Physiological adaptation of the cardiovascular system to high altitude

Progress in Cardiovascular Diseases

Volumn 52, Issue 6, 2010, Pages 456-466

  Naeije, Robert ^a  

^a ERASME HOSPITAL   (Belgium)

Author keywords

Cardiac failure; Cardiovascular system; Exercise; High altitude; Hypoxia; Physiologic adaptation; Pulmonary hypertension

Indexed keywords

BOSENTAN; DOBUTAMINE; OXYGEN; SILDENAFIL;

ACID BASE BALANCE; AEROBIC EXERCISE; ALTITUDE ACCLIMATIZATION; ARTICLE; AUTONOMIC NEUROPATHY; BLOOD VISCOSITY; CARDIOVASCULAR DISEASE; HEART MUSCLE ISCHEMIA; HEART OUTPUT; HEART RATE; HEART STROKE VOLUME; HEART VENTRICLE ENDDIASTOLIC PRESSURE; HEART VENTRICLE FUNCTION; HUMAN; HYPOCAPNIA; HYPOVOLEMIA; HYPOXIA; LUNG WEDGE PRESSURE; OXYGEN CONSUMPTION; OXYGEN TRANSPORT; POLYCYTHEMIA; PULMONARY HYPERTENSION; SYSTOLIC BLOOD PRESSURE; TACHYCARDIA; VASODILATATION; WORKLOAD;

ACCLIMATIZATION; ADAPTATION, PHYSIOLOGICAL; ALTITUDE; ALTITUDE SICKNESS; ANOXIA; AUTONOMIC NERVOUS SYSTEM; BLOOD PRESSURE; CARDIAC OUTPUT; CARDIOVASCULAR DISEASES; CARDIOVASCULAR PHYSIOLOGICAL PHENOMENA; CORONARY CIRCULATION; DIASTOLE; ELECTROCARDIOGRAPHY; EXERCISE; HEART FAILURE; HEART RATE; HEMODYNAMICS; HUMANS; HYPERTENSION, PULMONARY; OXYGEN CONSUMPTION; PULMONARY CIRCULATION; PULMONARY WEDGE PRESSURE; REST; STROKE VOLUME; SYSTOLE; TIME FACTORS; VENTRICULAR FUNCTION;

EID: 77952119909     PISSN: 00330620     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.pcad.2010.03.004     Document Type: Article

References (74)

