JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2000; 35:980-987
© 2000 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grünig, E.
Right arrow Articles by Bärtsch, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grünig, E.
Right arrow Articles by Bärtsch, P.

CLINICAL STUDIES

Stress Doppler echocardiography for identification of susceptibility to high altitude pulmonary edema

Ekkehard Grünig, MD*, Derliz Mereles, MD*, Wulf Hildebrandt, MD{dagger}, Erik R. Swenson, MD{dagger}, Wolfgang Kübler, MD*, Helmut Kuecherer, MD* and Peter Bärtsch, MD{dagger}

* Department of Cardiology, University of Heidelberg, Heidelberg, Germany
{dagger} Institute of Sports Medicine, University of Heidelberg, Heidelberg, Germany

Manuscript received April 2, 1999; revised manuscript received October 15, 1999, accepted November 19, 1999.

Reprint requests and correspondence: Dr. Ekkehard Grünig, Department of Cardiology, Bergheimer Strasse 58, D-69115 Heidelberg, Germany
ekkehard_gruenig{at}med.uni-heidelberg.de

OBJECTIVE

This prospective single-blinded study was performed to quantitate noninvasive pulmonary artery systolic pressure (PASP) responses to prolonged acute hypoxia and normoxic exercise.

BACKGROUND

Hypoxia-induced excessive rise in pulmonary artery pressure is a key factor in high-altitude pulmonary edema (HAPE). We hypothesized that subjects susceptible to HAPE (HAPE-S) have increased pulmonary artery pressure response not only to hypoxia but also to exercise.

METHODS

PASP was estimated at 45, 90 and 240 min of hypoxia (Fi02=12%) and during supine bicycle exercise in normoxia using Doppler-echocardiography in nine HAPE-S and in 11 control subjects.

RESULTS

In the control group, mean PASP increased from 26 ± 2 to 37 ± 4 mm Hg ({Delta}PASP 10.3 ± 2 mm Hg) after 90 min of hypoxia and from 27 ± 4 to 36 ± 3 mm Hg ({Delta}PASP 8 ± 2 mm Hg) during exercise. In contrast, all HAPE-S subjects revealed significantly greater increases (p = 0.002 vs. controls) in mean PASP both during hypoxia (from 28 ± 4 to 57 ± 10 mm Hg, {Delta}PASP 28.7 ± 6 mm Hg) and during exercise (from 28 ± 4 to 55 ± 11 mm Hg, {Delta}PASP 27 ± 8 mm Hg) than did control subjects. Stress echocardiography allowed discrimination between groups without overlap using a cut off PASP value of 45 mm Hg at work rates less than 150 W.

CONCLUSIONS

These data indicate that HAPE-S subjects may have abnormal pulmonary vascular responses not only to hypoxia but also to supine bicycle exercise under normoxic conditions. Thus, Doppler echocardiography during supine bicycle exercise or after 90 min of hypoxia may be useful noninvasive screening methods to identify subjects susceptible to HAPE.

Abbreviations and Acronyms
  ECG = electrocardiogram
  EF = ejection fraction
  HAPE = high-altitude pulmonary edema
  HAPE-S = high-altitude pulmonary edema-susceptible subjects
  LV = left ventricle, left ventricular
  PASP = pulmonary artery systolic pressure
  RV = right ventricle, right ventricular




This article has been cited by other articles:


Home page
 ChestHome page
R. B. Schoene
Illnesses at High Altitude
Chest, August 1, 2008; 134(2): 402 - 416.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
N. P. Talbot, G. M. Balanos, P. A. Robbins, and K. L. Dorrington
Can intravenous endothelin-1 be used to enhance hypoxic pulmonary vasoconstriction in healthy humans?
Br. J. Anaesth., July 17, 2008; (2008) aen214v1.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
B. A. Kaufmann, A. M. Bernheim, S. Kiencke, M. Fischler, J. Sklenar, H. Mairbaurl, M. Maggiorini, and H. P. Brunner-La Rocca
Evidence supportive of impaired myocardial blood flow reserve at high altitude in subjects developing high-altitude pulmonary edema
Am J Physiol Heart Circ Physiol, April 1, 2008; 294(4): H1651 - H1657.
[Abstract] [Full Text] [PDF]

