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Tanné C, Peyret B, Cherif-Alami S, Navarre M, Pruvost I, Said MH, Baret M, Le Fur E, Basso A, Bonnet-Ducrot S, Desbruyeres C, Mortamet G. What altitude is safe for infants? An expert panel survey. Arch Pediatr 2023; 30:483-485. [PMID: 37704526 DOI: 10.1016/j.arcped.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 02/13/2023] [Accepted: 06/21/2023] [Indexed: 09/15/2023]
Abstract
AIM To assess advice given to parents who wish to travel to high altitudes with an infant and to provide guidance on this topic. METHOD Using an anonymous self-report survey online, we collected information on the advice provided by practitioners, who practice in mountain environments, to parents who wish to travel to altitude with an infant. General practitioners and pediatricians working in the French Alps were asked about the maximum allowable altitude for different ages and the specific recommendations given. RESULTS A total of 104 practitioners (39% general practitioners) responded to the study. Overall, to spend 1 day at altitude, practitioners recommended a median altitude of 1200, 1500, 1600, and 2000 m for infants under 1, 3, 12, and 24 months, respectively. Their main recommendations for infant protection focused on cold protection, increased hydration, and increased humidity level in the ambient air. Prevention of sudden infant death syndrome was essential according to the respondents. For infants with upper airway infection, most of the participants (90%, n = 94) recommended against traveling to altitude. CONCLUSION This survey revealed a certain consensus about the maximum travel altitude to be recommended for infants.
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Affiliation(s)
- Corentin Tanné
- Ifremmont - Institut de Recherche et de Formation en Médecine de Montagne, Chamonix, France; Pediatric Department, Chambéry Hospital Chambéry, Ifremmont, Chamonix, France.
| | - Blandine Peyret
- Neonatal Intensive Care Unit, Annecy-Genevois Hospital, Annecy, France
| | - Sophia Cherif-Alami
- Pediatric Department, Hôpitaux du pays du Mont Blanc, 74700 Sallanches, France
| | - Manon Navarre
- Medical office, Megeve, France; Médecins de Montagne Association, Chambéry, France
| | | | | | - Marie Baret
- Pediatric Department, Voiron Hospital, Voiron, France
| | - Estelle Le Fur
- Maternity Department, Clinique Cèdres Echirolles, Echirolles, France
| | - Amélie Basso
- Pediatric Department, Albertville Hospital, Albertville, France
| | | | | | - Guillaume Mortamet
- Pediatric Intensive Care Unit, Grenoble University Hospital, Grenoble, France
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2
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Peng W, Li H, Xia C, Guo Y, Xu X, Zeng W, Liu K, Che Q, Jiang Y, Xiang K, Zhou X, Li G, Li Z. Cardiovascular indicators associated with ventricular remodeling in chronic high-altitude disease: a cardiovascular MRI study. Eur Radiol 2023; 33:6267-6277. [PMID: 37036481 DOI: 10.1007/s00330-023-09574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE This study aimed to assess biventricular function and mechanics in patients with the chronic high-altitude disease (CHAD) using cardiovascular MRI and explore the possible risk factors associated with ventricular remodeling. METHODS In this prospective study, consecutive CHAD patients and healthy controls at high-altitude (HA) and at sea level (SL) underwent cardiovascular MRI. Right ventricular (RV) and left ventricular (LV) function and global strain parameters were compared. To identify risk factors associated with ventricular remodeling, multiple linear regression analyses were used. RESULTS A total of 33 patients with CHAD (42.97 years ± 11.80; 23 men), 33 HA (41.18 years ± 8.58; 21 men), and 33 SL healthy controls (43.48 years ± 13.40; 21 men) were included. A Significantly decreased biventricular ejection fraction was observed in patients (all p < 0.05). Additionally, the HA group displayed lower magnitudes of biventricular longitudinal peak strain (PS) (RV, - 13.67% ± 4.05 vs. - 16.22% ± 3.03; LV, - 14.68% ± 2.20 vs. - 16.19% ± 2.51; both p < 0.05), but a higher LV circumferential PS (- 20.74% ± 2.02 vs. - 19.17% ± 2.34, p < 0.05) than the SL group. Moreover, multiple linear regression analyses revealed that HGB (β = 0.548) was related to the LV remodeling index, whereas BUN (β = 0.570) was associated with the RV remodeling index. CONCLUSIONS With the deterioration of RV function in patients with CHAD, LV function was also impaired concomitantly. Hypoxia-induced erythrocytosis may contribute to LV impairment, while BUN was considered an independent risk factor for RV remodeling. KEY POINTS • A significantly lower biventricular ejection fraction was observed in patients, with a decreased magnitude of left ventricular (LV) peak systolic strain rate (radial and circumferential) and peak diastolic strain rate (all p < 0.05). • High-altitude healthy natives showed a lower biventricular longitudinal peak strain (all p < 0.05). • Hemoglobin was related to LV remodeling (β = 0.548), while BUN (β = 0.570) was independently associated with RV remodeling in CHAD patients.
