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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, Francisco C.
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 https://hdl.handle.net/20.500.12866/5626
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. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries International Journal of Cardiac Imaging
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Chronic Disease en_US
dc.subject Middle Aged en_US
dc.subject Altitude en_US
dc.subject Altitude Sickness en_US
dc.subject Case-Control Studies en_US
dc.subject acclimatization en_US
dc.subject altitude en_US
dc.subject human en_US
dc.subject chronic disease en_US
dc.subject adult en_US
dc.subject comparative study en_US
dc.subject female en_US
dc.subject male en_US
dc.subject middle aged en_US
dc.subject young adult en_US
dc.subject Hypoxia en_US
dc.subject adolescent en_US
dc.subject pathophysiology en_US
dc.subject Chronic mountain sickness en_US
dc.subject case control study en_US
dc.subject Predictive Value of Tests en_US
dc.subject Heart Rate en_US
dc.subject anoxia en_US
dc.subject Acclimatization en_US
dc.subject predictive value en_US
dc.subject Doppler echocardiography en_US
dc.subject Echocardiography, Doppler en_US
dc.subject heart left ventricle function en_US
dc.subject echography en_US
dc.subject adrenergic system en_US
dc.subject heart rate en_US
dc.subject Anoxia en_US
dc.subject heart stroke volume en_US
dc.subject Left ventricular strain en_US
dc.subject Myocardial deformation en_US
dc.subject Stroke Volume en_US
dc.subject Sympathetic Nervous System en_US
dc.subject systole en_US
dc.subject Systole en_US
dc.subject Ventricular Function, Left en_US
dc.title Left ventricular adaptation to high altitude: speckle tracking echocardiography in lowlanders, healthy highlanders and highlanders with chronic mountain sickness en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1007/s10554-015-0614-1
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 1573-0743


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