1993
DOI: 10.1159/000470246
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Abnormal Left Ventricular Diastolic Filling Patterns in Acute Hypoxic Pulmonary Hypertension at High Altitude

Abstract: In order to evaluate left ventricular (LV) diastolic filling properties at high altitude, 19 healthy mountaineers were studied by Doppler echocardiography in a high altitude research laboratory at 4,559 m above sea level. Baseline examinations were carried out at 490 m. Measurements comprised mitral inflow velocity parameters and pulmonary artery pressure (PAP, mm Hg). The two-dimensional (2-D) cross-sectional parasternal short axis view of the left ventricle revealed a characteristic bulging of the interventr… Show more

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Cited by 11 publications
(14 citation statements)
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References 18 publications
(26 reference statements)
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“…In the present study, dogs at a moderate altitude of 2300 m had unremarkable flow profiles in the pulmonary outflow tract. The significant changes in the pulmonary outflow flow profile in these same dogs examined at 3500 m, including shortened AT, lower AT/ET and notching during deceleration are similar to findings in people with moderate high‐altitude pulmonary hypertension 6 . However, based on our study these were not reliable indicators of pulmonary hypertension, as control dogs had shorter AT than dogs at moderate altitude and notching was also commonly found in control dogs, and none of these had a tricuspid regurgitation peak gradient >23 mmHg 15 .…”
Section: Discussionsupporting
confidence: 75%
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“…In the present study, dogs at a moderate altitude of 2300 m had unremarkable flow profiles in the pulmonary outflow tract. The significant changes in the pulmonary outflow flow profile in these same dogs examined at 3500 m, including shortened AT, lower AT/ET and notching during deceleration are similar to findings in people with moderate high‐altitude pulmonary hypertension 6 . However, based on our study these were not reliable indicators of pulmonary hypertension, as control dogs had shorter AT than dogs at moderate altitude and notching was also commonly found in control dogs, and none of these had a tricuspid regurgitation peak gradient >23 mmHg 15 .…”
Section: Discussionsupporting
confidence: 75%
“…Changes in diastolic function are thought to be caused by alteration in LV geometry due to a rise in pulmonary artery pressure. The increase in RV pressure leads to a transseptal right‐to‐left pressure gradient that results in prolonged isovolumic relaxation 6 . Likewise, we found a reversed E/A‐ratio in dogs at high altitude, significantly different from that for moderate altitude and control dogs, indicating an effect of this degree of high‐altitude hypoxia on the filling pattern.…”
Section: Discussionmentioning
confidence: 45%
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“…Increasing cardiac output several-fold over baseline contributes to edema formation by increasing capillary pressure in overperfused areas and may even worsen the regional heterogeneity of blood flow. Furthermore, the greater increase of PAP in HAPE-susceptible individuals may impair left ventricular filling because of a ventricular septal shift shown by Ritter et al (88) and to possible mild left ventricular stiffness arising from decreased cardiac lymph clearance to the right heart (25). Diastolic dysfunction due to pulmonary hypertension likely explains the significantly greater wedge pressure increase in HAPE-susceptible individuals compared with nonsusceptible controls during exercise in hypoxia (34), whereas at rest, wedge pressure is normal in untreated HAPE (69).…”
Section: Additional Contributing Factorsmentioning
confidence: 99%