Pulmonary circulation and oxygen transport in lambs at high altitude

1963 ◽  
Vol 18 (3) ◽  
pp. 560-566 ◽  
Author(s):  
John T. Reeves ◽  
Estelle B. Grover ◽  
Robert F. Grover
Keyword(s):  
Pulmonary Artery ◽  
High Altitude ◽  
Oxygen Transport ◽  
Rapid Growth ◽  
Dissociation Curve ◽  
Pulmonary Hemodynamics ◽  
Consistent Finding ◽  
Low Altitude ◽  
The Right ◽  
Mixed Venous

The oxygen transport and pulmonary hemodynamics of lambs native to low altitude were evaluated in Denver and on Mount Evans (12,700 ft.). Because the Hb-O2 dissociation curve is placed well to the right of most other mammals, markedly depressed arterial O2 saturations (59%) occurred at high altitude. However, the lambs adapted remarkably well and showed normally rapid growth. The mixed venous Po2 was relatively well maintained, primarily by a narrowing of the A-V Po2 gradient to 11 mm Hg. Despite the marked hypoxemia, elevation of the pulmonary artery pressure was not a consistent finding, and when it occurred it was neither marked nor sustained. Submitted on June 6, 1962

High-Altitude Pulmonary Edema with Absent Right Pulmonary Artery

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 314-317
Author(s):  
Billy Rios ◽  
David J. Driscoll ◽  
Dan G. McNamara
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Edema ◽  
High Altitude ◽  
Congenital Absence ◽  
High Altitude Pulmonary Edema ◽  
Threatening Condition ◽  
Right Pulmonary Artery ◽  
Life Threatening ◽  
Low Altitude ◽  
The Right

High-altitude pulmonary edema potentially is fatal. Adults with unilateral absence of a right pulmonary artery are particularly susceptible to high-altitude pulmonary edema. The occurrence of high-altitude pulmonary edema was documented in a child with congenital absence of the right pulmonary artery. Improvement occurred only upon descent to low altitude. Physicians should be aware of this life-threatening condition in children ascending to high altitude, particularly in individuals with unilateral absence of a pulmonary artery.

scholarly journals Pulmonary artery pressure and arterial oxygen saturation in people living at high or low altitude: systematic review and meta-analysis

2016 ◽  
Vol 121 (5) ◽  
pp. 1151-1159 ◽  
Author(s):  
Rodrigo Soria ◽  
Matthias Egger ◽  
Urs Scherrer ◽  
Nicole Bender ◽  
Stefano F. Rimoldi
Keyword(s):  
Systematic Review ◽  
Pulmonary Artery ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Pulmonary Artery Pressure ◽  
Meta Analysis ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Low Altitude ◽  
Apparently Healthy

More than 140 million people are living at high altitude worldwide. An increase of pulmonary artery pressure (PAP) is a hallmark of high-altitude exposure and, if pronounced, may be associated with important morbidity and mortality. Surprisingly, there is little information on the usual PAP in high-altitude populations. We, therefore, conducted a systematic review (MEDLINE and EMBASE) and meta-analysis of studies published (in English or Spanish) between 2000 and 2015 on echocardiographic estimations of PAP and measurements of arterial oxygen saturation in apparently healthy participants from general populations of high-altitude dwellers (>2,500 m). For comparison, we similarly analyzed data published on these variables during the same period for populations living at low altitude. Twelve high-altitude studies comprising 834 participants and 18 low-altitude studies (710 participants) fulfilled the inclusion criteria. All but one high-altitude studies were performed between 3,600 and 4,350 m. The combined mean systolic PAP (right ventricular-to-right atrial pressure gradient) at high altitude [25.3 mmHg, 95% confidence interval (CI) 24.0, 26.7], as expected was significantly (P < 0.001) higher than at low altitude (18.4 mmHg, 95% CI 17.1,19.7), and arterial oxygen saturation was significantly lower (90.4%, 95% CI 89.3, 91.5) than at low altitude (98.1%; 95% CI 97.7, 98.4). These findings indicate that at an altitude where the very large majority of high-altitude populations are living, pulmonary hypertension appears to be rare. The reference values and distributions for PAP and arterial oxygen saturation in apparently healthy high-altitude dwellers provided by this meta-analysis will be useful to future studies on the adjustments to high altitude in humans.

scholarly journals Pulmonary hemodynamics and diastolic function of right ventricle at isometric exercises in children with chronic bronchopulmonary pathology

