| Exercise induces rapid interstitial lung water accumulation in patients with chronic mountain sickness. | |
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MedLine Citation:
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PMID: 21885723 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract BACKGROUND:Chronic mountain sickness (CMS) is a major public health problem in mountainous regions of the world. In its more advanced stages exercise intolerance is often found, but the underlying mechanism is not known. Recent evidence indicates that exercise-induced pulmonary hypertension is markedly exaggerated in CMS. We speculated that this problem may cause pulmonary fluid accumulation and aggravate hypoxemia during exercise. METHODS:We assessed extra-vascular lung water (chest ultrasound), pulmonary artery pressure and left ventricular function in 15 patients with CMS and 20 control subjects at rest and during exercise at 3600 m. RESULTS:Exercise at high altitude rapidly induced pulmonary interstitial fluid accumulation in all but one (14/15) patients with CMS and further aggravated the pre-existing hypoxemia. In contrast, in healthy high-altitude dwellers exercise did not induce fluid accumulation in the vast majority (16/20) of subjects (P=0.002 vs. CMS) and did not alter arterial oxygenation. Exercise-induced pulmonary interstitial fluid accumulation and hypoxemia in CMS patients was accompanied by a more than 2-times larger increase of pulmonary artery pressure than in controls (P<0.001), but no evidence of left ventricular dysfunction. Oxygen inhalation markedly attenuated the exercise-induced pulmonary hypertension (P<0.01) and interstitial fluid accumulation (P<0.05) in patients with CMS, but had no detectable effects in controls. CONCLUSIONS:These findings provide the first direct evidence that exercise induces rapid interstitial lung fluid accumulation and hypoxemia in patients with CMS that appear to be related to exaggerated pulmonary hypertension. We suggest that this problem contributes to exercise intolerance in patients with CMS.Clinical Trials Gov Registration # NCT01182792. |
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Authors:
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Lorenza Pratali; Stefano F Rimoldi; Emrush Rexhaj; Damian Hutter; Francesco Faita; Carlos Salinas Salmòn; Mercedes Villena; Rosa Sicari; Eugenio Picano; Yves Allemann; Urs Scherrer; Claudio Sartori |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-1 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Institute of Clinical Physiology, Pisa, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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