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Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3450 m.
MedLine Citation:
PMID:  22523248     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life threatening high-altitude pulmonary edema (HAPE), but there is limited data in this young population. We, therefore, assessed in 118 non-acclimatized healthy children and adolescents (mean±SD age 11±2 years) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 hours after rapid ascent to 3450 m. Pulmonary artery pressure was more than two-fold higher at high than at low altitude (35±11 vs. 16±3 mm Hg, P<0.0001) and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mm Hg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost 2-fold larger increase in the 6 to 9 than in the 14 to 16 years old participants (24±12 vs. 13±8 mm Hg, P=0.004). Even in children with the most severe altitude-induced pulmonary hypertension right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. High-altitude pulmonary edema appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.
Authors:
Yves Allemann; Thomas Stuber; Stefano Fausto de Marchi; Emrush Rexhaj; Claudio Sartori; Urs Scherrer; Stefano F Rimoldi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-20
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  -     ISSN:  1522-1539     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Swiss Cardiovascular Center Bern.
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