Left ventricular adaptation to high altitude: speckle tracking echocardiography in lowlanders, healthy highlanders and highlanders with chronic mountain sickness
Male
Sympathetic Nervous System
Acclimatization
Altitude Sickness
Ventricular Function, Left
0302 clinical medicine
Anoxia
Physiologie générale
Heart Rate
middle aged
Peru
heart rate
systole
Hypoxia
comparative study
pathophysiology
predictive value
https://purl.org/pe-repo/ocde/ford#3.02.04
adult
Altitude
anoxia
Middle Aged
Echocardiography, Doppler
3. Good health
acclimatization
female
heart stroke volume
young adult
Female
altitude
Adult
Adolescent
Systole
adrenergic system
Young Adult
03 medical and health sciences
male
Predictive Value of Tests
Humans
human
Myocardial deformation
echography
Stroke Volume
case control study
Doppler echocardiography
Left ventricular strain
adolescent
Chronic mountain sickness
Case-Control Studies
Chronic Disease
heart left ventricle function
chronic disease
DOI:
10.1007/s10554-015-0614-1
Publication Date:
2015-02-09T09:35:22Z
AUTHORS (6)
ABSTRACT
Hypoxic exposure depresses myocardial contractility in vitro, but has been associated with indices of increased cardiac performance in intact animals and in humans, possibly related to sympathetic nervous system activation. We explored left ventricular (LV) function using speckle tracking echocardiography and sympathetic tone by spectral analysis of heart rate variability (HRV) in recently acclimatized lowlanders versus adapted or maladapted highlanders at high altitude. Twenty-six recently acclimatized lowlanders, 14 healthy highlanders and 12 highlanders with chronic mountain sickness (CMS) were studied. Control measurements at sea level were also obtained in the lowlanders. Altitude exposure in the lowlanders was associated with slightly increased blood pressure, decreased LV volumes and decreased longitudinal strain with a trend to increased prevalence of post-systolic shortening (p = 0.06), whereas the low frequency/high frequency (LF/HF) ratio increased (1.62 ± 0.81 vs. 5.08 ± 4.13, p < 0.05) indicating sympathetic activation. Highlanders had a similarly raised LF/HF ratio, but no alteration in LV deformation. Highlanders with CMS had no change in LV deformation, no significant increase in LF/HF, but decreased global HRV still suggestive of increased sympathetic tone, and lower mitral E/A ratio compared to healthy highlanders. Short-term altitude exposure in lowlanders alters indices of LV systolic function and increases sympathetic nervous system tone. Life-long altitude exposure in highlanders is associated with similar sympathetic hyperactivity, but preserved parameters of LV function, whereas diastolic function may be altered in those with CMS. Altered LV systolic function in recently acclimatized lowlanders may be explained by combined effects of hypoxia and changes in loading conditions.
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