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Affiliation(s)
- Wanlin Peng
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Hongwei Li
- Department of Cardiology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, 20# Ximianqiao Street, Chengdu, 610041, Sichuan, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# South ren Min Road, Chengdu, 610041, Sichuan, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# South Ren Min Road, Chengdu, 610041, Sichuan, China
| | - Xu Xu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Wen Zeng
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Keling Liu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Qianqiu Che
- Department of Cardiology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, 20# Ximianqiao Street, Chengdu, 610041, Sichuan, China
| | - Yuexin Jiang
- Department of Radiology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, 20# Ximianqiao Street, Chengdu, 610041, Sichuan, China
| | - Kejin Xiang
- Department of Radiology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, 20# Ximianqiao Street, Chengdu, 610041, Sichuan, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, 200126, China
| | - Gang Li
- Department of Radiology, The People's Hospital of Ningnan County Sichuan Province, Ningnan, 615400, Sichuan, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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3
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Hou J, Wen X, Long P, Xiong S, Liu H, Cai L, Deng H, Zhang Z. The role of post-translational modifications in driving abnormal cardiovascular complications at high altitude. Front Cardiovasc Med 2022; 9:886300. [PMID: 36186970 PMCID: PMC9515308 DOI: 10.3389/fcvm.2022.886300] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
The high-altitude environment is characterized by hypobaric hypoxia, low temperatures, low humidity, and high radiation, which is a natural challenge for lowland residents entering. Previous studies have confirmed the acute and chronic effects of high altitude on the cardiovascular systems of lowlanders. Abnormal cardiovascular complications, including pulmonary edema, cardiac hypertrophy and pulmonary arterial hypertension were commonly explored. Effective evaluation of cardiovascular adaptive response in high altitude can provide a basis for early warning, prevention, diagnosis, and treatment of altitude diseases. At present, post-translational modifications (PTMs) of proteins are a key step to regulate their biological functions and dynamic interactions with other molecules. This process is regulated by countless enzymes called “writer, reader, and eraser,” and the performance is precisely controlled. Mutations and abnormal expression of these enzymes or their substrates have been implicated in the pathogenesis of cardiovascular diseases associated with high altitude. Although PTMs play an important regulatory role in key processes such as oxidative stress, apoptosis, proliferation, and hypoxia response, little attention has been paid to abnormal cardiovascular response at high altitude. Here, we reviewed the roles of PTMs in driving abnormal cardiovascular complications at high altitude.
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Affiliation(s)
- Jun Hou
- Department of Cardiology, Chengdu Third People’s Hospital, Cardiovascular Disease Research Institute of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- School of Material Science and Engineering, Southwest Jiaotong University, Chengdu, China
| | - Xudong Wen
- Department of Gastroenterology and Hepatology, Chengdu First People’s Hospital, Chengdu, China
| | - Pan Long
- School of Material Science and Engineering, Southwest Jiaotong University, Chengdu, China
| | - Shiqiang Xiong
- Department of Cardiology, Chengdu Third People’s Hospital, Cardiovascular Disease Research Institute of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Hanxiong Liu
- Department of Cardiology, Chengdu Third People’s Hospital, Cardiovascular Disease Research Institute of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Lin Cai
- Department of Cardiology, Chengdu Third People’s Hospital, Cardiovascular Disease Research Institute of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- *Correspondence: Lin Cai,
| | - Haoyu Deng
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Center for Heart and Lung Innovation, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Haoyu Deng,
| | - Zhen Zhang
- Department of Cardiology, Chengdu Third People’s Hospital, Cardiovascular Disease Research Institute of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Zhen Zhang,
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Yuan T, Chen Y, Zhang H, Fang L, Du G. Salvianolic Acid A, a Component of Salvia miltiorrhiza, Attenuates Endothelial-Mesenchymal Transition of HPAECs Induced by Hypoxia. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:1185-1200. [PMID: 28893092 DOI: 10.1142/s0192415x17500653] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Salvianolic acid A (SAA), a polyphenols acid, is a bioactive ingredient from a traditional Chinese medicine called Dan shen (Salvia Miltiorrhiza Bunge). According to previous studies, it was shown to have various effects such as anti-oxidative stress, antidiabetic complications and antipulmonary hypertension. This study aimed to investigate the effect of SAA on pulmonary arterial endothelial-mesenchymal transition (EndoMT) induced by hypoxia and the underlying mechanisms. Primary cultured human pulmonary arterial endothelial cells (HPAECs) were exposed to 1% O2 for 48[Formula: see text]h with or without SAA treatment. SAA treatment improved the morphology of HPAECs and inhibited the cytoskeleton remodeling. A total of 3[Formula: see text][Formula: see