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Boos, Christopher J., Pete Hodkinson, Adrian Mellor, Nicholas P. Green, and David R. Woods. High Alt. Med. Biol. 13: 105-111.-This study investigated, for the first time, the effects of simulated high altitude, following acute hypobaric hypoxia (HH), on simultaneous assessment of large artery stiffness and endothelial function and its inter-relationship to left ventricular (LV) diastolic function, pulmonary artery systolic pressure (PASP), and estimated PA vascular resistance (PVR). Ten healthy subjects were studied at baseline pre and following acute HH to 4800m for a total of 180 minutes. Assessments of LV diastolic function, mitral inflow, estimated LV filling pressure (E/e'), PVR, and PASP were undertaken using transthoracic echocardiography. Simultaneous assessments of arterial stiffness index (SI), systemic vascular resistance (SVR), vascular tone, and endothelial function (reflective index [RI]) were performed using pulse contour analysis of the digital arterial waveform. Acute hypoxia led to a fall in SpO(2) (98.1 +/- 0.7 vs. 71.8 +/- 7.1%; p = 0.0002), SVR (1589.1 +/- 191.2 vs. 1187.8 +/- 248.7; p = 0.004), and RI (50.8 +/- 10.3 vs. 33.0 +/- 6.5%; p = 0.0008) with an increase in PASP (24.3 +/- 2.2 to 35.0 +/- 5.3 mmHg; p = 0.0001) and estimated PVR (116.40 +/- 19.0 vs. 144.6 +/- 21.5; p < 0.001). There was no rise in either SI (p = 0.13), mitral early annular early e' filling velocity or E/e'. There was a significant inverse correlation between SpO(2) and PASP (r= -0.77; p < 0.0001), PVR (r = -0.57; p = 0.008) and between the fall in SpO(2) and change (Delta) in RI (baseline vs. 150 min, r= -0.52; p < 0.001). There was a modest inverse correlation between Delta RI (lower Delta RI = worsening endothelial function) and Delta PAP (r= -0.55; p = 0.10) and a strong inverse correlation between Delta RI and Delta PVR (r= -0.89; p = 0.0007). Acute hypobaric hypoxia does not significantly alter large artery stiffness or cause overt LV diastolic function. However, the degree of hypoxia influences both the systemic endothelial and pulmonary vascular responses. This noted association is intriguing and requires further investigation.
Author(s): Boos CJ, Hodkinson P, Mellor A, Green NP, Woods DR
Publication type: Article
Publication status: Published
Journal: High Altitude Medicine and Biology
Year: 2012
Volume: 13
Issue: 2
Pages: 105-111
Print publication date: 22/06/2012
ISSN (print): 1527-0297
ISSN (electronic): 1557-8682
Publisher: Mary Ann Liebert, Inc. Publishers
URL: http://dx.doi.org/10.1089/ham.2012.1009
DOI: 10.1089/ham.2012.1009
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