1. Moso A. La stanchezza del cuore. Fisiologia dell'uomo sulle Alpi 1897, Fraztelli Treves, Editori, Molano.
2. Hecht H.H., Kuida H., Lange R.L., et al. Clinical features and hemodynamic observations in altitude-dependent right heart failure of cattle. Am J Med 1962, 32:171-183.
3. Monge M. La Enfermedad de Los Andes. Sindromes eritremicos 1928, Annales de la Facultad de Medicina, Lima, Peru.
4. Anand I.S., Malhotra R., Chandershekhar Y., et al. Adultsubacute mountain sickness: a syndrome of congestive heart failure in man at very high altitude. Lancet 1990, 335:561-565.
5. Pei S.X., Chen X.J., Si Ren B.Z., et al. Chronic mountain sickness in Tibet. Q J Med 1989, 266:555-574.
6. Huez S., Faoro V., Vachiery J.L., et al. Images in cardiovascular medicine. High-altitude-induced right-heart failure. Circulation 2007, 115:308-309.
7. Heath D., Williams D.R. Heart and coronary circulation. High-Altitude Medicine and Pathology 1989, 186-195. Butterworths, London. 2nd ed.
8. Penaloza D., Arias-Stella J. The heart and pulmonary circulation at high altitudes. Healthy highlanders and chronic mountain sickness. Circulation 2007, 115:1132-1146.
9. Ghofrani H.A., Reichenberger F., Kohstall M.G., et al. 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 2004, 141:169-177.
10. Naeije R., Mélot C., Mols P., et al. Effects of vasodilators on hypoxic pulmonary vasoconstriction in normal man. Chest 1982, 82:404-410.
11. Klausen K. Cardiac output in man at rest and work during and after acclimatization to 3,800 m. J Appl Physiol 1966, 21:609-616.
12. Vogel J.A., Harris C.W. Cardiopulmonary responses of resting man during early exposure to high altitude. J Appl Physiol 1967, 22:1124-1128.
13. Hartley L.H., Alexander J.K., Modelski M., et al. Subnormal cardiac output at rest and during exercise in residents at 3100 m altitude. J Appl Physiol 1967, 23:839-848.
14. Banchero N., Sime F., Penaloza D., et al. Pulmonary pressure, cardiac output, and arterial oxygen saturation during exercise at high altitude and at sea level. Circulation 1968, 33:249-262.
15. Vogel J.A., Hartley H., Cruz J.C. Cardiac output during exercise in altitude natives at sea level and high altitude. J Appl Physiol 1974, 36:173-176.
16. Rahn H., Otis A.B. Man's respiratory response during and after acclimatization to high altitude. Am J Physiol 1949, 157:445-462.
17. Milnor W.R., Bergel D.H., Bargainer J.D. Hydraulic power associated with pulmonary flow and its relation to heart rate. Circ Res 1966, 19:467-480.
18. Cerritelli P. Gas exchange at high altitude. Pulmonary gas exchange 1980, vol II:97-147. Academic Press, New York. J.B. West (Ed.).
19. 2 content on circulation and physical performance. J Appl Physiol 1975, 39:71-75.
20. Alexander J.K., Hartley L.H., Modelski M., et al. Reduction of stroke volume during exercise in man following ascent to 3100 m altitude. J Appl Physiol 1967, 23:849-858.
21. Wagner P.D., Gale G.E., Moon R.E., et al. Pulmonary gas exchange in humans exercising at sea level and simulated altitude. J Appl Physiol 1986, 61:260-270.
22. Naeije R., Mélot C., Niset G., et al. Improved arterial oxygenation by a pharmacological increase in chemosensitivity during hypoxic exercise in normal subjects. J Appl Physiol 1993, 74:1666-1671.
23. Pugh I.G.C.E. Cardiac output in muscular exercise at 5800 m (19,000 ft). J Appl Physiol 1964, 19:441-447.
24. Reeves J.T., Groves B.M., Sutton J.R., et al. Operation Everest II: preservation of cardiac function at high altitude. J Appl Physiol 1987, 63:531-539.
25. Calbet J.A., Boushel R., Radegran G., et al. Determinants of maximal oxygen uptake in severe acute hypoxia. Am J Physiol Regul Integr Comp Physiol 2003, 284:R291-R303.
26. Calbet J.A., Boushel R., Radegran G., et al. Why is VO2 max after altitude acclimatization still reduced despite normalization of arterial O2 content?. Am J Physiol Regul Integr Comp Physiol 2003, 284:R304-R316.
