Acute live firefighting effects on ventricular-arterial coupling and pulsatile afterload in middle-aged firefighters

João L Marôco; Abbi D Lane; Sushant M Ranadive; Huimin Yan; Kanokwan Bunsawat; Gavin P Horn; Denise L Smith; Tracy Baynard; Bo Fernhall

doi:10.14814/phy2.70659

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Acute live firefighting effects on ventricular-arterial coupling and pulsatile afterload in middle-aged firefighters

Journal article

Open access

Peer reviewed

Acute live firefighting effects on ventricular-arterial coupling and pulsatile afterload in middle-aged firefighters

João L Marôco, Abbi D Lane, Sushant M Ranadive, Huimin Yan, Kanokwan Bunsawat, Gavin P Horn, Denise L Smith, Tracy Baynard and Bo Fernhall

Physiological reports, Vol.13(22), e70659

11/2025

DOI: 10.14814/phy2.70659

PMCID: PMC12618204

PMID: 41239550

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Abstract

Firefighting increases afterload, leading to ventricular-arterial coupling mismatch in young firefighters that may contribute to coronary hypoperfusion and the elevated risk of on-duty cardiac events. Since this risk is higher with aging in firefighters, we examined their ventricular-vascular coupling and afterload responses to acute firefighting. Twenty-two male firefighters (40-59 years) performed 18-min high-intensity firefighting drills while wearing protective gear and breathing apparatus. Echocardiography was conducted before and within 10 min after firefighting to estimate cardiac volumes, while tonometry-derived pulse wave analysis estimated wasted pressure effort (Ew) and aortic reservoir function. Ventricular-arterial coupling was quantified using the arterial (Ea) to ventricular (Ees) elastance ratio, and coronary perfusion was estimated via the Buckberg index. Firefighting reduced stroke volume (difference (∆) = -17 mL, p < 0.001), Ew (∆ = -800 dyne cm s, p = 0.005), aortic reservoir function (∆ = -6.9%, p < 0.001), and Buckberg index (∆ = -0.28, p < 0.001). Firefighting augmented Ea/Ees (∆ = 0.10, p = 0.035) stemming from increases in Ea (∆ = 0.16 mmHg.mL , p = 0.046) not counteracted by Ees. Heart rate changes were associated with Ew (r = -0.60, p = 0.017) and aortic reservoir function (r = -0.80, p < 0.001). Although middle-aged firefighters exhibited typical post-firefighting cardiovascular strain, including reduced coronary perfusion, the role of ventricular-arterial interactions and pulsatile afterload remains unclear due to heart rate confounding.

Adult

Coronary Circulation

Firefighters

Humans

Male

Middle Aged

Pulsatile Flow

Pulse Wave Analysis

Stroke Volume

Details

Title: Subtitle: Acute live firefighting effects on ventricular-arterial coupling and pulsatile afterload in middle-aged firefighters
Creators: João L Marôco - University of Massachusetts Boston
Abbi D Lane - University of Michigan
Sushant M Ranadive - University of Maryland, College Park
Huimin Yan - University of Massachusetts Boston
Kanokwan Bunsawat - University of Iowa
Gavin P Horn - American Institutes for Research
Denise L Smith - Skidmore College
Tracy Baynard - University of Massachusetts Boston
Bo Fernhall - University of Massachusetts Boston
Resource Type: Journal article
Publication Details: Physiological reports, Vol.13(22), e70659
DOI: 10.14814/phy2.70659
PMID: 41239550
PMCID: PMC12618204
NLM abbreviation: Physiol Rep
ISSN: 2051-817X
eISSN: 2051-817X
Publisher: Wiley
Grant note: EMW-2009-FP-00544 / U.S. Department of Homeland Security (DHS)
Language: English
Date published: 11/2025
Academic Unit: Health, Sport, and Human Physiology
Record Identifier: 9985033050502771

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