Sleep disturbances in long-term immigrants with chronic mountain sickness: A comparison with healthy immigrants at high altitude

2015 ◽  
Vol 206 ◽  
pp. 4-10 ◽  
Author(s):  
Wei Guan ◽  
Qin Ga ◽  
Rong Li ◽  
Zhen-Zhong Bai ◽  
Tana Wuren ◽  
...  
Keyword(s):  
High Altitude ◽  
Sleep Disturbances ◽  
Chronic Mountain Sickness ◽  
Mountain Sickness

scholarly journals Long-term chronic intermittent hypoxia: a particular form of chronic high-altitude pulmonary hypertension

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 5-12
Author(s):  
Julio Brito ◽  
Patricia Siques ◽  
Eduardo Pena
Keyword(s):  
Pulmonary Hypertension ◽  
High Altitude ◽  
Hypobaric Hypoxia ◽  
Intermittent Hypoxia ◽  
Clinical Presentation ◽  
Chronic Intermittent Hypoxia ◽  
Chronic Mountain Sickness ◽  
Epidemiological Pattern ◽  
Mountain Sickness

In some subjects, high-altitude hypobaric hypoxia leads to high-altitude pulmonary hypertension. The threshold for the diagnosis of high-altitude pulmonary hypertension is a mean pulmonary artery pressure of 30 mmHg, even though for general pulmonary hypertension is ≥25 mmHg. High-altitude pulmonary hypertension has been associated with high hematocrit findings (chronic mountain sickness), and although these are two separate entities, they have a synergistic effect that should be considered. In recent years, a new condition associated with high altitude was described in South America named long-term chronic intermittent hypoxia and has appeared in individuals who commute to work at high altitude but live and rest at sea level. In this review, we discuss the initial epidemiological pattern from the early studies done in Chile, the clinical presentation and possible molecular mechanism and a discussion of the potential management of this condition.

Global REACH 2018: Volume regulation in high-altitude Andeans with and without chronic mountain sickness

2021 ◽  
Author(s):  
Andrew R. Steele ◽  
Michael M. Tymko ◽  
Victoria L. Meah ◽  
Lydia L Simpson ◽  
Christopher Gasho ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Plasma Renin Activity ◽  
High Altitude ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Plasma Renin ◽  
Renin Activity ◽  
Chronic Mountain Sickness ◽  
Plasma Aldosterone Concentration ◽  
Mountain Sickness

The high-altitude maladaptation syndrome known as chronic mountain sickness (CMS) is characterized by polycythemia and is associated with proteinuria despite unaltered glomerular filtration rate. However, it remains unclear if indigenous highlanders with CMS have altered volume regulatory hormones. We assessed N-terminal pro-B-type natriuretic peptide (NT pro-BNP), plasma aldosterone concentration, plasma renin activity, kidney function (urinary microalbumin, glomerular filtration rate), blood volume, and estimated pulmonary artery systolic pressure (ePASP), in Andean males without (n=14; age=39±11) and with (n=10; age=40±12) CMS at 4330 meters (Cerro de Pasco, Peru). Plasma renin activity (non-CMS: 15.8±7.9 vs. CMS: 8.7±5.4 ng/ml; p=0.025) and plasma aldosterone concentration (non-CMS: 77.5±35.5 vs. CMS: 54.2±28.9 pg/ml; p=0.018) were lower in highlanders with CMS compared to non-CMS, while NT pro-BNP was not different between groups (non-CMS: 1394.9±214.3 vs. CMS: 1451.1±327.8 pg/ml; p=0.15). Highlanders had similar total blood volume (non-CMS: 90±15 vs. CMS: 103±18 ml • kg-1; p=0.071), but Andeans with CMS had greater total red blood cell volume (non-CMS: 46±10 vs. CMS 66±14 ml • kg-1; p<0.01) and smaller plasma volume (non-CMS 43±7 vs. CMS 35±5 ml • kg-1; p=0.03) compared to non-CMS. There were no differences in ePASP between groups (non-CMS 32±9 vs. CMS 31±8 mmHg; p=0.6). A negative correlation was found between plasma renin activity and glomerular filtration rate in both groups (group: r=-0.66; p<0.01; non-CMS: r=-0.60; p=0.022; CMS: r=-0.63; p=0.049). A smaller plasma volume in Andeans with CMS may indicate an additional CMS maladaptation to high-altitude, causing potentially greater polycythemia and clinical symptoms.

scholarly journals Thin Air Resulting in High Pressure: Mountain Sickness and Hypoxia-Induced Pulmonary Hypertension