27. Cunningham W.L., Becker E.J., Kreuzer F. Catecholamines in plasma and urine at high altitude. J Appl Physiol 1965, 20:607-610.
28. Bogaard H.J., Hopkins S.R., Yamaya Y., et al. Role of autonomic nervous system in the reduced maximal cardiac output at altitude. J Appl Physiol 2002, 93:271-279.
29. Mazzeo B.S., Brooks G.A., Butterfield G.E., et al. Acclimatization to high altitude increases muscle sympathetic activity both at rest and during exercise. Am J Physiol Regulatory Integrative Comp Physiol 1995, 269:R201-R207.
30. Hansen J., Sander M. Sympathetic neural overactivity in healthy humans after prolonged exposure to hypobaric hypoxia. J Physiol 2003, 546:921-929.
31. Richalet J.P., Larmignat P., Rathat C., et al. Decreased human cardiac response to isoproterenol infusion in acute and chronic hypoxia. J Appl Physiol 1988, 65:1957-1961.
32. Kacimi R., Richalet J.P., Corsin A., et al. Hypoxia-induced downregulation of β-adrenergic responses in rat heart. J Appl Physiol 1992, 73:1377-1382.
33. Kacemi R., Richalet J.P., Crozatier B. Hypoxia-induced differential modulation of adenosinergic and muscarinic receptors in the rat heart. J Appl Physiol 1993, 75:1123-1138.
34. Hartley R.H., Alexander J.K., Modelski M., et al. Reduction in maximal heart rate at altitude and its reversal with atropine. J Appl Physiol 1974, 36:362-365.
35. Boushel R., Calbet J.A., Radegran G., et al. Parasympathetic neural activity accounts for the lowering of exercise heart rate at high altitude. Circulation 2001, 104:1785-1791.
36. Moore L.G., Cymerman A., Shao-Yung H., et al. Propranolol does not impair exercise oxygen uptake in normal man at high altitude. J Appl Physiol 1986, 61:1935-1941.
37. Noakes T.D. Physiological models to understand exercise fatigue and the adaptations that predict or enhance athletic performance. Scand J Med Sci Sports 2000, 10:119-123.
38. Tucker C.E., James W.E., Berry M.A., et al. Depressed myocardial function in the goat at high altitude. J Appl Physiol 1976, 41:356-361.
39. Silverman H.S., Wei S., Haigney M.C., et al. Myocyte adaptation to chronic hypoxia and development of tolerance to subsequent acute severe hypoxia. Circ Res 1997, 80:699-707.
40. Suarez J., Alexander J.K., Houston C.S. Enhanced left ventricular systolic performance at high altitude during Operation Everest II. Am J Cardiol 1987, 60:137-142.
41. 2. Circ Res 1978, 38:391-396.
42. Pugh L.G.C.E. Blood volume and hemoglobin concentration at altitudes above 18,000 ft (5,500 m). J Physiol 1964, 170:344-354.
43. Grover R.F., Selland M.A., McCullough R.G., et al. Beta-adrenergic blockade does not prevent polycythemia or decrease plasma volume in men at 4300 m altitude. Eur J Appl Physiol 1998, 77:264-270.
44. 2max during prolonged altitude exposure. J Appl Physiol 2000, 89:29-37.
45. Poulsen T.D., Klausen K., Richalet J.P., et al. Plasma volume in acute hypoxia: comparison of a carbon monoxide rebreathing method and dye dilution with Evan's blue. Eur J Appl Physiol 1998, 77:457-461.
46. Sawka M.N., Young A.J., Rock P.B., et al. Altitude acclimatization and blood volume: effects of exogenous erythrocyte volume expansion. J Appl Physiol 1996, 81:636-642.
47. Calbet J.A.L., Rädegrän G., Boushel R., et al. Plasma volume expansion does not increase cardiac output or VO2max in lowlanders acclimatized to altitude. Am J Physiol Heart Circ Physiol 2004, 287:H1214-H1224.
48. Richardson T.Q., Guyton A.C. Effects of polycythemia andanemia on cardiac output and other circulatory factors. Am J Physiol 1959, 197:1667-1670.
49. Horstman D., Weiskoff R., Jackson R.E. Work capacity during 3-week sojourn at 4300 m.: effects of relative polycythemia. J Appl Physiol 1980, 49:311-318.
50. Sarnquist F., Scoene R., Hackett P., et al. Hemodilution of polycythemic mountaineers; effects of relative polycythemia. Aviat Space Environm Med 1986, 57:313-317.
