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Hoyos R, Lichtblau M, Cajamarca E, Mayer L, Schwarz EI, Ulrich S. Characteristics and risk profiles of patients with pulmonary arterial or chronic thromboembolic pulmonary hypertension living permanently at >2500 m of high altitude in Ecuador. Pulm Circ 2024; 14:e12404. [PMID: 38974936 PMCID: PMC11224915 DOI: 10.1002/pul2.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 05/09/2024] [Accepted: 06/12/2024] [Indexed: 07/09/2024] Open
Abstract
Over 80 Mio people worldwide live >2500 m, including at least as many patients with pulmonary vascular disease (PVD), defined as pulmonary arterial or chronic thromboembolic pulmonary hypertension (PAH/CTEPH), as elsewhere (estimated 0.1‰). Whether PVD patients living at high altitude have altered disease characteristics due to hypobaric hypoxia is unknown. In a cross-sectional study conducted at the Hospital Carlos Andrade Marin in Quito, Ecuador, located at 2840 m, we included 36 outpatients with PAH or CTEPH visiting the clinic from January 2022 to July 2023. We collected data on diagnostic right heart catheterization, treatment, and risk factors, including NYHA functional class (FC), 6-min walk distance (6MWD), and NT-brain natriuretic peptide (BNP) at baseline and at last follow-up. Thirty-six PVD patients (83% women, 32 PAH, 4 CTEPH, mean ± SD age 44 ± 13 years, living altitude 2831 ± 58 m) were included and had the following baseline values: PaO2 8.2 ± 1.6 kPa, PaCO2 3.9 ± 0.5 kPa, SaO2 91 ± 3%, mean pulmonary artery pressure 53 ± 16 mmHg, pulmonary vascular resistance 16 ± 4 WU, 50% FC II, 50% FC III, 6MWD 472 ± 118 m, BNP 490 ± 823 ng/L. Patients were treated for 1628 ± 1186 days with sildenafil (100%), bosentan (33%), calcium channel blockers (33%), diuretics (69%), and oxygen (nocturnal 53%, daytime 11%). Values at last visit were: FC (II 75%, III 25%), 6MWD of 496 ± 108 m, BNP of 576 ± 5774 ng/L. Compared to European PVD registries, ambulatory PVD patients living >2500 m revealed similar blood gases and relatively low and stable risk factor profiles despite severe hemodynamic compromise, suggesting that favorable outcomes are achievable for altitude residents with PVD. Future studies should focus on long-term outcomes in PVD patients dwelling >2500 m.
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Affiliation(s)
| | - Mona Lichtblau
- Department of PulmonologyUniversity Hospital ZurichZurichSwitzerland
| | | | - Laura Mayer
- Department of PulmonologyUniversity Hospital ZurichZurichSwitzerland
| | | | - Silvia Ulrich
- Department of PulmonologyUniversity Hospital ZurichZurichSwitzerland
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2
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Titz A, Schneider S, Mueller J, Mayer L, Lichtblau M, Ulrich S. Symposium review: high altitude travel with pulmonary vascular disease. J Physiol 2024. [PMID: 38780974 DOI: 10.1113/jp284585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are the main precapillary forms of pulmonary hypertension (PH) summarized as pulmonary vascular diseases (PVD). PVDs are characterized by exertional dyspnoea and oxygen desaturation, and reduced quality of life and survival. Medical therapies improve life expectancy and physical performance of PVD patients, of whom many wish to participate in professional work and recreational activities including traveling to high altitude. The exposure to the hypobaric hypoxic environment of mountain regions incurs the risk of high altitude adverse events (AEHA) due to severe hypoxaemia exacerbating symptoms and further increase in pulmonary artery pressure, which may lead to right heart decompensation. Recent prospective and randomized trials show that altitude-induced hypoxaemia, pulmonary haemodynamic changes and impairment of exercise performance in PVD patients are in the range found in healthy people. The vast majority of optimally treated stable PVD patients who do not require long-term oxygen therapy at low altitude can tolerate short-term exposure to moderate altitudes up to 2500 m. PVD patients that reveal persistent severe resting hypoxaemia (S p O 2 ${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ <80% for >30 min) at 2500 m respond well to supplemental oxygen therapy. Although there are no accurate predictors for AEHA, PVD patients with unfavourable risk profiles at low altitude, such as higher WHO functional class, lower exercise capacity with more pronounced exercise-induced desaturation and more severely impaired haemodynamics, are at increased risk of AEHA. Therefore, doctors with experience in PVD and high-altitude medicine should counsel PVD patients before any high-altitude sojourn. This review aims to summarize recent literature and clinical recommendations about PVD patients travelling to high altitude.
