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. 2020 Nov 10:2020:6028747.
doi: 10.1155/2020/6028747. eCollection 2020.

Low Stroke Volume Index in Healthy Young Men Is Associated with the Incidence of Acute Mountain Sickness after an Ascent by Airplane: A Case-Control Study

Jingbin Ke  1   2 , Chuan Liu  1   2 , Shiyong Yu  1   2 , Shizhu Bian  1   2 , Chen Zhang  1   2 , Jie Yang  1   2 , Jihang Zhang  1 , Jun Jin  1   2 , Rongsheng Rao  3 , Ying Zeng  1   2 , Lan Huang  1   2
Affiliations

Low Stroke Volume Index in Healthy Young Men Is Associated with the Incidence of Acute Mountain Sickness after an Ascent by Airplane: A Case-Control Study

Jingbin Ke et al. Biomed Res Int. .

Abstract

Background: The aims of this study were to explore the characteristics of left ventricular (LV) functional changes in subjects with or without acute mountain sickness (AMS) and their associations with AMS incidence.

Methods: A total of 589 healthy men were enrolled and took a trip from Chengdu (500 m, above sea level (asl)) to Lhasa (3700 m, asl) by airplane. Basic characteristics, physiological data, and echocardiographic parameters were collected both at Chengdu and Lhasa, respectively. AMS was identified by the Lake Louise Questionnaire Score.

Results: The oxygen saturation (SpO2), end-systolic volume index, end-diastolic volume index (EDVi), stroke volume index (SVi), E-wave velocity, and E/A ratio were decreased, whereas the heart rate (HR), ejection fraction, cardiac index (CI), and A-wave velocity were increased at the third day after arrival, as evaluated by an oximeter and echocardiography. However, AMS patients showed higher HR and lower EDVi, SVi, CI, E-wave velocity, and E/A ratio than AMS-free subjects. Among them, SVi, which is mainly correlated with the changes of EDVi and altered LV filling pattern, was the most valuable factor associated with AMS incidence following receiver-operator characteristic curves and linear and Poisson regression. Compared with subjects in the highest SVi tertile, subjects in the middle SVi tertile showed higher multivariable Incidence Rate Ratios (IRR) for AMS with higher incidences of mild headache and gastrointestinal symptoms, whereas subjects in the lowest SVi tertile showed even higher multivariable IRR with higher incidences of all the symptoms.

Conclusions: This relatively large-scale case-control study revealed that the reduction of SVi correlated with the altered LV filling pattern was associated with the incidence and clinical severity of AMS.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Outline of this study. For the description of the study design, sample size, measurements, and study time points, please refer to the text.
Figure 2
Figure 2
Changes of oxygen saturation and the main cardiac parameters in subjects at sea level or at high altitude with or without AMS: (a) EDVi; (b) ESVi; (c) SVI; (d) HR; (e) SpO2; (f) CI; (g) E-wave velocity; (h) A-wave velocity; (i) E/A ratio. Dark horizontal lines indicated median values, and the top and bottom of the boxes represent the 75th and 25th percentiles, respectively. The top and bottom whiskers represented the 90th and 10th percentiles, respectively. ALL: all the subjects at HA; AMS (-): subjects with non-AMS; AMS (+): AMS patients; other abbreviations are as in Table 1. ∗p < 0.05 and ∗∗p < 0.01 compared to the sea level groups or indicated groups.
Figure 3
Figure 3
Receiver operator characteristic curves of HR (a), E-wave velocity (b), E/A ratio (c), EDVi (d), SVi (e), and CI (f) in discriminating AMS. AUC = area under the curve; CI = confidence interval; other abbreviations are as in Table 1.
Figure 4
Figure 4
Distribution of stroke volume index (SVi) in subjects with or without acute mountain sickness (AMS) and its relationships with EDVi, E/A ratio, and E-wave velocity. (a) Incidence of AMS in different levels of SVi: green: lowest SVi tertile; red: middle SVi tertile; blue: highest SVi tertile. (b) The distribution of SVi in subjects with or without AMS. Linear regression analysis shows the correlations of SVi and EDVi (c), EDVi and E/A ratio (d), and EDVi and E-wave velocity (e).
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References

    1. Penaloza D., Arias-Stella J. The heart and pulmonary circulation at high altitudes: healthy highlanders and chronic mountain sickness. Circulation. 2007;115(9):1132–1146. doi: 10.1161/CIRCULATIONAHA.106.624544. - DOI - PubMed
    1. Parati G., Bilo G., Faini A., et al. Changes in 24 h ambulatory blood pressure and effects of angiotensin II receptor blockade during acute and prolonged high-altitude exposure: a randomized clinical trial. European Heart Journal. 2014;35(44):3113–3122. doi: 10.1093/eurheartj/ehu275. - DOI - PubMed
    1. Bilo G., Villafuerte F. C., Faini A., et al. Ambulatory blood pressure in untreated and treated hypertensive patients at high altitude: the High Altitude Cardiovascular Research-Andes study. Hypertension. 2015;65(6):1266–1272. doi: 10.1161/HYPERTENSIONAHA.114.05003. - DOI - PubMed
    1. Bartsch P., Gibbs J. S. Effect of altitude on the heart and the lungs. Circulation. 2007;116(19):2191–2202. doi: 10.1161/CIRCULATIONAHA.106.650796. - DOI - PubMed
    1. Stembridge M., Ainslie P. N., Shave R. Short-term adaptation and chronic cardiac remodelling to high altitude in lowlander natives and Himalayan Sherpa. Experimental Physiology. 2015;100(11):1242–1246. doi: 10.1113/expphysiol.2014.082503. - DOI - PubMed

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