; 103: 724-726
        • Womack C.J.
        • Paton C.M.
        • Coughlin A.M.
        • Nagelkirk P.
        • Dejong A.T.
        • Anderson J.
        • Franklin B.A.
        Coagulation and fibrinolytic responses to manual versus automated snow removal.
        Med Sci Sports Exerc. 2003; 35: 1755-1759
        • Chen Y.W.
        • Chen J.K.
        • Wang J.S.
        Strenuous exercise promotes shear-induced thrombin generation by increasing the shedding of procoagulant microparticles from platelets.
        Thromb Haemost. 2010; 104: 293-301
        • Hamsten A.
        • de Faire U.
        • Walldius G.
        • Dahlen G.
        • Szamos A.
        • Landou C.
        • Blomback M.
        • Wiman B.
        Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction.
        Lancet. 1987; 2: 3-9
        • Held C.
        • Hjemdahl P.
        • Renhqvist N.
        • Wallen H.
        • Bjorklander I.
        • Eriksson S.V.
        • Forslund L.
        • Winman B.
        Fibrinolytic variables and cardiovascular prognosis in patients with stable angina pectoris treated with verapamil or metoprolol.
        Circulation. 1997; 95: 2380-2386