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Affiliation(s)
- Anna Titz
- University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | | | | | - Laura Mayer
- University Hospital of Zurich, Zurich, Switzerland
| | | | - Silvia Ulrich
- University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Stepanek J, Farina JM, Mahmoud AK, Chao CJ, Alsidawi S, Ayoub C, Barry T, Pereyra M, Scalia IG, Abbas MT, Wraith RE, Brown LS, Radavich MS, Curtisi PJ, Hartzendorf PC, Lasota EM, Umetsu KN, Peterson JM, Karlson KE, Breznak K, Fortuin DF, Lester SJ, Arsanjani R. Identifying the Causes of Unexplained Dyspnea at High Altitude Using Normobaric Hypoxia with Echocardiography. J Imaging 2024; 10:38. [PMID: 38392086 PMCID: PMC10889907 DOI: 10.3390/jimaging10020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Exposure to high altitude results in hypobaric hypoxia, leading to physiological changes in the cardiovascular system that may result in limiting symptoms, including dyspnea, fatigue, and exercise intolerance. However, it is still unclear why some patients are more susceptible to high-altitude symptoms than others. Hypoxic simulation testing (HST) simulates changes in physiology that occur at a specific altitude by asking the patients to breathe a mixture of gases with decreased oxygen content. This study aimed to determine whether the use of transthoracic echocardiography (TTE) during HST can detect the rise in right-sided pressures and the impact of hypoxia on right ventricle (RV) hemodynamics and right to left shunts, thus revealing the underlying causes of high-altitude signs and symptoms. A retrospective study was performed including consecutive patients with unexplained dyspnea at high altitude. HSTs were performed by administrating reduced FiO2 to simulate altitude levels specific to patients' history. Echocardiography images were obtained at baseline and during hypoxia. The study included 27 patients, with a mean age of 65 years, 14 patients (51.9%) were female. RV systolic pressure increased at peak hypoxia, while RV systolic function declined as shown by a significant decrease in the tricuspid annular plane systolic excursion (TAPSE), the maximum velocity achieved by the lateral tricuspid annulus during systole (S' wave), and the RV free wall longitudinal strain. Additionally, right-to-left shunt was present in 19 (70.4%) patients as identified by bubble contrast injections. Among these, the severity of the shunt increased at peak hypoxia in eight cases (42.1%), and the shunt was only evident during hypoxia in seven patients (36.8%). In conclusion, the use of TTE during HST provides valuable information by revealing the presence of symptomatic, sustained shunts and confirming the decline in RV hemodynamics, thus potentially explaining dyspnea at high altitude. Further studies are needed to establish the optimal clinical role of this physiologic method.
