Abstract
The question addressed by the studyChronic exposure to hypoxia increases pulmonary artery pressure (PAP) in highlanders, but the criteria for diagnosis of high-altitude pulmonary hypertension (HAPH) are debated. We assessed cardiac function and PAP in highlanders at 3250 m and explored HAPH prevalence using different definitions.
Patients and methodsCentral Asian highlanders free of overt cardiorespiratory disease, permanently living at 2500–3500 m compared to age-matched lowlanders living <800 m. Participants underwent echocardiography close to their altitude of residence (at 3250 mversus760 m).
Results173 participants (97 highlanders, 76 lowlanders), mean±sdage 49±9 years (49% females) completed the study. Results in lowlandersversushighlanders were systolic PAP (23±5versus30±10 mmHg), right ventricular fractional area change (42±6%versus39±8%), tricuspid annular plane systolic excursion (2.1±0.3versus2.0±0.3 cm), right atrial volume index (20±6versus23±8 mL·m−2), left ventricular ejection fraction (62±4%versus57±5%) and stroke volume (64±10versus57±11 mL); all between-group comparisons p<0.05. Depending on criteria, HAPH prevalence varied between 6% and 35%.
The answer to the questionChronic exposure to hypoxia in highlanders is associated with higher PAP and slight alterations in right and left heart function compared to lowlanders. The prevalence of HAPH in this large highlander cohort varies between 6% according to expert consensus definition of chronic high-altitude disease to 35% according to the most recent definition of pulmonary hypertension proposed for lowlanders.
Abstract
This study of Central Asian highlanders living at altitudes >2500 m revealed slight alterations of right- and left-heart functions compared to lowlanders. Pulmonary hypertension prevalence depended on diagnostic criteria and was >6%.https://bit.ly/2zdpPb5
Footnotes
This study was registered atClinicalTrials.govasNCT03165656.
Author contributions: M. Lichtblau, S. Saxer, S. Ulrich: data acquisition, analysing and interpretation, drafting of the manuscript, final approval of the version to be published. M. Furian, L. Mayer, P.R. Bader, P.M. Scheiwiller, M. Mademilov, U. Sheraliev, F.C. Tanner, T.M. Sooronbaev: data acquisition, critical revision for important intellectual content, final approval of the version to be published. M. Lichtblau, S. Saxer, K.E. Bloch, S. Ulrich: substantial contributions to the conception and design of the study, interpretation of the data, critical revision for important intellectual content, final approval of the version to be published. S. Ulrich is the guarantor of the paper.
利益冲突:m . Lichtblau无关disclose. Conflict of interest: S. Saxer has nothing to disclose.
Conflict of interest: M. Furian has nothing to disclose.
Conflict of interest: L. Mayer has nothing to disclose.
Conflict of interest: P.R. Bader has nothing to disclose.
Conflict of interest: P.M. Scheiwiller has nothing to disclose.
Conflict of interest: M. Mademilov has nothing to disclose.
Conflict of interest: U. Sheraliev has nothing to disclose.
Conflict of interest: F.C. Tanner has nothing to disclose.
Conflict of interest: T.M. Sooronbaev has nothing to disclose.
Conflict of interest: K.E. Bloch reports grants from Zurich Lung League and Swiss National Science Foundation, during the conduct of the study.
Conflict of interest: S. Ulrich reports grants from Zurich Lung League and Swiss National Science Foundation, during the conduct of the study; grants and personal fees from Actelion SA and Orpha Swiss, personal fees from Bayer SA and MSD, outside the submitted work.
Support statement: The study was funded by grants from the Swiss National Science Foundation and the Zurich Lung. Funding information for this article has been deposited with theCrossref Funder Registry.
- ReceivedJanuary 7, 2020.
- AcceptedApril 17, 2020.
- Copyright ©ERS 2020