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Liu Z, Yang J, Yang B, Sun M, Ye X, Yu S, Tan H, Hu M, Lv H, Wu B, Gao X, Huang L. Effect of ubiquinol on electrophysiology during high-altitude acclimatization and de-acclimatization: A substudy of the Shigatse CARdiorespiratory fitness (SCARF) randomized clinical trial. Int J Cardiol 2024; 401:131817. [PMID: 38307422 DOI: 10.1016/j.ijcard.2024.131817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND High-altitude exposure changes the electrical conduction of the heart. However, reports on electrocardiogram (ECG) characteristics and potent prophylactic agents during high-altitude acclimatization and de-acclimatization are inadequate. This study aimed to investigate the effects of ubiquinol on electrophysiology after high-altitude hypoxia and reoxygenation. METHODS The study was a prospective, randomized, double-blind, placebo-controlled trial. Forty-one participants were randomly divided into two groups receiving ubiquinol 200 mg daily or placebo orally 14 days before flying to high altitude (3900 m) until the end of the study. Cardiopulmonary exercise testing was performed at baseline (300 m), on the third day after reaching high altitude, and on the seventh day after returning to baseline. RESULTS Acute high-altitude exposure prolonged resting ventricular repolarization, represented by increased corrected QT interval (455.9 ± 23.4 vs. 427.1 ± 19.1 ms, P < 0.001) and corrected Tpeak-Tend interval (155.5 ± 27.4 vs. 125.3 ± 21.1 ms, P < 0.001), which recovered after returning to low altitude. Ubiquinol supplementation shortened the hypoxia-induced extended Tpeak-Tend interval (-7.7 ms, [95% confidence interval (CI), -13.8 to -1.6], P = 0.014), Tpeak-Tend /QT interval (-0.014 [95% CI, -0.027 to -0.002], P = 0.028), and reserved maximal heart rate (11.9 bpm [95% CI, 3.2 to 20.6], P = 0.013) during exercise at high altitude. Furthermore, the decreased resting amplitude of the ST-segment in the V3 lead was correlated with decreased peak oxygen pulse (R = 0.713, P < 0.001) and maximum oxygen consumption (R = 0.595, P < 0.001). CONCLUSIONS Our results illustrated the electrophysiology changes during high-altitude acclimatization and de-acclimatization. Similarly, ubiquinol supplementation shortened the prolonged Tpeak-Tend interval and reserved maximal heart rate during exercise at high altitude. REGISTRATION URL: www.chictr.org.cn; Unique identifier: ChiCTR2200059900.
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Affiliation(s)
- Zhen Liu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Jie Yang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Bingjie Yang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Xiaowei Ye
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Shiyong Yu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Hu Tan
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Mingdong Hu
- Department of Physical Examination, the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hailin Lv
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Boji Wu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Xubin Gao
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Lan Huang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China.
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Yang J, Ye X, Liu Z, Sun M, Yu S, Lv H, Wu B, Zhang C, Gu W, He J, Wang X, Huang L. Effect of ubiquinol on cardiorespiratory fitness during high-altitude acclimatization and de-acclimatization in healthy adults: the Shigatse CARdiorespiratory fitness study design. Front Cardiovasc Med 2023; 10:1129144. [PMID: 37560117 PMCID: PMC10407655 DOI: 10.3389/fcvm.2023.1129144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Cardiorespiratory function influences exercise capacity and is an important determinant of high-altitude adaptation. Some studies have investigated the characteristics of changes in cardiorespiratory fitness during high-altitude acclimatization. However, studies on changes in cardiorespiratory fitness during high-altitude de-acclimatization are still lacking and have not yet been elucidated. Furthermore, few drugs have been studied to improve cardiorespiratory function during both processes. The Shigatse CARdiorespiratory Fitness (SCARF) study is a single-center, randomized, double-blind, placebo-control clinical trial to explore the effects of ubiquinol on cardiorespiratory fitness during high-altitude acclimatization and de-acclimatization in healthy adults. Participants will be randomly assigned 1:1 to ubiquinol 200 mg daily or a placebo for 14 days before departure until the end of data collection after return in 7 days. Cardiorespiratory fitness is the primary outcome, while acute mountain sickness and high-altitude de-acclimatization symptoms are secondary endpoints. In addition, laboratory measurements, including routine blood tests and serological measurements, will be performed. To the best of our knowledge, the SCARF study will be the first to reveal the changes in the cardiorespiratory fitness characteristics during high-altitude acclimatization and de-acclimatization. Furthermore, the results of this study will contribute to exploring whether ubiquinol supplementation could be beneficial for endurance exercise capacity at different altitudes and help improve adaptation to acute hypoxia and de-acclimatization. Clinical Trial Registration: This study has been registered in the Chinese Clinical Trial Register (www.chictr.org.cn) as ChiCTR2200059900 and ChiCTR2200066328.