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Affiliation(s)
- Jan Stepanek
- Aerospace Medicine Program, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Juan M Farina
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Ahmed K Mahmoud
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Chieh-Ju Chao
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Said Alsidawi
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Chadi Ayoub
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Timothy Barry
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Milagros Pereyra
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Isabel G Scalia
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | | | - Rachel E Wraith
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Lisa S Brown
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Michael S Radavich
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Pamela J Curtisi
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | | | - Elizabeth M Lasota
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Kyley N Umetsu
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Jill M Peterson
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Kristin E Karlson
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Karen Breznak
- Aerospace Medicine Program, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - David F Fortuin
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Steven J Lester
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Reza Arsanjani
- Department of Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
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Lichtblau M, Harutyunova S, Nechwatal R, Mayer L, Kabitz HJ, Wilkens FM, Uiker S, Grünig E, Ritter D, Florea A, Benjamin N. [General measures and management of pulmonary arterial hypertension]. Pneumologie 2023; 77:907-915. [PMID: 37963480 DOI: 10.1055/a-2145-4741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Care of patients with pulmonary arterial hypertension (PAH) needs a multi-facetet concept and measures, including management of adverse reactions, right heart insufficiency as well as information on pregnancy, travels by air, psychosocial support, physical exercise training and prophylaxis by vaccination.Positive study results led to an higher recommendation of specialized exercise training in pulmonary hypertension. Also, the recommendation on iron substitution was amended according to the current evidence.In the current guidelines, special focus was given to the elaboration of recommendations regarding pregnancy, including patient information, contraception and patient management in case of pregnancy.This article aims to provide an overview on the recommendations of general measuremes, special circumstances and patient management according to the ESC/ERS guidelines. Amendments to the guideline recommendations are given as comments from the authors of this article.
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Affiliation(s)
- Mona Lichtblau
- Klinik für Pneumologie, Universitätsspital Zürich, Zürich, Schweiz
| | - Satenik Harutyunova
- Zentrum für pulmonale Hypertonie, Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | | | - Laura Mayer
- Klinik für Pneumologie, Universitätsspital Zürich, Zürich, Schweiz
| | - Hans-Joachim Kabitz
- Klinik für Pneumologie und Schlafmedizin, Kantonsspital Aarau (KSA), Schweiz
| | - Finn Moritz Wilkens
- Zentrum für pulmonale Hypertonie, Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Sören Uiker
- Rehaklinik Heidelberg Königstuhl, Heidelberg, Deutschland
| | - Ekkehard Grünig
- Zentrum für pulmonale Hypertonie, Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Daniel Ritter
- Klinikum Würzburg Mitte, Standort Missionsärztliche Klinik, Würzburg, Deutschland
| | - Andreea Florea
- Zentrum für pulmonale Hypertonie, Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Nicola Benjamin
- Zentrum für pulmonale Hypertonie, Thoraxklinik Heidelberg gGmbH am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Saxer S, Bader PR, Schneider SR, Mademilov M, Sheraliev U, Appenzeller P, Müller J, Sooronbaev TM, Bloch KE, Ulrich S, Lichtblau M. Echocardiography and extravascular lung water during 3 weeks of exposure to high altitude in otherwise healthy asthmatics. Front Physiol 2023; 14:1214887. [PMID: 37560159 PMCID: PMC10407397 DOI: 10.3389/fphys.2023.1214887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
Background: Asthma rehabilitation at high altitude is common. Little is known about the acute and subacute cardiopulmonary acclimatization to high altitude in middle-aged asthmatics without other comorbidities. Methods: In this prospective study in lowlander subjects with mostly mild asthma who revealed an asthma control questionnaire score >0.75 and participated in a three-week rehabilitation program, we assessed systolic pulmonary artery pressure (sPAP), cardiac function, and extravascular lung water (EVLW) at 760 m (baseline) by Doppler-echocardiography and on the second (acute) and last day (subacute) at a high altitude clinic in Kyrgyzstan (3100 m). Results: The study included 22 patients (eight male) with a mean age of 44.3 ± 12.4 years, body mass index of 25.8 ± 4.7 kg/m2, a forced expiratory volume in 1 s of 92% ± 19% predicted (post-bronchodilator), and partially uncontrolled asthma. sPAP increased from 21.8 mmHg by mean difference by 7.5 [95% confidence interval 3.9 to 10.5] mmHg (p < 0.001) during acute exposure and by 4.8 [1.0 to 8.6] mmHg (p = 0.014) during subacute exposure. The right-ventricular-to-pulmonary-artery coupling expressed by TAPSE/sPAP decreased from 1.1 by -0.2 [-0.3 to -0.1] mm/mmHg (p < 0.001) during acute exposure and by -0.2 [-0.3 to -0.1] mm/mmHg (p = 0.002) during subacute exposure, accordingly. EVLW significantly increased from baseline (1.3 ± 1.8) to acute hypoxia (5.5 ± 3.5, p < 0.001) but showed no difference after 3 weeks (2.0 ± 1.8). Conclusion: In otherwise healthy asthmatics, acute exposure to hypoxia at high altitude increases pulmonary artery pressure (PAP) and EVLW. During subacute exposure, PAP remains increased, but EVLW returns to baseline values, suggesting compensatory mechanisms that contribute to EVLW homeostasis during acclimatization.