2011 ◽  
Vol 10 (3) ◽  
pp. 105-110
Author(s):  
L. I. Agapitov ◽  
Yu. M. Belozerov ◽  
Yu. L. Mizernitsky ◽  
S. E. Tsyplenkova
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Diastolic Function ◽  
Pulmonary Artery Pressure ◽  
Isometric Exercise ◽  
Healthy Children ◽  
Pulmonary Hemodynamics ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
The Right

We studied pulmonary hemodynamics and right ventricular diastolic function in 300 healthy children and 392 children with chronic bronchopulmonary pathology in an isometric exercise. Using echocardiography were determined systolic, diastolic, mean, pulmonary artery pressure, total pulmonary resistance, diastolic function of the right ventricle. Defined normal values of reactivity of pulmonary hemodynamics and diastolic function of the right ventricle in an isometric load. In patients with chronic bronchopulmonary pathology set higher increase of systolic, diastolic, mean, pulmonary artery pressure, decrease diastolic reserve the right ventricle compared to the control. The worst violations of pulmonary hemodynamics and diastolic function of the right ventricle during isometric load observed in patients with chronic Infectious-inflammatory and interstitial lung disease.

Rapid growth of pulmonary artery after intrapulmonary artery septation

2018 ◽  
Vol 26 (6) ◽  
pp. 479-481
Author(s):  
Kota Agematsu ◽  
Toru Okamura ◽  
Yoji Takiguchi ◽  
Fumiya Yoneyama ◽  
Yorikazu Harada
Keyword(s):  
Pulmonary Artery ◽  
Rapid Growth ◽  
Neonatal Period ◽  
Left Pulmonary Artery ◽  
Fontan Circulation ◽  
Early Infancy ◽  
Pulmonary Shunt ◽  
Baby Girl ◽  
Right Pulmonary Artery ◽  
The Right

Intrapulmonary artery septation is employed in patients with unbalanced pulmonary artery growth. A baby girl received a systemic pulmonary shunt in the neonatal period and bilateral Glenn shunts in early infancy. Once the Glenn shunts were established, the right pulmonary artery became hypoplastic. We performed intrapulmonary artery septation involving the Glenn shunts to the left pulmonary artery and the systemic pulmonary shunt to the right pulmonary artery. As early as 3 months after intrapulmonary artery septation, right pulmonary artery growth was observed. Eventually, Fontan circulation was achieved with fenestration.

Oxygen transport of hemoglobin in high-altitude animals (Camelidae)

1975 ◽  
Vol 38 (5) ◽  
pp. 806-810 ◽  
Author(s):  
C. Reynafarje ◽  
J. Faura ◽  
D. Villavicencio ◽  
A. Curaca ◽  
B. Reynafarje ◽  
...  
Keyword(s):  
High Altitude ◽  
Sea Level ◽  
Oxygen Transport ◽  
Fetal Hemoglobin ◽  
Lactic Dehydrogenase ◽  
Tissue Level ◽  
Dissociation Curve ◽  
Blood Characteristics ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
2,3 Dpg

To clarify the mechanisms by which high-altitude Camelidae can adapt to hypoxia, the study of some blood characteristics were carried out in apacas and llamas. The results show that there is a peculiar dissociation curve of hemoglobin in alpacas which permits great affinity of hemoglobin for oxygen at lung level and the release of oxygen at the tissue level with a facility similar to that in man. Fetal hemoglobin was found high in adult alpacas (55 percent). Electrophoretic studies of hemoglobin showed that this pigment has two components, both of which have a very low mobility. Lactic dehydrogenase was found six times higher than in humans. RBC glucose-6-phosphate dehydrogenase was two times higher than in man living at the same altitude. Myoglobin was found to be higher than in man living at altitude. Alpacas have erythrocytes in which the amount of 2,3-DPG is approximately the same as in man. RBC are more resistent to hypotonic solutions than humans. The amount of lactic dehydrogenase, myoglobin, and glucose-6-phosphate dehydrogenase dimishes when alpacas are bought down to sea level.

