Markers of cardiovascular risk and their reversibility with acute oxygen therapy in Kyrgyz highlanders with high altitude pulmonary hypertension

Furian, Michael; Latshang, Tsogyal D.; Aeschbacher, Sayaka S.; Sheraliev, Ulan; Marazhapov, Nuriddin H.; Mirrakhimov, Erkin M.; Ulrich, Stefanie; Sooronbaev, Talant; Bloch, Konrad E.

doi:10.1016/j.pulmoe.2021.02.001

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Previous studies by Wang et al ( 27 ) have shown that lower blood oxygen saturation levels are independent risk factors for HAH. At the same time, HAPH can make blood oxygen saturation much lower than health level ( 28 ). Meanwhile, the addition of NCG can be seen from the Index associated with altitude stress and still plays a regulatory role.…”

Section: Discussionmentioning

confidence: 99%

N-Carbamoylglutamate Supplementation on the Digestibility, Rumen Fermentation, Milk Quality, Antioxidant Parameters, and Metabolites of Jersey Cattle in High-Altitude Areas

Liu

Yan²,

et al. 2022

Front. Vet. Sci.

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This study aimed to assess the impact of the dietary supplementation of N-carbamoylglutamate (NCG) on nutrient digestibility, rumen fermentation, milk quality, oxidative stress, and metabolites in the plasma and feces of Jersey cattle under high altitude with the hypoxic condition. A total of 14 healthy lactating Jersey dairy cows with similar body conditions were selected and randomly divided into 2 groups. The control group (CON group, N = 6 replicates) was fed with a conventional complete diet, whereas the experimental group (NCG group, N = 8 replicates) received 20 g/d per head NCG supplementation. The experiment lasted for 60 days, the adaptation period was 12 days, and the formal experiment period was 48 days. Except that the NCG group showed an upward trend in dry matter intake (DMI) (p = 0.09) and the fermentation parameters, the molar proportion of butyric acid tended to decrease (p = 0.08); the two groups had no significant differences (p > 0.05) in nutrients digestibility, plasma immunity, and antioxidant ability. However, compared with the CON group, the milk fat rate and blood oxygen saturation of the NCG group showed an upward trend (p = 0.09). For indexes associated with altitude stress, the contents of thyroxine, transferrin, and endothelin both decreased significantly (p < 0.05) in the NCG group. Meanwhile, heat shock protein (p = 0.07) and aldosterone (p = 0.06) also showed a downward trend. A total of 114 different metabolites were identified from feces and plasma, 42 metabolites were derived from plasma that mainly included 5 kinds of Super Class, and 72 metabolites were derived from feces that mainly included 9 kinds of Super Class. The significantly increased plasma differential metabolites were 2,5-dihydroxybenzoate and salicyluric acid, and the significantly increased fecal differential metabolites were Butenafine (fold change > 2). Pathway analysis showed that after applying NCG as a feed additive, the changes of the Jersey dairy cows mainly focused on amino acid metabolism and lipid metabolism. These results indicated that adding NCG to the diet can prevent the hypoxic stress state of lactating Jersey cows in high-altitude areas and has a tendency to improve milk quality.

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Section: Discussionmentioning

confidence: 99%

N-Carbamoylglutamate Supplementation on the Digestibility, Rumen Fermentation, Milk Quality, Antioxidant Parameters, and Metabolites of Jersey Cattle in High-Altitude Areas

Liu

Yan²,

et al. 2022

Front. Vet. Sci.

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“…It is important to recognize that this study focused on an Asian population, and it is unclear whether the GENTH scoring model can be applied to other populations. However, previous studies in the Aksay and Andean highlanders have reported similar risk factors (4,18). Thus, the GENTH scoring model may have predictive value in other highaltitude regions, but the relative weighted point value of these risk factors may differ.…”

Section: Discussionmentioning

confidence: 64%

“…This difference can be linked to hepatocyte lipid accumulation ( 42 ) and alterations in peripheral lipid metabolism under hypoxic conditions ( 43 ). These factors may potentially contribute to the decreased incidence of obesity in high-altitude regions ( 4 , 44 ). Moreover, the prevalence of pulmonary embolism in the retrospective cohort was high at 21% (52/248).…”

