Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study
Background: Acute high-altitude (HA) exposure results in blood pressure (BP) and cardiac function variations in most subjects, some of whom suffer from acute mountain sickness (AMS). Several previous studies have found that cardiovascular function indicators are potentially correlated with AMS.Objec...
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Frontiers Media S.A.
2021-08-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2021.708862/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
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DOAJ |
author |
Renzheng Chen Renzheng Chen Mengjia Sun Mengjia Sun Jie Yang Jie Yang Chuan Liu Chuan Liu Jihang Zhang Jihang Zhang Jingbin Ke Jingbin Ke Yuhan Deng Yuhan Deng Chunyan He Chunyan He Yuanqi Yang Yuanqi Yang Ran Cheng Ran Cheng Fangzhengyuan Yuan Fangzhengyuan Yuan Hu Tan Hu Tan Xubin Gao Xubin Gao Lan Huang Lan Huang |
spellingShingle |
Renzheng Chen Renzheng Chen Mengjia Sun Mengjia Sun Jie Yang Jie Yang Chuan Liu Chuan Liu Jihang Zhang Jihang Zhang Jingbin Ke Jingbin Ke Yuhan Deng Yuhan Deng Chunyan He Chunyan He Yuanqi Yang Yuanqi Yang Ran Cheng Ran Cheng Fangzhengyuan Yuan Fangzhengyuan Yuan Hu Tan Hu Tan Xubin Gao Xubin Gao Lan Huang Lan Huang Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study Frontiers in Physiology ambulatory blood pressure cardiac ultrasound cardiovascular indicators of systemic circulation acute mountain sickness high altitude |
author_facet |
Renzheng Chen Renzheng Chen Mengjia Sun Mengjia Sun Jie Yang Jie Yang Chuan Liu Chuan Liu Jihang Zhang Jihang Zhang Jingbin Ke Jingbin Ke Yuhan Deng Yuhan Deng Chunyan He Chunyan He Yuanqi Yang Yuanqi Yang Ran Cheng Ran Cheng Fangzhengyuan Yuan Fangzhengyuan Yuan Hu Tan Hu Tan Xubin Gao Xubin Gao Lan Huang Lan Huang |
author_sort |
Renzheng Chen |
title |
Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study |
title_short |
Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study |
title_full |
Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study |
title_fullStr |
Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study |
title_full_unstemmed |
Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study |
title_sort |
cardiovascular indicators of systemic circulation and acute mountain sickness: an observational cohort study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2021-08-01 |
description |
Background: Acute high-altitude (HA) exposure results in blood pressure (BP) and cardiac function variations in most subjects, some of whom suffer from acute mountain sickness (AMS). Several previous studies have found that cardiovascular function indicators are potentially correlated with AMS.Objectives: This study aims to examine HA-induced cardiovascular adaptations in AMS patients and compare them with healthy subjects. It also aims to investigate the relationship between cardiovascular function indicators and AMS, as well as to provide some insightful information about the prevention and treatment of AMS.Methods: Seventy-two subjects were enrolled in this cohort study. All the subjects ascended Litang (4,100 m above sea level). They were monitored by a 24-h ambulatory blood pressure (ABP) device and underwent echocardiography examination within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS.Results: Acute mountain sickness group consisted of more women (17 [60.7%] vs. 10 [22.7%], p = 0.001) and fewer smokers (5 [17.9%] vs. 23 [52.3%], p = 0.003). Compared with subjects without AMS, subjects with AMS had lower pulse pressure (PP) (daytime PP, 45.23 ± 7.88 vs. 52.14 ± 4.75, p < 0.001; nighttime PP, 42.81 ± 5.92 vs. 49.39 ± 7.67, p < 0.001) and lower effective arterial elastance (Ea) (1.53 ± 0.24 vs. 1.73 ± 0.39, p = 0.023). Multivariate regression indicated that female sex (OR = 0.23, p = 0.024), lower daytime PP (OR = 0.86, p = 0.004), and lower Ea (OR = 0.03, p = 0.015) at low altitude (LA) were independent risk factors for AMS. Combined daytime PP and Ea at LA had a high predictive value for AMS (AUC = 0.873; 95% CI: 0.789–0.956). Correlation analysis showed that AMS-induced headache correlated with daytime PP (R = −0.401, p < 0.001) and nighttime PP at LA (R = −0.401, p < 0.001).Conclusion: Our study demonstrated that AMS patients had a lower PP and Ea at LA. These baseline indicators of vasodilation at LA were closely associated with AMS, which may explain the higher headache severity in subjects with higher PP at LA. |
topic |
ambulatory blood pressure cardiac ultrasound cardiovascular indicators of systemic circulation acute mountain sickness high altitude |
url |
https://www.frontiersin.org/articles/10.3389/fphys.2021.708862/full |
work_keys_str_mv |
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doaj-098464216cc34443925b017bfd9afd5f2021-09-03T12:45:25ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-08-011210.3389/fphys.2021.708862708862Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort StudyRenzheng Chen0Renzheng Chen1Mengjia Sun2Mengjia Sun3Jie Yang4Jie Yang5Chuan Liu6Chuan Liu7Jihang Zhang8Jihang Zhang9Jingbin Ke10Jingbin Ke11Yuhan Deng12Yuhan Deng13Chunyan He14Chunyan He15Yuanqi Yang16Yuanqi Yang17Ran Cheng18Ran Cheng19Fangzhengyuan Yuan20Fangzhengyuan Yuan21Hu Tan22Hu Tan23Xubin Gao24Xubin Gao25Lan Huang26Lan Huang27Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaInstitute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaBackground: Acute high-altitude (HA) exposure results in blood pressure (BP) and cardiac function variations in most subjects, some of whom suffer from acute mountain sickness (AMS). Several previous studies have found that cardiovascular function indicators are potentially correlated with AMS.Objectives: This study aims to examine HA-induced cardiovascular adaptations in AMS patients and compare them with healthy subjects. It also aims to investigate the relationship between cardiovascular function indicators and AMS, as well as to provide some insightful information about the prevention and treatment of AMS.Methods: Seventy-two subjects were enrolled in this cohort study. All the subjects ascended Litang (4,100 m above sea level). They were monitored by a 24-h ambulatory blood pressure (ABP) device and underwent echocardiography examination within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS.Results: Acute mountain sickness group consisted of more women (17 [60.7%] vs. 10 [22.7%], p = 0.001) and fewer smokers (5 [17.9%] vs. 23 [52.3%], p = 0.003). Compared with subjects without AMS, subjects with AMS had lower pulse pressure (PP) (daytime PP, 45.23 ± 7.88 vs. 52.14 ± 4.75, p < 0.001; nighttime PP, 42.81 ± 5.92 vs. 49.39 ± 7.67, p < 0.001) and lower effective arterial elastance (Ea) (1.53 ± 0.24 vs. 1.73 ± 0.39, p = 0.023). Multivariate regression indicated that female sex (OR = 0.23, p = 0.024), lower daytime PP (OR = 0.86, p = 0.004), and lower Ea (OR = 0.03, p = 0.015) at low altitude (LA) were independent risk factors for AMS. Combined daytime PP and Ea at LA had a high predictive value for AMS (AUC = 0.873; 95% CI: 0.789–0.956). Correlation analysis showed that AMS-induced headache correlated with daytime PP (R = −0.401, p < 0.001) and nighttime PP at LA (R = −0.401, p < 0.001).Conclusion: Our study demonstrated that AMS patients had a lower PP and Ea at LA. These baseline indicators of vasodilation at LA were closely associated with AMS, which may explain the higher headache severity in subjects with higher PP at LA.https://www.frontiersin.org/articles/10.3389/fphys.2021.708862/fullambulatory blood pressurecardiac ultrasoundcardiovascular indicators of systemic circulationacute mountain sicknesshigh altitude |