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Affiliation(s)
- Jie Yang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaowei Ye
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhen Liu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shiyong Yu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hailin Lv
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Boji Wu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chen Zhang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wenzhu Gu
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jingyu He
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xuhong Wang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Lan Huang
- Institute of Cardiovascular Diseases of PLA, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Cardiology, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Ye X, Sun M, Yu S, Yang J, Liu Z, Lv H, Wu B, He J, Wang X, Huang L. Smartwatch-Based Maximum Oxygen Consumption Measurement for Predicting Acute Mountain Sickness: Diagnostic Accuracy Evaluation Study. JMIR Mhealth Uhealth 2023; 11:e43340. [PMID: 37410528 PMCID: PMC10360014 DOI: 10.2196/43340] [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: 10/09/2022] [Revised: 12/11/2022] [Accepted: 06/09/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Cardiorespiratory fitness plays an important role in coping with hypoxic stress at high altitudes. However, the association of cardiorespiratory fitness with the development of acute mountain sickness (AMS) has not yet been evaluated. Wearable technology devices provide a feasible assessment of cardiorespiratory fitness, which is quantifiable as maximum oxygen consumption (VO2max) and may contribute to AMS prediction. OBJECTIVE We aimed to determine the validity of VO2max estimated by the smartwatch test (SWT), which can be self-administered, in order to overcome the limitations of clinical VO2max measurements. We also aimed to evaluate the performance of a VO2max-SWT-based model in predicting susceptibility to AMS. METHODS Both SWT and cardiopulmonary exercise test (CPET) were performed for VO2max measurements in 46 healthy participants at low altitude (300 m) and in 41 of them at high altitude (3900 m). The characteristics of the red blood cells and hemoglobin levels in all the participants were analyzed by routine blood examination before the exercise tests. The Bland-Altman method was used for bias and precision assessment. Multivariate logistic regression was performed to analyze the correlation between AMS and the candidate variables. A receiver operating characteristic curve was used to evaluate the efficacy of VO2max in predicting AMS. RESULTS VO2max decreased after acute high altitude exposure, as measured by CPET (25.20 [SD 6.46] vs 30.17 [SD 5.01] at low altitude; P<.001) and SWT (26.17 [SD 6.71] vs 31.28 [SD 5.17] at low altitude; P<.001). Both at low and high altitudes, VO2max was slightly overestimated by SWT but had considerable accuracy as the mean absolute percentage error (<7%) and mean absolute error (<2 mL·kg-1·min-1), with a relatively small bias compared with VO2max-CPET. Twenty of the 46 participants developed AMS at 3900 m, and their VO2max was significantly lower than that of those without AMS (CPET: 27.80 [SD 4.55] vs 32.00 [SD 4.64], respectively; P=.004; SWT: 28.00 [IQR 25.25-32.00] vs 32.00 [IQR 30.00-37.00], respectively; P=.001). VO2max-CPET, VO2max-SWT, and red blood cell distribution width-coefficient of variation (RDW-CV) were found to be independent predictors of AMS. To increase the prediction accuracy, we used combination models. The combination of VO2max-SWT and RDW-CV showed the largest area under the curve for all parameters and models, which increased the area under the curve from 0.785 for VO2max-SWT alone to 0.839. CONCLUSIONS Our study demonstrates that the smartwatch device can be a feasible approach for estimating VO2max. In both low and high altitudes, VO2max-SWT showed a systematic bias toward a calibration point, slightly overestimating the proper VO2max when investigated in healthy participants. The SWT-based VO2max at low altitude is an effective indicator of AMS and helps to better identify susceptible individuals following acute high-altitude exposure, particularly by combining the RDW-CV at low altitude. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200059900; https://www.chictr.org.cn/showproj.html?proj=170253.
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Affiliation(s)
- Xiaowei Ye
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shiyong Yu
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Yang
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhen Liu
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hailin Lv
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Boji Wu
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jingyu He
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xuhong Wang
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Lan Huang
- Institute of Cardiovascular Diseases of People's Liberation Army, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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