text]M SAA reduced migration distances from 262.2[Formula: see text][Formula: see text]m to 198.4[Formula: see text][Formula: see text]m at 24[Formula: see text]h and 344.8[Formula: see text][Formula: see text]m to 109.3[Formula: see text][Formula: see text]m at 48[Formula: see text]h. It was observed that the production of ROS in cells was significantly reduced by the treatment of 3[Formula: see text][Formula: see text]M SAA. Meanwhile, SAA alleviated the loss of CD31 and slightly inhibited the expression of [Formula: see text]-SMA. The mechanisms study shows that SAA treatment increased the phosphorylation levels of Smad1/5, but inhibited that of Smad2/3. Furthermore, SAA attenuated the phosphorylation levels of ERK and Cofilin, which were enhanced by hypoxia. Based on these results, our study indicated that SAA treatment can protect HPAECs from endoMT induced by hypoxia, which may perform via the inhibition on ROS production and further through the downstream effectors of BMPRs or TGF[Formula: see text]R including Smads, ERK and ROCK/cofilin pathways.
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Affiliation(s)
- Tianyi Yuan
- * Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Union Medical College, Beijing 100050, China
| | - Yucai Chen
- * Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Union Medical College, Beijing 100050, China
| | - Huifang Zhang
- * Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Union Medical College, Beijing 100050, China
| | - Lianhua Fang
- * Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Union Medical College, Beijing 100050, China.,† Beijing Key Laboratory of Active Substance Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Guanhua Du
- * Beijing Key Laboratory of Drug Targets Identification and Drug Screening, Union Medical College, Beijing 100050, China.,† Beijing Key Laboratory of Active Substance Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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5
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Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, Hanna BD, Rosenzweig EB, Raj JU, Cornfield D, Stenmark KR, Steinhorn R, Thébaud B, Fineman JR, Kuehne T, Feinstein JA, Friedberg MK, Earing M, Barst RJ, Keller RL, Kinsella JP, Mullen M, Deterding R, Kulik T, Mallory G, Humpl T, Wessel DL. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015; 132:2037-99. [PMID: 26534956 DOI: 10.1161/cir.0000000000000329] [Citation(s) in RCA: 676] [Impact Index Per Article: 75.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension.
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MESH Headings
- Cardiovascular Agents/therapeutic use
- Child
- Child, Preschool
- Combined Modality Therapy
- Diagnostic Imaging/methods
- Disease Management
- Extracorporeal Membrane Oxygenation
- Genetic Counseling
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Hernias, Diaphragmatic, Congenital/complications
- Hernias, Diaphragmatic, Congenital/therapy
- Humans
- Hypertension, Pulmonary/diagnosis
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/genetics
- Hypertension, Pulmonary/therapy
- Infant
- Infant, Newborn
- Lung/embryology
- Lung Transplantation
- Nitric Oxide/administration & dosage
- Nitric Oxide/therapeutic use
- Oxygen Inhalation Therapy
- Persistent Fetal Circulation Syndrome/diagnosis
- Persistent Fetal Circulation Syndrome/therapy
- Postoperative Complications/therapy
- Respiration, Artificial/adverse effects
- Respiration, Artificial/methods
- Ventilator-Induced Lung Injury/prevention & control
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6
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Qi HY, Ma RY, Jiang LX, Li SP, Mai S, Chen H, Ge M, Wang MY, Liu HN, Cai YH, Xu SY, Li J. Anatomical and hemodynamic evaluations of the heart and pulmonary arterial pressure in healthy children residing at high altitude in China. IJC HEART & VASCULATURE 2015; 7:158-164. [PMID: 28785667 PMCID: PMC5497184 DOI: 10.1016/j.ijcha.2014.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 09/22/2014] [Accepted: 10/26/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Altitude-hypoxia induces pulmonary arterial hypertension and altered cardiac morphology and function, which is little known in healthy children at high altitude. We compared the cardiopulmonary measurements between the healthy children at 16 m and those at 3700 m in China and between the Hans and the Tibetans at 3700 m. METHODS Echocardiography was assessed in 477 children (15 day-14 years) including 220 at 16 m and 257 at 3700 m. The dimensions and wall thickness of the left- and right-sided heart, systolic and diastolic functions including cardiac output index (CI) were measured using standard methods. Mean pulmonary arterial pressure (mPAP) was estimated by the Doppler waveforms in the main pulmonary artery. RESULTS Compared to the 16 m-group, 3700 m-group had higher mPAP, increasing dilatation of the right heart, and slower decrease in right ventricular hypertrophy in 14 years (p < 0.05). The left heart morphology was not different (p > 0.20). Systolic and diastolic functions of both ventricles were significantly reduced, but CI was higher (p < 0.0001). There was no difference in any measurement between the Hans and the Tibetans (p > 0.05). CONCLUSIONS Children living at high altitude in China have significantly higher mPAP, dilated right heart and slower regression of right ventricular hypertrophy in the first 14 years of life. Systolic and diastolic functions of both ventricles were reduced with a paradoxically higher CI. There was no significant difference in these features between the Hans and the Tibetans. These values provide references for the care of healthy children and the sick ones with cardiopulmonary diseases at high altitude.
