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Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors

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dc.contributor.author Brito, Julio
dc.contributor.author Siques, Patricia
dc.contributor.author Lopez, Rosario
dc.contributor.author Romero, Raul
dc.contributor.author Leon-Velarde, Fabiola
dc.contributor.author Flores, Karen
dc.contributor.author Lueneburg, Nicole
dc.contributor.author Hannemann, Juliane
dc.contributor.author Boeger, Rainer H.
dc.date.accessioned 2018-12-01T00:04:14Z
dc.date.available 2018-12-01T00:04:14Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4245
dc.description.abstract Background: Living at high altitude or with chronic hypoxia implies functional and morphological changes in the right ventricle and pulmonary vasculature with a 10% prevalence of high-altitude pulmonary hypertension (HAPH). The implications of working intermittently (day shifts) at high altitude (hypobaric hypoxia) over the long term are still not well-defined. The aim of this study was to evaluate the right cardiac circuit status along with potentially contributory metabolic variables and distinctive responses after long exposure to the latter condition. Methods: A cross-sectional study of 120 healthy miners working at an altitude of 4,400-4,800 m for over 5 years in 7-day commuting shifts was designed. Echocardiography was performed on day 2 at sea level. Additionally, biomedical and biochemical variables, Lake Louise scores (LLSs), sleep disturbances and physiological variables were measured at altitude and at sea level. Results: The population was 41.8 +/- 0.7 years old, with an average of 14 +/- 0.5 (range 5-29) years spent at altitude. Most subjects still suffered from mild to moderate symptoms of acute mountain sickness (mild was an LLS of 3-5 points, including cephalea; moderate was LLS of 6-10 points) (38.3%) at the end of day 1 of the shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP),25 mmHg, 9% HAPH (>= 30 mmHg), 85% mild increase in right ventricle wall thickness (>= 5 mm), 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR) and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA) (OR 8.84 (1.18-66.39); p < 0.05) and insulin (OR: 1.11 (1.02-1.20); p < 0.05) were associated with elevated mPAP and were defined as a cut-off. Interestingly, the correspondence analysis identified association patterns of several other variables (metabolic, labor, and biomedical) with higher mPAP. Conclusions: Working intermittently at high altitude involves a distinctive pattern. The most relevant and novel characteristics are a greater prevalence of elevated mPAP and HAPH than previously reported at chronic intermittent hypobaric hypoxia (CIHH), which is accompanied by subsequent morphological characteristics. These findings are associated with cardiometabolic factors (insulin and ADMA). However, the functional repercussions seem to be minor or negligible. This research contributes to our understanding and surveillance of this unique model of chronic intermittent high altitude exposure. en_US
dc.language.iso eng
dc.publisher Frontiers Media
dc.relation.ispartof urn:issn:1664-042X
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject altitude en_US
dc.subject chronic intermittent hypobaric hypoxia en_US
dc.subject high-altitude pulmonary hypertension en_US
dc.subject insulin and ADMA en_US
dc.subject right heart en_US
dc.title Long-Term Intermittent Work at High Altitude: Right Heart Functional and Morphological Status and Associated Cardiometabolic Factors en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.3389/fphys.2018.00248

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