Left Ventricular Function during Acute High-Altitude Exposure in a Large Group of Healthy Young Chinese Men

Rao, Mingyue; Li, Jiabei; Qin, Jun; Zhang, Jihang; Gao, Xubin; Yu, Shanshan; Yu, Jie; Chen, Guozhu; Xu, Bin; Li, Huijie; Rao, Rongsheng; Huang, Lan; Jin, Jun

doi:10.1371/journal.pone.0116936

Cited by 26 publications

(34 citation statements)

References 40 publications

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“…The systolic LVEF was slightly but significantly reduced at 2,590 m -albeit with a median decrease of only 5%, which should be interpreted with caution, since it could be within the range of measurement variability [33]. In contrast, recent studies have reported an increase in EF with acute exposure to 3,700 m [34] (n = 139) and 3,750 m (n = 15) in healthy subjects [28]. Thus, the measured reduction in EF in our COPD collective seems to be noteworthy.…”

Section: Discussionmentioning

confidence: 67%

Right and Left Heart Function in Lowlanders with COPD at Altitude: Data from a Randomized Study

et al. 2018

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Background: Changes in pulmonary hemodynamics and cardiac function in patients with chronic obstructive pulmonary disease (COPD) traveling to altitude have not been assessed despite an increasing prevalence of the disease. Objectives: We hypothesized that pulmonary artery pressure (PAP) significantly increases and cardiac function deteriorates during exposure to hypobaric hypoxia as encountered by traveling to moderate altitude or air flight. Methods: A total of 37 patients (17 female; median age [quartiles] 66 years [60; 69] with COPD GOLD grade 2–3 [FEV₁ 57% predicted (49; 71)]) living < 800 m underwent echocardiography in Zurich (490 m) and after 1 night at Davos Jakobshorn (2,590 m) in a randomized order of allocation. Results: The transtricuspid pressure gradient increased from 23 mm Hg (18; 29) to 32 mm Hg (25; 41) (p < 0.0001; Δmedian [95% CI] 7.5 [2.0; 13.0]), the right ventricular fractional area change decreased from 45% (39; 49) to 38% (33; 43) (p = 0.002), while the heart rate and systolic blood pressure increased from 70 bpm (64; 78) to 82 bpm (70; 86) (p < 0.0001) and from 133 mm Hg (123; 141) to 136 mm Hg (126; 148) (p = 0.002), respectively, and left ventricular diastolic dysfunction was more prevalent (24–54%, p = 0.02). Conclusions: This is a first study assessing changes in pulmonary hemodynamics and cardiac function in patients with COPD during a short altitude sojourn. Despite the increase in PAP and indications of change in cardiac function, the exposure was well tolerated. None of the patients had to descend to lower altitude for symptomatic altitude-related disease.

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Section: Discussionmentioning

confidence: 67%

Right and Left Heart Function in Lowlanders with COPD at Altitude: Data from a Randomized Study

et al. 2018

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“…Myocardial performance index has been used to investigate different populations, such as patients with heart failure [2], acute myocardial infarction [3], heart transplants [4], COPD [25], patients with chronic ischemic cardiomyopathy who have undergone revascularization [26], as well as in healthy young men during high altitude exposure [27]. MPI has also been investigated in relation to age [28].…”

Section: Discussionmentioning

confidence: 99%

Effect of food intake on myocardial performance index

Gårdinger

Dieden

Hlebowicz

et al. 2017

Cardiovasc Ultrasound

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BackgroundMyocardial performance index (MPI) has been investigated in a variety of populations, but the effect of food intake has not been evaluated. We assessed whether myocardial performance index is affected by food intake in healthy subjects.MethodsTwenty-three healthy subjects aged 25.6 ± 4.5 years were investigated. MPI was measured before, 30 min after, and 110 min after a standardized meal.ResultsMPI decreased significantly (P < 0.05) from fasting values 30 min after the meal, and had almost returned to baseline after 110 min. MPI decreased from 0.28 ± 0.06 (fasting) to 0.20 ± 0.07 30 min after eating. At 110 min after eating the index value was almost back to the baseline value 0.26 ± 0.06. (P = 0.15).ConclusionsThis study shows that myocardial performance index is affected by food intake in healthy subjects.

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“…Hypoxic conditions as during high‐altitude exposure challenge LVdiastole by decreasing cardiac energy supply, increasing sympathetic nervous activity and pulmonary hypertension . Impaired diastolic function and its main hemodynamic consequence, that is, an increased LV end‐diastolic pressure (LVEDP), are of clinical importance at high altitude because a recently hypothesized deterioration might increase pulmonary capillary pressure and thereby increase the risk for high‐altitude pulmonary edema (HAPE) . Furthermore, impaired diastolic function might contribute to the reduction in stroke volume (SV) at high altitude .…”

Section: Introductionmentioning

confidence: 99%

Impairment of left atrial mechanics does not contribute to the reduction in stroke volume after active ascent to 4559 m

Sareban

Perz

Macholz

et al. 2018

Scandinavian Med Sci Sports

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Hypoxia challenges left ventricular (LV) function due to reduced energy supply. Conflicting results exist whether high‐altitude exposure impairs LV diastolic function and thus contributes to the high altitude‐induced increase in systolic pulmonary artery pressure (sPAP) and reduction in stroke volume (SV). This study aimed to assess LV diastolic function, LV end‐diastolic pressure (LVEDP), and LA mechanics using comprehensive echocardiographic imaging in healthy volunteers at 4559 m. Fifty subjects performed rapid (<20 hours) and active ascent from 1130 m to 4559 m (high). All participants underwent echocardiography during baseline examination at 424 m (low) as well as 7, 20 and 44 hours after arrival at high altitude. Heart rate (HR), sPAP, and comprehensive volumetric‐ and Doppler‐ as well as speckle tracking‐derived LA strain parameters were obtained to assess LV diastolic function, LA mechanics, and LVEDP in a multiparametric approach. Data for final analyses were available in 46 subjects. HR (low: 64 ± 11 vs high: 79 ± 14 beats/min, P < 0.001) and sPAP (low: 24.4 ± 3.8 vs high: 38.5 ± 8.2 mm Hg, P < 0.001) increased following ascent and remained elevated at high altitude. Stroke volume (low: 64.5 ± 15.0 vs high: 58.1 ± 16.4 mL, P < 0.001) and EDV decreased following ascent and remained decreased at high altitude due to decreased LV passive filling volume, whereas LA mechanics were preserved. There was no case of LV diastolic dysfunction or increased LVEDP estimates. In summary, this study shows that rapid and active ascent of healthy individuals to 4559 m impairs passive filling and SV of the LV. These alterations were not related to changes in LV and LA mechanics.

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Left Ventricular Function during Acute High-Altitude Exposure in a Large Group of Healthy Young Chinese Men

Cited by 26 publications

References 40 publications

Right and Left Heart Function in Lowlanders with COPD at Altitude: Data from a Randomized Study

Right and Left Heart Function in Lowlanders with COPD at Altitude: Data from a Randomized Study

Effect of food intake on myocardial performance index

Impairment of left atrial mechanics does not contribute to the reduction in stroke volume after active ascent to 4559 m

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