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Left ventricular adaptation to high altitude: speckle tracking echocardiography in lowlanders, healthy highlanders and highlanders with chronic mountain sickness

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dc.contributor.author Dedobbeleer, C.
dc.contributor.author Hadefi, A.
dc.contributor.author Pichon, A.
dc.contributor.author Villafuerte, F.
dc.contributor.author Naeije, R.
dc.contributor.author Unger, P.
dc.date.accessioned 2019-02-22T14:54:06Z
dc.date.available 2019-02-22T14:54:06Z
dc.date.issued 2015
dc.identifier.uri http://doi.org/10.1007/s10554-015-0614-1
dc.identifier.uri http://repositorio.upch.edu.pe/handle/upch/5626
dc.description.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.
dc.language.iso eng
dc.publisher Springer Verlag
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru
dc.subject Adolescent
dc.subject Adult
dc.subject Female
dc.subject Humans
dc.subject Male
dc.subject Young Adult
dc.subject Chronic Disease
dc.subject Middle Aged
dc.subject Altitude
dc.subject Altitude Sickness
dc.subject Case-Control Studies
dc.subject acclimatization
dc.subject altitude
dc.subject human
dc.subject chronic disease
dc.subject adult
dc.subject comparative study
dc.subject female
dc.subject male
dc.subject middle aged
dc.subject young adult
dc.subject Hypoxia
dc.subject adolescent
dc.subject pathophysiology
dc.subject Chronic mountain sickness
dc.subject case control study
dc.subject Predictive Value of Tests
dc.subject Heart Rate
dc.subject anoxia
dc.subject Acclimatization
dc.subject predictive value
dc.subject Doppler echocardiography
dc.subject Echocardiography, Doppler
dc.subject heart left ventricle function
dc.subject echography
dc.subject adrenergic system
dc.subject heart rate
dc.subject Anoxia
dc.subject heart stroke volume
dc.subject Left ventricular strain
dc.subject Myocardial deformation
dc.subject Stroke Volume
dc.subject Sympathetic Nervous System
dc.subject systole
dc.subject Systole
dc.subject Ventricular Function, Left
dc.title Left ventricular adaptation to high altitude: speckle tracking echocardiography in lowlanders, healthy highlanders and highlanders with chronic mountain sickness
dc.type info:eu-repo/semantics/article
dc.identifier.journal International Journal of Cardiovascular Imaging

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