Ventricular structure, function, and mechanics at high altitude: Chronic remodeling in Sherpa vs. short-term lowlander adaptation

Journal of Applied Physiology

Volumn 117, Issue 3, 2014, Pages 334-343

  Stembridge, Mike ^a   Ainslie, Philip N ^b   Hughes, Michael G ^a   Stöhr, Eric J ^a   Cotter, James D ^c   Nio, Amanda Q X ^a   Shave, Rob ^a  

^a CARDIFF METROPOLITAN UNIVERSITY   (United Kingdom)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^c UNIVERSITY OF OTAGO   (New Zealand)

Author keywords

Cardiac remodeling; Hypoxia; Sherpa; Ventricular mechanics

Indexed keywords

ACCLIMATIZATION; ADAPTATION; ADULT; ANIMAL; ANOXIA; DIASTOLE; ECHOCARDIOGRAPHY; HEART LEFT VENTRICLE FUNCTION; HEART RIGHT VENTRICLE FUNCTION; HEART STROKE VOLUME; HEART VENTRICLE; HUMAN; MALE; PATHOPHYSIOLOGY; PHYSIOLOGY; PROCEDURES; SYSTOLE;

ACCLIMATIZATION; ADAPTATION, PHYSIOLOGICAL; ADULT; ANIMALS; ANOXIA; DIASTOLE; ECHOCARDIOGRAPHY; HEART VENTRICLES; HUMANS; MALE; STROKE VOLUME; SYSTOLE; VENTRICULAR FUNCTION, LEFT; VENTRICULAR FUNCTION, RIGHT;

EID: 84905489673     PISSN: 87507587     EISSN: 15221601     Source Type: Journal    
DOI: 10.1152/japplphysiol.00233.2014     Document Type: Article

References (50)

