Effect of High-Altitude Exposure on the Heart
High altitude brings a great physiological change in human beings, both during short-term exposure and in lifelong residents, especially in the cardiovascular system. Hypoxia notably induces pulmonary vasoconstriction, thus resulting in a moderate increase in pulmonary arterial pressure. Acclimatize...
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| Language: | English |
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Wolters Kluwer Health/LWW
2023-03-01
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| Series: | Cardiology Discovery |
| Online Access: | http://journals.lww.com/10.1097/CD9.0000000000000082 |
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| author | Lan Huang |
| author_facet | Lan Huang |
| author_sort | Lan Huang |
| collection | DOAJ |
| description | High altitude brings a great physiological change in human beings, both during short-term exposure and in lifelong residents, especially in the cardiovascular system. Hypoxia notably induces pulmonary vasoconstriction, thus resulting in a moderate increase in pulmonary arterial pressure. Acclimatized inhabitants exhibit lower pulmonary pressure and better exercise capacity than lowlanders during short-term high-altitude exposure. Rapid ascent to high altitude without adequate acclimatization can cause high-altitude pulmonary edema in susceptible individuals, with a rapid increase in pulmonary pressure. Cardiac output increases initially following acute high-altitude exposure and returns to normal as at sea level after a few days of acclimatization. Ventricular volumes at high altitude change consistently with decreases in plasma volume. Left ventricular systolic function is enhanced after acute high-altitude exposure and during chronic acclimatization. However, there are controversies on whether right ventricular systolic function is preserved or decreases after high-altitude exposure, probably due to variable hypoxic pulmonary vasoconstriction. High altitude induces altered ventricular diastolic patterns. Recently, a new perspective has emerged, whereby ventricular intrinsic relaxation is not impaired, as assessed by untwisting through speckle-tracking imaging. Persistent hypoxic pulmonary hypertension probably induced right ventricular dilation and hypertrophy, and even right heart failure, described as high-altitude heart diseases. Descent to lower altitude should be the best treatment for them, and potential pharmacological agents majorly focus on the inhabitation of pulmonary vasoconstriction, such as phosphodiesterase-5 inhibitors and endothelin receptor antagonists. Evidence on the risks of high-altitude exposure for patients with previous cardiovascular diseases is limited, and thus they should be prudent when ascending to high altitude. Further randomized large-scale studies are needed to explore cardiac performance at high altitudes and provide more evidence for the prevention and clinical management of medical complications at high altitude. |
| format | Article |
| id | doaj-art-d1a03ea856ff486e8a670b4d056bd1a6 |
| institution | OA Journals |
| issn | 2096-952X 2693-8499 |
| language | English |
| publishDate | 2023-03-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Cardiology Discovery |
| spelling | doaj-art-d1a03ea856ff486e8a670b4d056bd1a62025-08-20T01:54:19ZengWolters Kluwer Health/LWWCardiology Discovery2096-952X2693-84992023-03-0131485310.1097/CD9.0000000000000082202303000-00007Effect of High-Altitude Exposure on the HeartLan Huang0Institute of Cardiovascular Diseases of People’s Liberation Army, Department of Cardiology, Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing 400037, China.High altitude brings a great physiological change in human beings, both during short-term exposure and in lifelong residents, especially in the cardiovascular system. Hypoxia notably induces pulmonary vasoconstriction, thus resulting in a moderate increase in pulmonary arterial pressure. Acclimatized inhabitants exhibit lower pulmonary pressure and better exercise capacity than lowlanders during short-term high-altitude exposure. Rapid ascent to high altitude without adequate acclimatization can cause high-altitude pulmonary edema in susceptible individuals, with a rapid increase in pulmonary pressure. Cardiac output increases initially following acute high-altitude exposure and returns to normal as at sea level after a few days of acclimatization. Ventricular volumes at high altitude change consistently with decreases in plasma volume. Left ventricular systolic function is enhanced after acute high-altitude exposure and during chronic acclimatization. However, there are controversies on whether right ventricular systolic function is preserved or decreases after high-altitude exposure, probably due to variable hypoxic pulmonary vasoconstriction. High altitude induces altered ventricular diastolic patterns. Recently, a new perspective has emerged, whereby ventricular intrinsic relaxation is not impaired, as assessed by untwisting through speckle-tracking imaging. Persistent hypoxic pulmonary hypertension probably induced right ventricular dilation and hypertrophy, and even right heart failure, described as high-altitude heart diseases. Descent to lower altitude should be the best treatment for them, and potential pharmacological agents majorly focus on the inhabitation of pulmonary vasoconstriction, such as phosphodiesterase-5 inhibitors and endothelin receptor antagonists. Evidence on the risks of high-altitude exposure for patients with previous cardiovascular diseases is limited, and thus they should be prudent when ascending to high altitude. Further randomized large-scale studies are needed to explore cardiac performance at high altitudes and provide more evidence for the prevention and clinical management of medical complications at high altitude.http://journals.lww.com/10.1097/CD9.0000000000000082 |
| spellingShingle | Lan Huang Effect of High-Altitude Exposure on the Heart Cardiology Discovery |
| title | Effect of High-Altitude Exposure on the Heart |
| title_full | Effect of High-Altitude Exposure on the Heart |
| title_fullStr | Effect of High-Altitude Exposure on the Heart |
| title_full_unstemmed | Effect of High-Altitude Exposure on the Heart |
| title_short | Effect of High-Altitude Exposure on the Heart |
| title_sort | effect of high altitude exposure on the heart |
| url | http://journals.lww.com/10.1097/CD9.0000000000000082 |
| work_keys_str_mv | AT lanhuang effectofhighaltitudeexposureontheheart |