51. Faoro V., Lamotte M., Deboeck G., et al. Effects of sildenafil on exercise capacity in hypoxic normal subjects. High Alt Med Biol 2007, 8:155-163.
52. Faoro V., Boldingh S., Moreels M., et al. Naeije. Bosentan decreases pulmonary vascular resistance and increases exercise capacity in hypoxia. Chest 2009, 135:1215-1222.
53. Fischler M., Maggiorini M., Dorschner L., et al. Dexamethasone but not tadalafil improves exercise capacity in adults prone to high altitude pulmonary edema. Am J Respir Crit Care Med 2009, 180:346-352.
54. Wagner P.D. Gas exchange and peripheral diffusion limitation. Med Sci Sports Exerc 1992, 24:54-58.
55. Boussuges A., Molenat F., Burnet H., et al. Operation Everest III (Comex '97): Modifications of cardiac function secondary to altitude-induced hypoxia. Am J Respir Crit Care Med 2000, 161:264-270.
56. Allemann Y., Rotter M., Hutter D., et al. Impact of acute hypoxic pulmonary hypertension on LV diastolic function in healthy mountaineers at high altitude. Am J Physiol Heart Circ Physiol 2004, 286:H856-862.
57. Huez S., Retailleau K., Unger P., et al. Right and left ventricular adaptation to hypoxia: a tissue Doppler imaging study. Am J Physiol Heart Circ Physiol 2005, 289:H1391-H1398.
58. Huez S., Faoro V., Guénard H., et al. Echocardiographic and tissue Doppler imaging of cardiac adaptation to high altitude in native highlanders versus acclimatized lowlanders. Am J Cardiol 2009, 103:1605-1609.
59. Maignan M., Privat C., Leon-Velarde F., et al. Pulmonary pressure and cardiac function in chronic mountain sickness patients. Chest 2008, 135:499-504.
60. Bärtsch P., Gibbs S. Effect of altitude on the heart and the lungs. Circulation 2007, 116:2191-2202.
61. Marcus J.T., Gan C.T., Zwanenburg J.J., et al. Interventricular mechanical asynchrony in pulmonary arterial hypertension: left-to-right delay in peak shortening is related to right ventricular overload and left ventricular underfilling. J Am Coll Cardiol 2008, 51:750-757.
62. Hilton R., Eichholtz F. The influence of some chemical factors on the coronary circulation. J Physiol 1925, 9:413-425.
63. Wyss C.A., Koepfli P., Fretz G., et al. Influence of altitude exposure on coronary flow reserve. Circulation 2003, 108:1202-1207.
64. Grover R.F., Lufschanowski R., Alexander J.K. Alterations in the coronary circulation of man following ascent to 3100 m altitude. J Appl Physiol 1976, 41:832-838.
65. Moret P.R. Coronary blood flow and myocardial metabolism in man at high altitude. High altitude physiology: cardiac and respiratory aspects 1971, 131. Ciba.
66. Karliner J.S., Sarnquist F.F., Graber D.J., et al. The electrocardiogram at extreme altitude: experience on Mt Everest. Am Heart J 1985, 109:505-513.
67. Malconian M., Rock P., Hutgren H., et al. The electrocardiogram at rest and exercise during a simulated ascent of Mt Everest (Operation Everest II). Am J Cardiol 1990, 65:1475-1480.
68. Mortimer E.A., Monson R.R., MacMahon B. Reduction in mortality from coronary heart disease in men residing at high altitude. N Engl J Med 1977, 296:581-585.
69. Wolfel E., Selland M., Mazzeo R., et al. Sympathetic hypertension at 4300 m is related to sympathoadrenal activity. J Appl Physiol 1994, 76:1643-1650.
70. Hultgren H.N. Effect of high altitude on cardiovascular diseases. J Wilderness Med 1992, 3:301-308.
71. Ruiz L., Penaloza D. Altitude and hypertension. Mayo Clin Proc 1977, 52:442-445.
72. Westendorp R.G., Blauw G.J., Frolich M., et al. Hypoxic syncope. Aviat Space Environ Med 1997, 68:410-414.
73. Zhongyuan S., Xuehan N., Pengguo H., et al. Comparison of physiological responses to hypoxia at high altitudes between highlanders and lowlanders. Sci Sin 1979, 22:1455-1469.
74. Moore L.G., Grover R.F. Jack Reeves and his science. Respir Physiol Neurobiol 2006, 151:96-108.