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Affiliation(s)
- S. Saxer
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
- Eastern University of Applied Sciences, St Gallen, Switzerland
| | - P. R. Bader
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - S. R. Schneider
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - M. Mademilov
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - U. Sheraliev
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - P. Appenzeller
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - J. Müller
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - T. M. Sooronbaev
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - K. E. Bloch
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - S. Ulrich
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
| | - M. Lichtblau
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Tuja-Ashu, Kyrgyzstan
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Meszaros M, Schneider SR, Mayer LC, Lichtblau M, Pengo MF, Berlier C, Saxer S, Furian M, Bloch KE, Ulrich S, Schwarz EI. Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease. J Clin Med 2023; 12:jcm12051782. [PMID: 36902567 PMCID: PMC10003175 DOI: 10.3390/jcm12051782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Pulmonary vascular diseases (PVDs), defined as arterial or chronic thromboembolic pulmonary hypertension, are associated with autonomic cardiovascular dysregulation. Resting heart rate variability (HRV) is commonly used to assess autonomic function. Hypoxia is associated with sympathetic overactivation and patients with PVD might be particularly vulnerable to hypoxia-induced autonomic dysregulation. In a randomised crossover trial, 17 stable patients with PVD (resting PaO2 ≥ 7.3 kPa) were exposed to ambient air (FiO2 = 21%) and normobaric hypoxia (FiO2 = 15%) in random order. Indices of resting HRV were derived from two nonoverlapping 5-10-min three-lead electrocardiography segments. We found a significant increase in all time- and frequency-domain HRV measures in response to normobaric hypoxia. There was a significant increase in root mean squared sum difference of RR intervals (RMSSD; 33.49 (27.14) vs. 20.76 (25.19) ms; p < 0.01) and RR50 count divided by the total number of all RR intervals (pRR50; 2.75 (7.81) vs. 2.24 (3.39) ms; p = 0.03) values in normobaric hypoxia compared to ambient air. Both high-frequency (HF; 431.40 (661.56) vs. 183.70 (251.25) ms2; p < 0.01) and low-frequency (LF; 558.60 (746.10) vs. 203.90 (425.63) ms2; p = 0.02) values were significantly higher in normobaric hypoxia compared to normoxia. These results suggest a parasympathetic dominance during acute exposure to normobaric hypoxia in PVD.
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Affiliation(s)
- Martina Meszaros
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Simon R. Schneider
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
| | - Laura C. Mayer
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Mona Lichtblau
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Martino F. Pengo
- Istituto Auxologico Italiano IRCCS, Department of Cardiology, San Luca Hospital, 20149 Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20122 Milan, Italy
| | - Charlotte Berlier
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Stéphanie Saxer
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Michael Furian
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Konrad E. Bloch
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Medical Faculty, University of Zurich, 8006 Zurich, Switzerland
| | - Silvia Ulrich
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Medical Faculty, University of Zurich, 8006 Zurich, Switzerland
| | - Esther I. Schwarz
- Department of Pulmonology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Medical Faculty, University of Zurich, 8006 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-255-243-38125
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Hohenauer E, Taube W, Freitag L, Clijsen R. Sex differences during a cold-stress test in normobaric and hypobaric hypoxia: A randomized controlled crossover study. Front Physiol 2022; 13:998665. [PMID: 36225301 PMCID: PMC9549379 DOI: 10.3389/fphys.2022.998665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Cold and hypoxia are two stressors that are frequently combined and investigated in the scientific literature. Despite the growing literature regarding normobaric hypoxia (NH) and hypobaric hypoxia (HH), responses between females and males are less often evaluated. Therefore, this study aims to investigate the physiological sex differences following a cold-stress test under normoxia, normobaric- and hypobaric hypoxia. A total of n = 10 females (24.8 ± 5.1 years) and n = 10 males (30.3 ± 6.3 years) from a university population volunteered for this study. The cold-stress test (CST) of the right hand (15°C for 2 min) was performed using a randomised crossover design in normobaric normoxia, NH and HH. The change (∆) from baseline to post-CST up to 15 min was analysed for cutaneous vascular conductance (CVC) and the hands’ skin temperature, whilst the mean values across time (post-CST up to 15 min) were assessed for peripheral oxygen saturation (SpO2), thermal sensation- and comfort. Pressure pain threshold (PPT) was assessed after the post-CST 15 min period. The hands’ skin temperature drop was higher (p = 0.01) in the female group (∆3.3 ± 1.5°C) compared to the male group (∆1.9 ± 0.9°C) only in NH. Females (−0.9 ± 0.5) rated this temperature drop in NH to feel significantly colder (p = 0.02) compared to the males (−0.2 ± 0.7). No differences were observed between sexes in NN, NH, and HH for ∆CVC, SpO2, thermal comfort and PPT. In conclusion, females and males show similar reactions after a CST under normoxia and hypoxia. Sex differences were observed in the local skin temperature response and thermal sensation only in NH.