1. Alam M, Wardell J, Andersson E, Samad BA, Nordlander R. Characteristics of mitral and tricuspid annular velocities determined by pulsed wave Doppler tissue imaging in healthy subjects. J Am Soc Echocardiogr 12:618-628, 1999.
2. Aldenderfer M. Peopling the Tibetan plateau: insights from archaeology. High Alt Med Biol 12:141-147, 2011.
3. Batterham AM, George KP, Mullineaux DR. Allometric scaling of left ventricular mass by body dimensions in males and females. Med Sci Sports Exerc 29:181-186, 1997.
4. Beall CM, Brittenham GM, Strohl KP, Blangero J, Williams-Blangero S, Goldstein MC, Decker MJ, Vargas E, Villena M, Soria R, Alarcon AM, Gonzales C. Hemoglobin concentration of high-Altitude Tibetans and Bolivian Aymara. Am J Phys Anthropol 106:385-400, 1998.
5. Beyar R, Sideman S. A computer study of the left ventricular performance based on fiber structure, sarcomere dynamics, and transmural electrical propagation velocity. Circ Res 55:358-375, 1984.
6. Beyar R, Sideman S. Left ventricular mechanics related to the local distribution of oxygen demand throughout the wall. Circ Res 58:664-677, 1986.
7. Bossone E, Duong-Wagner TH, Paciocco G, Oral H, Ricciardi M, Bach DS, Rubenfire M, Armstrong WF. Echocardiographic features of primary pulmonary hypertension. J Am Soc Echocardiogr 12:655-662, 1999.
8. Boussuges A, Molenat F, Burnet H, Cauchy E, Gardette B, Sainty JM, Jammes Y, Richalet JP. Operation Everest III (Comex' 97): modifications of cardiac function secondary to altitude-induced hypoxia. An echocardiographic and Doppler study. Am J Respir Crit Care Med 161:264-270, 2000.
9. Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 37:247-248, 1974.
10. Dong L, Zhang F, Shu X, Guan L, Chen H. Left ventricular torsion in patients with secundum atrial septal defect. Circ J 73:1308-1314, 2009.
11. Faoro V, Huez S, Vanderpool RR, Groepenhoff H, De Bisschop C, Martinot JB, Lamotte M, Pavelescu A, Guenard H, Naeije R. Pulmonary circulation and gas exchange at exercise in Sherpas at high altitude. J Appl Physiol (1985) 116:919-926, 2014.
12. Garrido E, Rodas G, Javierre C, Segura R, Estruch A, Ventura JL. Cardiorespiratory response to exercise in elite Sherpa climbers transferred to sea level. Med Sci Sports Exerc 29:937-942, 1997.
13. Gibbons Kroeker CA, Tyberg JV, Beyar R. Effects of load manipulations, heart rate, and contractility on left ventricular apical rotation. An experimental study in anesthetized dogs. Circulation 92:130-141, 1995.
14. Gibbs JS. Biventricular function at high altitude: implications for regulation of stroke volume in chronic hypoxia. Adv Exp Med Biol 618:13-24, 2007.
15. Halperin BD, Sun S, Zhuang J, Droma T, Moore LG. ECG observations in Tibetan and Han residents of Lhasa. J Electrocardiol 31:237-243, 1998.
16. Hansen DE, Daughters GT 2nd, Alderman EL, Ingels NB, Stinson EB, Miller DC. Effect of volume loading, pressure loading, and inotropic stimulation on left ventricular torsion in humans. Circulation 83:1315-1326, 1991.
17. Hansen J, Sander M. Sympathetic neural overactivity in healthy humans after prolonged exposure to hypobaric hypoxia. J Physiol 546:921-929, 2003.
18. Hodt A, Hisdal J, Stugaard M, Stranden E, Atar D, Steine K. Reduced preload elicits increased LV twist in healthy humans: an echocardiographic speckle-tracking study during lower body negative pressure. Clin Physiol Funct Imaging 31:382-389, 2011.
19. Holloway C, Cochlin L, Codreanu I, Bloch E, Fatemian M, Szmigielski C, Atherton H, Heather L, Francis J, Neubauer S, Robbins P, Montgomery H, Clarke K. Normobaric hypoxia impairs human cardiac energetics. FASEB J 25:3130-3135, 2011.
20. Holloway CJ, Montgomery HE, Murray AJ, Cochlin LE, Codreanu I, Hopwood N, Johnson AW, Rider OJ, Levett DZ, Tyler DJ, Francis JM, Neubauer S, Grocott MP, Clarke K. Cardiac response to hypobaric hypoxia: persistent changes in cardiac mass, function, and energy metabolism after a trek to Mt. Everest Base Camp. FASEB J 25:792-796, 2011.
21. Huez S, Faoro V, Guenard H, Martinot JB, Naeije R. Echocardiographic and tissue Doppler imaging of cardiac adaptation to high altitude in native highlanders versus acclimatized lowlanders. Am J Cardiol 103:1605-1609, 2009.
22. Kaul S, Tei C, Hopkins JM, Shah PM. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 107:526-531, 1984.
23. Kihara Y, Grossman W, Morgan JP. Direct measurement of changes in intracellular calcium transients during hypoxia, ischemia, and reperfusion of the intact mammalian heart. Circ Res 65:1029-1044, 1989.
24. La Gerche A, Burns AT, Taylor AJ, Macisaac AI, Heidbuchel H, Prior DL. Maximal oxygen consumption is best predicted by measures of cardiac size rather than function in healthy adults. Eur J Appl Physiol 112:2139-2147, 2012.
25. Lahiri S, Milledge JS, Chattopadhyay HP, Bhattacharyya AK, Sinha AK. Respiration and heart rate of Sherpa highlanders during exercise. J Appl Physiol 23:545-554, 1967.
26. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440-1463, 2005.
27. Lumens J, Blanchard DG, Arts T, Mahmud E, Delhaas T. Left ventricular underfilling and not septal bulging dominates abnormal left ventricular filling hemodynamics in chronic thromboembolic pulmonary hypertension. Am J Physiol Heart Circ Physiol 299:H1083-H1091, 2010.
28. Naeije R. Physiological adaptation of the cardiovascular system to high altitude. Prog Cardiovasc Dis 52:456-466, 2010.
29. Naeije R. RV is doing well at high altitudes!-Always? JACC Cardiovasc Imaging 6:1298-1300, 2013.
30. Naeije R, Huez S, Lamotte M, Retailleau K, Neupane S, Abramowicz D, Faoro V. Pulmonary artery pressure limits exercise capacity at high altitude. Eur Respir J 36:1049-1055, 2010.
31. Nottin S, Doucende G, Schuster-Beck I, Dauzat M, Obert P. Alteration in left ventricular normal and shear strains evaluated by 2D-strain echocardiography in the athlete's heart. J Physiol 586:4721-4733, 2008.
32. Opdahl A, Remme EW, Helle-Valle T, Edvardsen T, Smiseth OA. Myocardial relaxation, restoring forces, and early-diastolic load are independent determinants of left ventricular untwisting rate. Circulation 126:1441-1451, 2012.
33. Penaloza D, Arias-Stella J. The heart and pulmonary circulation at high altitudes: healthy highlanders and chronic mountain sickness. Circulation 115:1132-1146, 2007.
34. Pratali L, Allemann Y, Rimoldi SF, Faita F, Hutter D, Rexhaj E, Brenner R, Bailey DM, Sartori C, Salmon CS, Villena M, Scherrer U, Picano E, Sicari R. RV contractility and exercise-induced pulmonary hypertension in chronic mountain sickness: a stress echocardiographic and tissue Doppler imaging study. JACC Cardiovasc Imaging 6:1287-1297, 2013.
35. Pugh LG. Blood volume and haemoglobin concentration at altitudes above 18, 000 ft. (5500 M). J Physiol 170:344-354, 1964.
36. Reeves JT, Groves BM, Sutton JR, Wagner PD, Cymerman A, Malconian MK, Rock PB, Young PM, Houston CS. Operation Everest II: preservation of cardiac function at extreme altitude. J Appl Physiol 63:531-539, 1987.
37. Robach P, Dechaux M, Jarrot S, Vaysse J, Schneider JC, Mason NP, Herry JP, Gardette B, Richalet JP. Operation Everest III: role of plasma volume expansion on VO (2) (max) during prolonged high-Altitude exposure. J Appl Physiol 89:29-37, 2000.
38. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685-713, 2010.
39. Ryan T, Petrovic O, Dillon JC, Feigenbaum H, Conley MJ, Armstrong WF. An echocardiographic index for separation of right ventricular volume and pressure overload. J Am Coll Cardiol 5:918-927, 1985.
40. Silverman HS, Wei S, Haigney MC, Ocampo CJ, Stern MD. Myocyte adaptation to chronic hypoxia and development of tolerance to subsequent acute severe hypoxia. Circ Res 80:699-707, 1997.
41. Stohr EJ, Gonzalez-Alonso J, Shave R. Left ventricular mechanical limitations to stroke volume in healthy humans during incremental exercise. Am J Physiol Heart Circ Physiol 301:H478-H487, 2011.
42. Stohr EJ, McDonnell B, Thompson J, Stone K, Bull T, Houston R, Cockcroft J, Shave R. Left ventricular mechanics in humans with high aerobic fitness: adaptation independent of structural remodelling, arterial haemodynamics and heart rate. J Physiol 590:2107-2119, 2012.
43. Tanner JM. Fallacy of per-weight and per-surface area standards, and their relation to spurious correlation. J Appl Physiol 2:1-15, 1949.
44. Tucker R, Kayser B, Rae E, Raunch L, Bosch A, Noakes T. Hyperoxia improves 20 km cycling time trial performance by increasing muscle activation levels while perceived exertion stays the same. Eur J Appl Physiol 101:771-781, 2007.
45. Van Dalen BM, Soliman OI, Kauer F, Vletter WB, Zwaan HB, Cate FJ, Geleijnse ML. Alterations in left ventricular untwisting with ageing. Circ J 74:101-108, 2010.
46. Van Dalen BM, Vletter WB, Soliman OI, Ten Cate FJ, Geleijnse ML. Importance of transducer position in the assessment of apical rotation by speckle tracking echocardiography. J Am Soc Echocardiogr 21:895-898, 2008.
47. Vendelin M, Bovendeerd PH, Engelbrecht J, Arts T. Optimizing ventricular fibers: uniform strain or stress, but not ATP consumption, leads to high efficiency. Am J Physiol Heart Circ Physiol 283:H1072-H1081, 2002.
48. Vogel M, Cheung MM, Li J, Kristiansen SB, Schmidt MR, White PA, Sorensen K, Redington AN. Noninvasive assessment of left ventricular force-frequency relationships using tissue Doppler-derived isovolumic acceleration: validation in an animal model. Circulation 107:1647-1652, 2003.
49. Wagner PD. Reduced maximal cardiac output at altitude-mechanisms and significance. Respir Physiol 120:1-11, 2000.
50. Zhou W, Benharash P, Ho J, Ko Y, Patel NA, Mahajan A. Left ventricular twist and untwist rate provide reliable measures of ventricular function in myocardial ischemia and a wide range of hemodynamic states. Physiol Rep 1:e00110, 2013.