A Case of Chronic Thromboembolic Pulmonary Hypertension in a High-Altitude Dweller

Sydykov, Akylbek; Uulu, Kubatbek Muratali; Maripov, Abdirashit; Cholponbaeva, Meerim; Khan, Tatyana; Sarybaev, Akpay

doi:10.1089/ham.2018.0132

Cited by 3 publications

(5 citation statements)

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“…Pulmonary hypertension due to hypoxia is classified as group 3 pulmonary hypertension [286,287]. However, it should be noted that causes other than hypoxia might potentially underlie and/or contribute to pulmonary hypertension at high altitude [288].…”

Section: Other Clinical Forms Of Pulmonary Hypertension At High Altitudementioning

confidence: 99%

“…Furthermore, pulmonary hypertension due to thrombotic occlusive vascular disease was described in lowlanders after long-term acclimatization to high altitude [315]. In addition, there have been anecdotal reports of cases of chronic thromboembolic pulmonary hypertension in high altitude dwellers [288].…”

Section: Other Clinical Forms Of Pulmonary Hypertension At High Altitudementioning

confidence: 99%

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Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Sydykov

Mamazhakypov

Maripov

et al. 2021

IJERPH

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Alveolar hypoxia is the most prominent feature of high altitude environment with well-known consequences for the cardio-pulmonary system, including development of pulmonary hypertension. Pulmonary hypertension due to an exaggerated hypoxic pulmonary vasoconstriction contributes to high altitude pulmonary edema (HAPE), a life-threatening disorder, occurring at high altitudes in non-acclimatized healthy individuals. Despite a strong physiologic rationale for using vasodilators for prevention and treatment of HAPE, no systematic studies of their efficacy have been conducted to date. Calcium-channel blockers are currently recommended for drug prophylaxis in high-risk individuals with a clear history of recurrent HAPE based on the extensive clinical experience with nifedipine in HAPE prevention in susceptible individuals. Chronic exposure to hypoxia induces pulmonary vascular remodeling and development of pulmonary hypertension, which places an increased pressure load on the right ventricle leading to right heart failure. Further, pulmonary hypertension along with excessive erythrocytosis may complicate chronic mountain sickness, another high altitude maladaptation disorder. Importantly, other causes than hypoxia may potentially underlie and/or contribute to pulmonary hypertension at high altitude, such as chronic heart and lung diseases, thrombotic or embolic diseases. Extensive clinical experience with drugs in patients with pulmonary arterial hypertension suggests their potential for treatment of high altitude pulmonary hypertension. Small studies have demonstrated their efficacy in reducing pulmonary artery pressure in high altitude residents. However, no drugs have been approved to date for the therapy of chronic high altitude pulmonary hypertension. This work provides a literature review on the role of pulmonary hypertension in the pathogenesis of acute and chronic high altitude maladaptation disorders and summarizes current knowledge regarding potential treatment options.

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Section: Other Clinical Forms Of Pulmonary Hypertension At High Altitudementioning

confidence: 99%

Section: Other Clinical Forms Of Pulmonary Hypertension At High Altitudementioning

confidence: 99%

Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Sydykov

Mamazhakypov

Maripov

et al. 2021

IJERPH

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“…La patogenia de la HPA es multifactorial y se caracteriza por un incremento de la presión de la arteria pulmonar, siendo en la mayoría de los casos de grados leves a moderados; sin embargo, en algunas personas es posible evidenciar las formas severas (8,17,29) .…”

Section: Fisiopatologiaunclassified

“…La hipoxia crónica produce una serie de cambios fisiológicos en el individuo que habita en la altura, principalmente en el pulmón donde se produce vasoconstricción pulmonar sostenida y remodelación vascular, lo que progresivamente ocasionará incremento de la resistencia vascular e hipertensión pulmonar (8,22,29) . La HPA puede ocurrir en el pulmón sano en respuesta a un nivel bajo de oxígeno atmosférico, lo que se observa en poblaciones que viven a gran altura (30) .…”

Section: Efecto De La Hipoxia Crónica Sobre El Sistema Vascular Pulmonarunclassified

Hipertension pulmonar de altura

Díaz-Lazo¹,

Sanchez

2022

revista de salud udh

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La hipertensión pulmonar de altura (HPA) es una enfermedad producto de la exposición crónica a la altitud. La prevalencia de la HPA es variable según la localización geográfica, ambiental y genética. La población que vive en altura está expuesta crónicamente a una hipoxia alveolar debido a que la presión parcial de oxigeno se encuentra disminuido, este hecho ocasiona vasoconstricción y posteriormente una remodelación vascular pulmonar, ocurrida por la neomuscularización proliferativa de las arterias pulmonares distales y capilares previamente no muscularizados y el engrosamiento de la capa adventicial por la acumulación de fibroblastos y matriz. La HPA generalmente es asintomático, recién en estadios avanzados produce sintomatología caracterizado por disnea de esfuerzo, y fatiga. El diagnóstico preciso es con cateterismo cardiaco derecho con valores de presión arterial media (PAPm) mayor a 30 mmHg y/o presión arterial pulmonar sistólica (PAPS) mayor a 50 mmHg. El tratamiento ideal es el descenso del poblador a lugares bajos. Su pronóstico es bueno en la mayoría de casos.

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“…The hypobaric and hypoxic environment in high-altitude areas can easily lead to the decrease of blood oxygen saturation level and the increase of blood viscosity in mammals and birds, which affects the occurrence of vascular remodeling. Studies have shown that humans living at high altitudes are in a state of chronic hypoxia for a long time, which causes them to have varying degrees of vascular remodeling [ 3 ], which seriously affects their health [ 4 ]. To date, there are few studies on hypoxia-mediated vascular smooth muscle cell (VSMC) proliferation leading to vascular remodeling.…”

Section: Introductionmentioning

confidence: 99%

Mechanism of Hypoxia-Mediated Smooth Muscle Cell Proliferation Leading to Vascular Remodeling

Huang

Akgün

Mehmood

et al. 2022

BioMed Research International

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Vascular remodeling refers to changes in the size, contraction, distribution, and flow rate of blood vessels and even changes in vascular function. Vascular remodeling can cause cardiovascular and cerebrovascular diseases. It can also lead to other systemic diseases, such as pulmonary hypertension, pulmonary atherosclerosis, chronic obstructive pulmonary disease, stroke, and ascites of broilers. Hypoxia is one of the main causes of vascular remodeling. Prolonged hypoxia or intermittent hypoxia can lead to loss of lung ventilation, causing respiratory depression, irregular respiratory rhythms, and central respiratory failure. Animals that are unable to adapt to the highland environment are also prone to sustained constriction of the small pulmonary arteries, increased resistance to pulmonary circulation, and impaired blood circulation, leading to pulmonary hypertension and right heart failure if they live in a highland environment for long periods of time. However, limited studies have been found on the relationship between hypoxia and vascular remodeling. Therefore, this review will explore the relationship between hypoxia and vascular remodeling from the aspects of endoplasmic reticulum stress, mitochondrial dysfunction, abnormal calcium channel, disordered cellular metabolism, abnormal expression of miRNA, and other factors. This will help to understand the detailed mechanism of hypoxia-mediated smooth muscle cell proliferation and vascular remodeling for the better treatment and management of diseases due to vascular remodeling.

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A Case of Chronic Thromboembolic Pulmonary Hypertension in a High-Altitude Dweller

Cited by 3 publications

References 9 publications

Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Hipertension pulmonar de altura

Mechanism of Hypoxia-Mediated Smooth Muscle Cell Proliferation Leading to Vascular Remodeling

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