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Jan Grimminger ◽  
Manuel Richter ◽  
Khodr Tello ◽  
Natascha Sommer ◽  
Henning Gall ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
High Altitude ◽  
Hypobaric Hypoxia ◽  
Current Knowledge ◽  
Treatment Options ◽  
Acute Response ◽  
Mechanisms Of Adaptation ◽  
Mountain Sickness

With rising altitude the partial pressure of oxygen falls. This phenomenon leads to hypobaric hypoxia at high altitude. Since more than 140 million people permanently live at heights above 2500 m and more than 35 million travel to these heights each year, understanding the mechanisms resulting in acute or chronic maladaptation of the human body to these circumstances is crucial. This review summarizes current knowledge of the body’s acute response to these circumstances, possible complications and their treatment, and health care issues resulting from long-term exposure to high altitude. It furthermore describes the characteristic mechanisms of adaptation to life in hypobaric hypoxia expressed by the three major ethnic groups permanently dwelling at high altitude. We additionally summarize current knowledge regarding possible treatment options for hypoxia-induced pulmonary hypertension by reviewing in vitro, rodent, and human studies in this area of research.

Role of sex hormones in development of chronic mountain sickness in rats

1994 ◽  
Vol 77 (1) ◽  
pp. 427-433 ◽  
Author(s):  
L. C. Ou ◽  
G. L. Sardella ◽  
J. C. Leiter ◽  
T. Brinck-Johnsen ◽  
R. P. Smith
Keyword(s):  
Gender Differences ◽  
Pulmonary Hypertension ◽  
High Altitude ◽  
Sex Hormones ◽  
Systolic Pressure ◽  
Female Rats ◽  
Hypoxic Exposure ◽  
Chronic Mountain Sickness ◽  
Mountain Sickness

After chronic exposure to hypoxia, Hilltop Sprague-Dawley rats developed excessive polycythemia and severe pulmonary hypertension and right ventricular (RV) hypertrophy, signs consistent with human chronic mountain sickness; however, there were gender differences in the magnitude of the polycythemia and susceptibility to the fatal consequence of chronic mountain sickness. Orchiectomy and ovariectomy were performed to evaluate the role of sex hormones in the gender differences in these hypoxic responses. After 40 days of exposure to simulated high altitude (5,500 m; barometric pressure of 370 Torr and inspired Po2 of 73 Torr), both sham-gonadectomized male and female rats developed polycythemia and had increased RV peak systolic pressure and RV hypertrophy. The hematocrit was slightly but significantly higher in males than in females. Orchiectomy did not affect these hypoxic responses, although total ventricular weight was less in the castrated high-altitude rats. At high altitude, the mortality rates were 67% in the sham-operated male rats and 50% in the castrated animals. In contrast, ovariectomy aggravated the high-altitude-associated polycythemia and increased RV peak systolic pressure and RV weight compared with the sham-operated high-altitude female rats. Both sham-operated control and ovariectomized females suffered negligible mortality at high altitude. The present study demonstrated that 1) the male sex hormones play no role in the development of the excessive polycythemia, pulmonary hypertension, and RV hypertrophy during chronic hypoxic exposure or in the associated high mortality and 2) the female sex hormones suppressed both the polycythemic and cardiopulmonary responses in vivo during chronic hypoxic exposure.

scholarly journals Erinnerung an Paul Bert (1833—1886) und die Entwicklung der Höhenphysiologie in der Schweiz

Gesnerus ◽  
1993 ◽  
Vol 50 (1-2) ◽  
pp. 79-95
Author(s):  
Gerhard Rudolph
Keyword(s):  
Partial Pressure ◽  
High Altitude ◽  
Important Task ◽  
Atmospheric Gases ◽  
Long Time ◽  
Mountain Sickness ◽  
The Law

It is the merit of Paul Bert to have assigned as an important task to experimental physiology the investigation of mountain sickness, of immediate accommodation of the organism to high altitude, and of its long-term acclimatation. In his “Pression Barométrique” of1878, he established the foundations of high-altitude physiology. In particular, he formulated the «law of partial pressure», the partial pressure of the atmospheric gases alone being responsible for their action on the organism, Paul Bert’s historic role, for a long time nearly forgotten, has been recalled to memory by the Swiss medical historians E. H. Ackerknecht and N.Mani. Bert’s line of investigation has been followed especially by Angelo Mosso of Turin and, more recently, by F. Verzár, A. von Muralt, A. Fleisch and other Swiss physiologists.