Section: Discussionmentioning

confidence: 99%

“…High-altitude pulmonary hypertension (HAPH) is classified as group 3 PH, primarily attributed to prolonged exposure to high-altitude environments ( 4 , 5 ). These high-altitude regions are typically 2,500 m above sea level ( 6 ), inhabited by over 140 million permanent residents, with an additional 40 million temporary visitors ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

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A novel clinical prediction scoring system of high-altitude pulmonary hypertension

Zeng,

Zhakeer,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundHigh-altitude pulmonary hypertension (HAPH) is a common disease in regions of high altitude where performing right heart catheterization (RHC) is challenging. The development of a diagnostic scoring system is crucial for effective disease screening.MethodsA total of 148 individuals were included in a retrospective analysis, and an additional 42 residents were prospectively enrolled. We conducted a multivariable analysis to identify independent predictors of HAPH. Subsequently, we devised a prediction score based on the retrospective training set to anticipate the occurrence and severity of HAPH. This scoring system was further subjected to validation in the prospective cohort, in which all participants underwent RHC.ResultsThis scoring system, referred to as the GENTH score model (Glycated hemoglobin [OR = 4.5], Echocardiography sign [OR = 9.1], New York Heart Association-functional class [OR = 12.5], Total bilirubin [OR = 3.3], and Hematocrit [OR = 3.6]), incorporated five independent risk factors and demonstrated strong predictive accuracy. In the training set, the area under the curve (AUC) values for predicting the occurrence and severity of HAPH were 0.851 and 0.832, respectively, while in the validation set, they were 0.841 and 0.893. In the validation set, GENTH score model cutoff values of ≤18 or >18 points were established for excluding or confirming HAPH, and a threshold of >30 points indicated severe HAPH.ConclusionsThe GENTH score model, combining laboratory and echocardiography indicators, represents an effective tool for distinguishing potential HAPH patients and identifying those with severe HAPH. This scoring system improves the clinical screening of HAPH diseases and offers valuable insights into disease diagnosis and management.

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“…Previous study on Kyrgyz highlanders have reported 14-20% of the population with PH [4] . Furian et al [5] suggested that highlanders with PH at high altitude may be at increased risk of cardiovascular mortality and morbidity. Therefore, more attention should be paid on the MI with PH at high altitude.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of myocardial injury in highlanders with pulmonary hypertension

Zhao

Wu²,

Duanmu³

et al. 2023

Preprint

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Background: High altitude environment can give rise to Myocardial injury (MI) mainly because of hypoxia, where MI with pulmonary hypertension (PH) is one of the severe pathologies. In the present study, we intend to explore clinical characteristics of MI in patients with PH at high altitude and diagnostic value of various myocardial markers. Methods: Consecutive patients at the altitude of 3650m were selected into this retrospective study. Clinical and biochemical data were collected. According to the results of Cardiac troponin I (cTnI), patients were divided into MI group and non-MI group. Results: A total of 231 patients were enrolled in this study. MI occurred in 29 patients (12.6%). We found that body mass index (BMI, P=0.045), left ventricular end-diastolic dimension (LVEDD, P=0.005), and serum level of creatine kinase-MB (CK-MB, P=0.001) in MI group were significantly higher than that in non-MI group. Spearman correlation analysis revealed that cTnI have a significant positive correlation with CK-MB (P=0.000) and LDH (P <0.001) instead of aspartate aminotransferase (AST). A receiver operating characteristic (ROC) curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of MI with an area under the curve (AUC) of 0.749 (P=0.000), and the level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion: The incidence of MI with PH is high in highlander. As a convenient and efficient marker, CK-MB is closely associated with cTnI and have a predict role in the occurrence of MI with PH under expose to high altitude hypoxia.

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Markers of cardiovascular risk and their reversibility with acute oxygen therapy in Kyrgyz highlanders with high altitude pulmonary hypertension

Cited by 6 publications

References 30 publications

N-Carbamoylglutamate Supplementation on the Digestibility, Rumen Fermentation, Milk Quality, Antioxidant Parameters, and Metabolites of Jersey Cattle in High-Altitude Areas

N-Carbamoylglutamate Supplementation on the Digestibility, Rumen Fermentation, Milk Quality, Antioxidant Parameters, and Metabolites of Jersey Cattle in High-Altitude Areas

A novel clinical prediction scoring system of high-altitude pulmonary hypertension

Clinical analysis of myocardial injury in highlanders with pulmonary hypertension

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