Document Detail

Exaggerated pulmonary hypertension during mild exercise in chronic mountain sickness.
MedLine Citation:
PMID:  19783668     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Chronic mountain sickness (CMS) is an important public health problem and is characterized by exaggerated hypoxemia, erythrocytosis, and pulmonary hypertension. While pulmonary hypertension is a leading cause of morbidity and mortality in patients with CMS, it is relatively mild and its underlying mechanisms are not known. We speculated that during mild exercise associated with daily activities, pulmonary hypertension in CMS is much more pronounced. METHODS: We estimated pulmonary artery pressure by using echocardiography at rest and during mild bicycle exercise at 50 W in 30 male patients with CMS and 32 age-matched, healthy control subjects who were born and living at an altitude of 3,600 m. RESULTS: The modest, albeit significant difference of the systolic right-ventricular-to-right-atrial pressure gradient between patients with CMS and controls at rest (30.3 +/- 8.0 vs 25.4 +/- 4.5 mm Hg, P 5 .002) became more than three times larger during mild bicycle exercise (56.4 +/- 19.0 vs 39.8 +/- 8.0 mm Hg, P < .001). CONCLUSIONS: Measurements of pulmonary artery pressure at rest greatly underestimate pulmonary artery pressure during daily activity in patients with CMS. The marked pulmonary hypertension during mild exercise associated with daily activity may explain why this problem is a leading cause of morbidity and mortality in patients with CMS.
Thomas Stuber; Claudio Sartori; Marcos Schwab; Pierre-Yves Jayet; Stefano F Rimoldi; Sophie Garcin; Sébastien Thalmann; Hilde Spielvogel; Carlos Salinas Salmòn; Mercedes Villena; Urs Scherrer; Yves Allemann
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-25
Journal Detail:
Title:  Chest     Volume:  137     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-05     Completed Date:  2010-03-11     Revised Date:  2010-09-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  388-92     Citation Subset:  AIM; IM    
University Hospital of Bern, Cardiology, Bern, Switzerland.
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MeSH Terms
Altitude Sickness / complications*,  epidemiology,  physiopathology
Bolivia / epidemiology
Chronic Disease
Exercise / physiology*
Exercise Test / adverse effects,  methods*
Hypertension, Pulmonary / epidemiology,  etiology*,  physiopathology
Middle Aged
Morbidity / trends
Pulmonary Wedge Pressure / physiology*
Survival Rate / trends
Comment In:
Chest. 2010 Sep;138(3):757-8; author reply 758   [PMID:  20823008 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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