scholarly journals Effect of Hypoxia in the Pharmacological Treatment of Chronic Mountain Sickness (monge sickness) in Native Residents of High Altitude

2020 ◽  
Vol 5 (12) ◽  
pp. 3-3
Author(s):  
Aquino Lopez Tatiana; Aylas Aylas ◽  
Lucero; Brian Talledo Flores; Correa ◽  
Munoz; Mishel Loayza Miranda Jesus Alexander; Mendoza Chuquillanqui ◽  
Lenin; Mercado Baltazar Maria de los Angeles; Quispe Hidalgo ◽  
Natalia; Quispe Tovar Consuelo Milagros; Ramos Lucas ◽  
...  
Keyword(s):  
High Altitude ◽  
Pharmacological Treatment ◽  
Chronic Mountain Sickness ◽  
Mountain Sickness

scholarly journals Pulmonary arterial pressure at rest and during exercise in chronic mountain sickness: a meta-analysis

2019 ◽  
Vol 53 (6) ◽  
pp. 1802040 ◽  
Author(s):  
Rodrigo Soria ◽  
Matthias Egger ◽  
Urs Scherrer ◽  
Nicole Bender ◽  
Stefano F. Rimoldi
Keyword(s):  
Arterial Pressure ◽  
High Altitude ◽  
Pulmonary Arterial Pressure ◽  
Meta Analysis ◽  
Right Heart Failure ◽  
Exercise Intolerance ◽  
Point Estimate ◽  
Chronic Mountain Sickness ◽  
Pulmonary Arterial ◽  
Mountain Sickness

Up to 10% of the more than 140 million high-altitude dwellers worldwide suffer from chronic mountain sickness (CMS). Patients suffering from this debilitating problem often display increased pulmonary arterial pressure (PAP), which may contribute to exercise intolerance and right heart failure. However, there is little information on the usual PAP in these patients.We systematically reviewed and meta-analysed all data published in English or Spanish until June 2018 on echocardiographic estimations of PAP at rest and during mild exercise in CMS patients.Nine studies comprising 287 participants fulfilled the inclusion criteria. At rest, the point estimate from meta-analysis of the mean systolic PAP was 27.9 mmHg (95% CI 26.3–29.6 mmHg). These values are 11% (+2.7 mmHg) higher than those previously meta-analysed in apparently healthy high-altitude dwellers. During mild exercise (50 W) the difference in mean systolic PAP between patients and high-altitude dwellers was markedly more accentuated (48.3 versus 36.3 mmHg) than at rest.These findings indicate that in patients with CMS PAP is moderately increased at rest, but markedly increased during mild exercise, which will be common with activities of daily living.

scholarly journals Autonomic cardiovascular function in high-altitude Andean natives with chronic mountain sickness

2003 ◽  
Vol 94 (1) ◽  
pp. 213-219 ◽  
Author(s):  
C. Keyl ◽  
A. Schneider ◽  
A. Gamboa ◽  
L. Spicuzza ◽  
N. Casiraghi ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
High Altitude ◽  
Baroreflex Sensitivity ◽  
Cardiovascular Function ◽  
Supplemental Oxygen ◽  
Arterial Oxygen ◽  
Control Group ◽  
Chronic Mountain Sickness ◽  
Mountain Sickness ◽  
Spontaneous Baroreflex

We evaluated autonomic cardiovascular regulation in subjects with polycythemia and chronic mountain sickness (CMS) and tested the hypothesis that an increase in arterial oxygen saturation has a beneficial effect on arterial baroreflex sensitivity in these subjects. Ten Andean natives with a Hct >65% and 10 natives with a Hct <60%, all living permanently at an altitude of 4,300 m, were included in the study. Cardiovascular autonomic regulation was evaluated by spectral analysis of hemodynamic parameters, while subjects breathed spontaneously or frequency controlled at 0.1 and 0.25 Hz, respectively. The recordings were repeated after a 1-h administration of supplemental oxygen and after frequency-controlled breathing at 6 breaths/min for 1 h, respectively. Subjects with Hct >65% showed an increased incidence of CMS compared with subjects with Hct <60%. Spontaneous baroreflex sensitivity was significantly lower in subjects with high Hct compared with the control group. The effects of supplemental oxygen or modification of the breathing pattern on autonomic function were as follows: 1) heart rate decreased significantly after both maneuvers in both groups, and 2) spontaneous baroreflex sensitivity increased significantly in subjects with high Hct and did not differ from subjects with low Hct. Temporary slow-frequency breathing may provide a beneficial effect on the autonomic cardiovascular function in high-altitude natives with CMS.

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