Impact of acute hypoxic pulmonary hypertension on LV diastolic function in healthy mountaineers at high altitude

2004 ◽  
Vol 286 (3) ◽  
pp. H856-H862 ◽  
Author(s):  
Yves Allemann ◽  
Martin Rotter ◽  
Damian Hutter ◽  
Ernst Lipp ◽  
Claudio Sartori ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
High Altitude ◽  
Diastolic Function ◽  
Pulmonary Artery Pressure ◽  
Healthy Subjects ◽  
Artery Pressure ◽  
Altitude Exposure ◽  
Low Altitude ◽  
Lv Diastolic Function

In pulmonary hypertension right ventricular pressure overload leads to abnormal left ventricular (LV) diastolic function. Acute high-altitude exposure is associated with hypoxia-induced elevation of pulmonary artery pressure particularly in the setting of high-altitude pulmonary edema. Tissue Doppler imaging (TDI) allows assessment of LV diastolic function by direct measurements of myocardial velocities independently of cardiac preload. We hypothesized that in healthy mountaineers, hypoxia-induced pulmonary artery hypertension at high altitude is quantitatively related to LV diastolic function as assessed by conventional and TDI Doppler methods. Forty-one healthy subjects (30 men and 11 women; mean age 41 ± 12 yr) underwent transthoracic echocardiography at low altitude (550 m) and after a rapid ascent to high altitude (4,559 m). Measurements included the right ventricular to right atrial pressure gradient (ΔPRV-RA), transmitral early ( E) and late ( A) diastolic flow velocities and mitral annular early ( Em) and late ( Am) diastolic velocities obtained by TDI at four locations: septal, inferior, lateral, and anterior. At a high altitude, ΔPRV-RA increased from 16 ± 7to44 ± 15 mmHg ( P < 0.0001), whereas the transmitral E-to- A ratio ( E/ A ratio) was significantly lower (1.11 ± 0.27 vs. 1.41 ± 0.35; P < 0.0001) due to a significant increase of A from 52 ± 15 to 65 ± 16 cm/s ( P = 0.0001). ΔPRV-RA and transmitral E/ A ratio were inversely correlated ( r2 = 0.16; P = 0.0002) for the whole spectrum of measured values (low and high altitude). Diastolic mitral annular motion interrogation showed similar findings for spatially averaged (four locations) as well as for the inferior and septal locations: Am increased from low to high altitude (all P < 0.01); consequently, Em/ Am ratio was lower at high versus low altitude (all P < 0.01). These intraindividual changes were reflected interindividually by an inverse correlation between ΔPRV-RA and Em/ Am (all P < 0.006) and a positive association between ΔPRV-RA and Am (all P < 0.0009). In conclusion, high-altitude exposure led to a two- to threefold increase in pulmonary artery pressure in healthy mountaineers. This acute increase in pulmonary artery pressure led to a change in LV diastolic function that was directly correlated with the severity of pulmonary hypertension. However, in contrast to patients suffering from some form of cardiopulmonary disease and pulmonary hypertension, in these healthy subjects, overt LV diastolic dysfunction was not observed because it was prevented by augmented atrial contraction. We propose the new concept of compensated diastolic (dys)function.

High-Altitude Pulmonary Edema in Persons without the Right Pulmonary Artery

1980 ◽  
Vol 302 (19) ◽  
pp. 1070-1073 ◽  
Author(s):  
Peter H. Hackett ◽  
C. Edward Creagh ◽  
Robert F. Grover ◽  
Benjamin Honigman ◽  
Charles S. Houston ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Edema ◽  
High Altitude ◽  
High Altitude Pulmonary Edema ◽  
Right Pulmonary Artery ◽  
The Right

Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3,450 m

2012 ◽  
Vol 302 (12) ◽  
pp. H2646-H2653 ◽  
Author(s):  
Yves Allemann ◽  
Thomas Stuber ◽  
Stefano F. de Marchi ◽  
Emrush Rexhaj ◽  
Claudio Sartori ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
High Altitude ◽  
Children And Adolescents ◽  
Pulmonary Artery Pressure ◽  
Young Population ◽  
Artery Pressure ◽  
Rapid Ascent ◽  
Low Altitude

High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life-threatening high-altitude pulmonary edema (HAPE), but there are limited data in this young population. We, therefore, assessed in 118 nonacclimatized healthy children and adolescents (mean ± SD; age: 11 ± 2 yr) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 h after rapid ascent to 3,450 m. Pulmonary artery pressure was more than twofold higher at high than at low altitude (35 ± 11 vs. 16 ± 3 mmHg; P < 0.0001), and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mmHg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost twofold larger increase in the 6- to 9- than in the 14- to 16-yr-old participants (24 ± 12 vs. 13 ± 8 mmHg; P = 0.004). Even in children with the most severe altitude-induced pulmonary hypertension, right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. HAPE appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.

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