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Pulmonary haemodynamic response to exercise in highlanders versus lowlanders

The aim of the study was to investigate the pulmonary haemodynamic response to exercise in Central Asian high- and lowlanders. This was a cross-sectional study in Central Asian highlanders (living >2500 m) compared with lowlanders (living <800 m), assessing cardiac function, including tricuspi...

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Autores principales: Ulrich, Silvia, Saxer, Stéphanie, Furian, Michael, Bader, Patrick R., Appenzeller, Paula, Scheiwiller, Philipp M., Mademilov, Maamed, Sheraliev, Ulan, Tanner, Felix, Sooronbaev, Talantbek M., Bloch, Konrad E., Lichtblau, Mona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021810/
https://www.ncbi.nlm.nih.gov/pubmed/33834057
http://dx.doi.org/10.1183/23120541.00937-2020
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author Ulrich, Silvia
Saxer, Stéphanie
Furian, Michael
Bader, Patrick R.
Appenzeller, Paula
Scheiwiller, Philipp M.
Mademilov, Maamed
Sheraliev, Ulan
Tanner, Felix
Sooronbaev, Talantbek M.
Bloch, Konrad E.
Lichtblau, Mona
author_facet Ulrich, Silvia
Saxer, Stéphanie
Furian, Michael
Bader, Patrick R.
Appenzeller, Paula
Scheiwiller, Philipp M.
Mademilov, Maamed
Sheraliev, Ulan
Tanner, Felix
Sooronbaev, Talantbek M.
Bloch, Konrad E.
Lichtblau, Mona
author_sort Ulrich, Silvia
collection PubMed
description The aim of the study was to investigate the pulmonary haemodynamic response to exercise in Central Asian high- and lowlanders. This was a cross-sectional study in Central Asian highlanders (living >2500 m) compared with lowlanders (living <800 m), assessing cardiac function, including tricuspid regurgitation pressure gradient (TRPG), cardiac index and tricuspid annular plane systolic excursion (TAPSE) by echocardiography combined with heart rate and oxygen saturation measured by pulse oximetry (S(pO(2))) during submaximal stepwise cycle exercise (10 W increase per 3 min) at their altitude of residence (at 760 m or 3250 m, respectively). 52 highlanders (26 females; aged 47.9±10.7 years; body mass index (BMI) 26.7±4.6 kg·m(−2); heart rate 75±11 beats·min(−1); S(pO(2)) 91±5%;) and 22 lowlanders (eight females; age 42.3±8.0 years; BMI 26.9±4.1 kg·m(−2); heart rate 68±7 beats·min(−1); S(pO(2)) 96±1%) were studied. Highlanders had a lower resting S(pO(2)) compared to lowlanders but change during exercise was similar between groups (highlanders versus lowlanders −1.4±2.9% versus −0.4±1.1%, respectively, p=0.133). Highlanders had a significantly elevated TRPG and exercise-induced increase was significantly higher (13.6±10.5 mmHg versus 6.1±4.8 mmHg, difference 7.5 (2.8 to 12.2) mmHg; p=0.002), whereas cardiac index increase was slightly lower in highlanders (2.02±0.89 L·min(−1) versus 1.78±0.61 L·min(−1), difference 0.24 (−0.13 to 0.61) L·min(−1); p=0.206) resulting in a significantly steeper pressure–flow ratio (ΔTRPG/Δcardiac index) in highlanders 9.4±11.4 WU and lowlanders 3.0±2.4 WU (difference 6.4 (1.4 to 11.3) WU; p=0.012). Right ventricular-arterial coupling (TAPSE/TRPG) was significantly lower in highlanders but no significant difference in change with exercise in between groups was detected (−0.01 (−0.20 to 0.18); p=0.901). In highlanders, chronic exposure to hypoxia leads to higher pulmonary artery pressure and a steeper pressure–flow relation during exercise.
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spelling pubmed-80218102021-04-07 Pulmonary haemodynamic response to exercise in highlanders versus lowlanders Ulrich, Silvia Saxer, Stéphanie Furian, Michael Bader, Patrick R. Appenzeller, Paula Scheiwiller, Philipp M. Mademilov, Maamed Sheraliev, Ulan Tanner, Felix Sooronbaev, Talantbek M. Bloch, Konrad E. Lichtblau, Mona ERJ Open Res Original Articles The aim of the study was to investigate the pulmonary haemodynamic response to exercise in Central Asian high- and lowlanders. This was a cross-sectional study in Central Asian highlanders (living >2500 m) compared with lowlanders (living <800 m), assessing cardiac function, including tricuspid regurgitation pressure gradient (TRPG), cardiac index and tricuspid annular plane systolic excursion (TAPSE) by echocardiography combined with heart rate and oxygen saturation measured by pulse oximetry (S(pO(2))) during submaximal stepwise cycle exercise (10 W increase per 3 min) at their altitude of residence (at 760 m or 3250 m, respectively). 52 highlanders (26 females; aged 47.9±10.7 years; body mass index (BMI) 26.7±4.6 kg·m(−2); heart rate 75±11 beats·min(−1); S(pO(2)) 91±5%;) and 22 lowlanders (eight females; age 42.3±8.0 years; BMI 26.9±4.1 kg·m(−2); heart rate 68±7 beats·min(−1); S(pO(2)) 96±1%) were studied. Highlanders had a lower resting S(pO(2)) compared to lowlanders but change during exercise was similar between groups (highlanders versus lowlanders −1.4±2.9% versus −0.4±1.1%, respectively, p=0.133). Highlanders had a significantly elevated TRPG and exercise-induced increase was significantly higher (13.6±10.5 mmHg versus 6.1±4.8 mmHg, difference 7.5 (2.8 to 12.2) mmHg; p=0.002), whereas cardiac index increase was slightly lower in highlanders (2.02±0.89 L·min(−1) versus 1.78±0.61 L·min(−1), difference 0.24 (−0.13 to 0.61) L·min(−1); p=0.206) resulting in a significantly steeper pressure–flow ratio (ΔTRPG/Δcardiac index) in highlanders 9.4±11.4 WU and lowlanders 3.0±2.4 WU (difference 6.4 (1.4 to 11.3) WU; p=0.012). Right ventricular-arterial coupling (TAPSE/TRPG) was significantly lower in highlanders but no significant difference in change with exercise in between groups was detected (−0.01 (−0.20 to 0.18); p=0.901). In highlanders, chronic exposure to hypoxia leads to higher pulmonary artery pressure and a steeper pressure–flow relation during exercise. European Respiratory Society 2021-04-06 /pmc/articles/PMC8021810/ /pubmed/33834057 http://dx.doi.org/10.1183/23120541.00937-2020 Text en Copyright ©The authors 2021 http://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org)
spellingShingle Original Articles
Ulrich, Silvia
Saxer, Stéphanie
Furian, Michael
Bader, Patrick R.
Appenzeller, Paula
Scheiwiller, Philipp M.
Mademilov, Maamed
Sheraliev, Ulan
Tanner, Felix
Sooronbaev, Talantbek M.
Bloch, Konrad E.
Lichtblau, Mona
Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title_full Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title_fullStr Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title_full_unstemmed Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title_short Pulmonary haemodynamic response to exercise in highlanders versus lowlanders
title_sort pulmonary haemodynamic response to exercise in highlanders versus lowlanders
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021810/
https://www.ncbi.nlm.nih.gov/pubmed/33834057
http://dx.doi.org/10.1183/23120541.00937-2020
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