Home page
 Exp PhysiolHome page
C. K. Lykidis, M. J. White, and G. M. Balanos
The pulmonary vascular response to the sustained activation of the muscle metaboreflex in man
Exp Physiol, February 1, 2008; 93(2): 247 - 253.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S. Kiencke, A. Bernheim, M. Maggiorini, M. Fischler, S. V. Aschkenasy, L. Dorschner, J. Debrunner, K. Bloch, H. Mairbaurl, and H. P. Brunner-La Rocca
Exercise-induced pulmonary artery hypertension a rare finding?
J. Am. Coll. Cardiol., January 29, 2008; 51(4): 513 - 514.
[Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
J.-L. Vachiery and A. Pavelescu
Exercise echocardiography in pulmonary hypertension
Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H48 - H53.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
S. Huez, F. Roufosse, J-L. Vachiery, A. Pavelescu, G. Derumeaux, J-C. Wautrecht, E. Cogan, and R. Naeije
Isolated right ventricular dysfunction in systemic sclerosis: latent pulmonary hypertension?
Eur. Respir. J., November 1, 2007; 30(5): 928 - 936.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. M. Taveira-DaSilva, O. M. Hathaway, V. Sachdev, Y. Shizukuda, C. W. Birdsall, and J. Moss
Pulmonary Artery Pressure in Lymphangioleiomyomatosis: An Echocardiographic Study
Chest, November 1, 2007; 132(5): 1573 - 1578.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. M. Bernheim, S. Kiencke, M. Fischler, L. Dorschner, J. Debrunner, H. Mairbaurl, M. Maggiorini, and H. P. Brunner-La Rocca
Acute Changes in Pulmonary Artery Pressures Due to Exercise and Exposure to High Altitude Do Not Cause Left Ventricular Diastolic Dysfunction
Chest, August 1, 2007; 132(2): 380 - 387.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
C. Dehnert, P. Bartsch, E. Grunig, and D. Mereles
High-Altitude Pulmonary Edema and Patent Foramen Ovale
JAMA, April 4, 2007; 297(13): 1432 - 1432.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
A. M. Luks and E. R. Swenson
Travel to high altitude with pre-existing lung disease
Eur. Respir. J., April 1, 2007; 29(4): 770 - 792.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. Dehnert, F. Risse, S. Ley, T. A. Kuder, R. Buhmann, M. Puderbach, E. Menold, D. Mereles, H.-U. Kauczor, P. Bartsch, et al.
Magnetic Resonance Imaging of Uneven Pulmonary Perfusion in Hypoxia in Humans
Am. J. Respir. Crit. Care Med., November 15, 2006; 174(10): 1132 - 1138.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
D. Mereles, N. Ehlken, S. Kreuscher, S. Ghofrani, M. M. Hoeper, M. Halank, F. J. Meyer, G. Karger, J. Buss, J. Juenger, et al.
Exercise and Respiratory Training Improve Exercise Capacity and Quality of Life in Patients With Severe Chronic Pulmonary Hypertension
Circulation, October 3, 2006; 114(14): 1482 - 1489.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
E. K. Weir and A. Olschewski
Role of ion channels in acute and chronic responses of the pulmonary vasculature to hypoxia
Cardiovasc Res, September 1, 2006; 71(4): 630 - 641.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. Grunig, C. Dehnert, D. Mereles, R. Koehler, H. Olschewski, P. Bartsch, and B. Janssen
Enhanced Hypoxic Pulmonary Vasoconstriction in Families of Adults or Children With Idiopathic Pulmonary Arterial Hypertension
Chest, December 1, 2005; 128(6_suppl): 630S - 633S.
[Full Text] [PDF]

Home page
 ChestHome page
E. Grunig, C. Dehnert, D. Mereles, R. Koehler, H. Olschewski, P. Bartsch, and B. Janssen
Enhanced Hypoxic Pulmonary Vasoconstriction in Families of Adults or Children With Idiopathic Pulmonary Arterial Hypertension
Chest, December 1, 2005; 128(6_suppl): 630S - 633S.
[Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
S. Huez, K. Retailleau, P. Unger, A. Pavelescu, J.-L. Vachiery, G. Derumeaux, and R. Naeije
Right and left ventricular adaptation to hypoxia: a tissue Doppler imaging study
Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1391 - H1398.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. M. Berger, C. Hesse, C. Dehnert, H. Siedler, P. Kleinbongard, H. J. Bardenheuer, M. Kelm, P. Bartsch, and W. E. Haefeli
Hypoxia Impairs Systemic Endothelial Function in Individuals Prone to High-Altitude Pulmonary Edema
Am. J. Respir. Crit. Care Med., September 15, 2005; 172(6): 763 - 767.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C. Dehnert, E. Grunig, D. Mereles, N. von Lennep, and P. Bartsch
Identification of individuals susceptible to high-altitude pulmonary oedema at low altitude
Eur. Respir. J., March 1, 2005; 25(3): 545 - 551.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
P. Bartsch, H. Mairbaurl, M. Maggiorini, and E. R. Swenson
Physiological aspects of high-altitude pulmonary edema
J Appl Physiol, March 1, 2005; 98(3): 1101 - 1110.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
N. P. Talbot, G. M. Balanos, K. L. Dorrington, and P. A. Robbins
Two temporal components within the human pulmonary vascular response to ~2 h of isocapnic hypoxia
J Appl Physiol, March 1, 2005; 98(3): 1125 - 1139.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
H. A. Ghofrani, F. Reichenberger, M. G. Kohstall, E. H. Mrosek, T. Seeger, H. Olschewski, W. Seeger, and F. Grimminger
Sildenafil Increased Exercise Capacity during Hypoxia at Low Altitudes and at Mount Everest Base Camp: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial
Ann Intern Med, August 3, 2004; 141(3): 169 - 177.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. M. Hoeper, R. J. Oudiz, A. Peacock, V. F. Tapson, S. G. Haworth, A. E. Frost, and A. Torbicki
End points and clinical trial designs in pulmonary arterial hypertension: Clinical and regulatory perspectives
J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 48S - 55S.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. Rindermann, E. Grunig, A. von Hippel, R. Koehler, G. Miltenberger-Miltenyi, D. Mereles, K. Arnold, M. Pauciulo, W. Nichols, H. Olschewski, et al.
Primary pulmonary hypertension may be a heterogeneous disease with a second locus on chromosome 2q31
J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2237 - 2244.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. R. Woods, A. J. Pollard, D. J. Collier, Y. Jamshidi, V. Vassiliou, E. Hawe, S. E. Humphries, and H. E. Montgomery
Insertion/Deletion Polymorphism of the Angiotensin I-Converting Enzyme Gene and Arterial Oxygen Saturation at High Altitude
Am. J. Respir. Crit. Care Med., August 1, 2002; 166(3): 362 - 366.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
G. M. Balanos, K. L. Dorrington, and P. A. Robbins
Desferrioxamine elevates pulmonary vascular resistance in humans: potential for involvement of HIF-1
J Appl Physiol, June 1, 2002; 92(6): 2501 - 2507.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
P. H. Hackett and R. C. Roach
High-Altitude Illness
N. Engl. J. Med., July 12, 2001; 345(2): 107 - 114.
[Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2000 by the American College of Cardiology Foundation.