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Affiliation(s)
- Erich Hohenauer
- Rehabilitation and Exercise Science Laboratory (RES lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- Department of Physiotherapy, International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- *Correspondence: Erich Hohenauer,
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Livia Freitag
- Rehabilitation and Exercise Science Laboratory (RES lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation and Exercise Science Laboratory (RES lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- Department of Physiotherapy, International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland
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Zhang Y, Su F, Song Y, Lu J. Associations between Physical Fitness Index and Body Mass Index in Tibetan Children and Adolescents in Different High-Altitude Areas: Based on a Study in Tibet, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10155. [PMID: 36011789 PMCID: PMC9408390 DOI: 10.3390/ijerph191610155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the relationship between physical fitness index (PFI) and body mass index (BMI) of Tibetan children and adolescents in different high-altitude areas in Tibet, China. Methods: Using the stratified cluster sampling method, 3819 Tibetan children and adolescents from three different high-altitude areas including Nyingchi, Lhasa and Nagqu in the Tibet area of China were given grip strength, standing long jump, sitting forward bend, 50 m running and endurance running tests. One-way analysis of variance was used to compare the physical fitness index in different high-altitude areas. In addition, the method of curve regression analysis was used to analyze the relationship between PFI and BMI. Results: In general, the level of PFI in Nagqu, Tibet, China was lower than that in Nyingchi and Lhasa, and the levels of girls were generally lower than those of boys. The proportions of malnourished, normal, overweight and obese Tibetan boys in high-altitude areas were 11.8%, 79.7%, and 8.5%; those of girls were 3.3%, 82.3%, and 14.4%, respectively. The curve regression analysis showed that the model fitting of male Nyingchi, Lhasa, Nagqu and female Nyingchi, Lhasa, Nagqu were all significant (F values were 29.697, 34.709, 37.500, 9.123, 9.785, 6.939, p < 0.01). The relationship between BMI and PFI generally showed an inverted “U” curve relationship. Conclusion: The negative impact of overweight and obesity on physical fitness of Tibetan boys in high-altitude areas is significantly higher than that of girls, and the negative impact of overweight and obesity on physical fitness of boys in Lhasa and Nyingchi area is more significant than that in the Nagqu area. In the future, attention should be paid to Lhasa and the occurrence of overweight and obesity among Tibetan boys in Nyingchi area in order to prevent the sharp decline of physical fitness and promote the physical and mental development of Tibetan children and adolescents in high-altitude areas.
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Affiliation(s)
- Yunjie Zhang
- College of Education and Sports Sciences, Yangtze University, Jingzhou 434020, China
| | - Fan Su
- College of Physical Education, China Three Gorges University, Yichang 443002, China
| | - Yongjing Song
- College of Education and Sports Sciences, Yangtze University, Jingzhou 434020, China
| | - Jinkui Lu
- School of Physical Education, Shangrao Normal University, Shangrao 334000, China
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