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Affiliation(s)
- Hai-Ying Qi
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Ru-Yan Ma
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Li-Xia Jiang
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Shu-Ping Li
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Shu Mai
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Hong Chen
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Mei Ge
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Mei-Ying Wang
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Hai-Ning Liu
- Division of Echocardiography, Women and Children's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Yue-Hong Cai
- Statistician, Data Center of Congenital Heart Surgeons' Society, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Su-Ya Xu
- Clinical Physiology Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Jia Li
- Clinical Physiology Research Center, Capital Institute of Pediatrics, Beijing, China
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7
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Shim CY. Down Syndrome in Moderate Altitude Residents: Are There Unique Features? J Cardiovasc Ultrasound 2015; 23:70-1. [PMID: 26140147 PMCID: PMC4486180 DOI: 10.4250/jcu.2015.23.2.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 05/30/2015] [Accepted: 06/01/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Chi Young Shim
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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Sable CA, Aliyu ZY, Dham N, Nouraie M, Sachdev V, Sidenko S, Miasnikova GY, Polyakova LA, Sergueeva AI, Okhotin DJ, Bushuev V, Remaley AT, Niu X, Castro OL, Gladwin MT, Kato GJ, Prchal JT, Gordeuk VR. Pulmonary artery pressure and iron deficiency in patients with upregulation of hypoxia sensing due to homozygous VHL(R200W) mutation (Chuvash polycythemia). Haematologica 2011; 97:193-200. [PMID: 21993671 DOI: 10.3324/haematol.2011.051839] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patients with Chuvash polycythemia, (homozygosity for the R200W mutation in the von Hippel Lindau gene (VHL)), have elevated levels of hypoxia inducible factors HIF-1 and HIF-2, often become iron-deficient secondary to phlebotomy, and have elevated estimated pulmonary artery pressure by echocardiography. The objectives of this study were to provide a comprehensive echocardiographic assessment of cardiovascular physiology and to identify clinical, hematologic and cardiovascular risk factors for elevation of tricuspid regurgitation velocity in children and adults with Chuvash polycythemia. DESIGN AND METHODS This cross-sectional observational study of 120 adult and pediatric VHL(R200W) homozygotes and 31 controls at outpatient facilities in Chuvashia, Russian Federation included echocardiography assessment of pulmonary artery pressure (tricuspid regurgitation velocity), cardiac volume, and systolic and diastolic function, as well as hematologic and clinical parameters. We determined the prevalence and risk factors for elevation of tricuspid regurgitation velocity in this population and its relationship to phlebotomy. RESULTS The age-adjusted mean ± SE tricuspid regurgitation velocity was higher in VHL(R200W) homozygotes than controls with normal VHL alleles (2.5±0.03 vs. 2.3±0.05 m/sec, P=0.005). The age-adjusted left ventricular diastolic diameter (4.8±0.05 vs. 4.5±0.09 cm, P=0.005) and left atrial diameter (3.4±0.04 vs. 3.2±0.08 cm, P=0.011) were also greater in the VHL(R200W) homozygotes, consistent with increased blood volume, but the elevation in tricuspid regurgitation velocity persisted after adjustment for these variables. Among VHL(R200W) homozygotes, phlebotomy therapy was associated with lower serum ferritin concentration, and low ferritin independently predicted higher tricuspid regurgitation velocity (standardized beta=0.29; P=0.009). CONCLUSIONS Children and adults with Chuvash polycythemia have higher estimated right ventricular systolic pressure, even after adjustment for echocardiography estimates of blood volume. Lower ferritin concentration, which is associated with phlebotomy, independently predicts higher tricuspid regurgitation velocity (www.clinicaltrials.gov identifier NCT00495638).
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Affiliation(s)
- Craig A Sable
- Division of Cardiology, Children’s National Medical Center, Washington, DC, USA.
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