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. 2023 Apr 13;42(1):6.
doi: 10.1186/s40101-023-00322-7.

Association between high cardiac output at altitude and acute mountain sickness: preliminary study on Mt. Fuji

Takeshi Ebihara  1 , Kentaro Shimizu  2 , Yumi Mitsuyama  2 , Hiroshi Ogura  2 , Jun Oda  2
Affiliations

Association between high cardiac output at altitude and acute mountain sickness: preliminary study on Mt. Fuji

Takeshi Ebihara et al. J Physiol Anthropol. .

Erratum in

Abstract

Background: Acute mountain sickness (AMS) affects around 30% of people climbing Mt. Fuji, but its pathogenesis is incompletely understood. The influence of a rapid ascent to high altitude by climbing and summiting Mt. Fuji on cardiac function in the general population is unknown, and its association with altitude sickness has not been clarified.

Methods: Subjects climbing Mt. Fuji were included. Heart rate, oxygen saturation, systolic blood pressure, cardiac index (CI) and stroke volume index were measured multiple times at 120 m as baseline values and at Mt. Fuji Research Station (MFRS) at 3,775 m. Each value and its difference from the baseline value (Δ) of subjects with AMS (defined as Lake Louise Score [LLS] ≥ 3 with headache after sleeping at 3,775 m) were compared with those of non-AMS subjects.

Results: Eleven volunteers who climbed from 2,380 m to MFRS within 8 h and stayed overnight at MFRS were included. Four suffered AMS. Compared with the non-AMS subjects, CI in the AMS subjects was significantly higher than that before sleeping (median [interquartile range]: 4.9 [4.5, 5.0] vs. 3.8 [3.4, 3.9] mL/min/m2; p = 0.04), and their ΔCI was significantly higher before sleeping (1.6 [1.4, 2.1] vs. 0.2 [0.0, 0.7] mL/min/m2; p < 0.01) and after sleeping (0.7 [0.3, 1.7] vs. -0.2 [-0.5, 0.0] mL/min/m2; p < 0.01). ΔCI in the AMS subjects dropped significantly after sleeping versus before sleeping (3.8 [3.6, 4.5] vs. 4.9 [4.5, 5.0] mL/min/m2; p = 0.04).

Conclusions: Higher values of CI and ΔCI were observed at high altitude in the AMS subjects. A high cardiac output might be associated with the development of AMS.

Keywords: Cardiac function; Mt. Fuji; Mt. Fuji research station; Non-invasive hemodynamic monitor.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Time course of study and changes of LLS and physiological parameters. A The X axis shows the times after departing from Fujinomiya city at 120 m. The Y axis shows the altitude. B In this study, AMS was defined as a LLS ≥ 3 with headache after sleeping at 3775 m. Dotted line indicates LLS of 3. C Change in SpO2, HR, sBP, dBP and MAP. All values are expressed as the mean ± SD. D SpO2, HR, CI and SVI values of the AMS and non-AMS subjects at 120 m and 3775 m. #Indicates a statistically significant difference between the AMS and non-AMS subjects (p < 0.05). E The ΔSpO2, ΔHR, ΔCI and ΔSVI values of the AMS and non-AMS subjects at 120 m and 3775 m. #Indicates a statistically significant difference between the AMS and non-AMS subjects (p < 0.05). All values are expressed as the mean ± SD. AMS acute mountain sickness, CI cardiac index, dBP Diastolic blood pressure, HR heart rate, LLS Lake Louise Score, MAP Mean arterial pressure, MFRS Mt. Fuji Research Station, sBP Systolic blood pressure, SD standard deviation, SVI stroke volume index
Fig. 1
Fig. 1
Time course of study and changes of LLS and physiological parameters. A The X axis shows the times after departing from Fujinomiya city at 120 m. The Y axis shows the altitude. B In this study, AMS was defined as a LLS ≥ 3 with headache after sleeping at 3775 m. Dotted line indicates LLS of 3. C Change in SpO2, HR, sBP, dBP and MAP. All values are expressed as the mean ± SD. D SpO2, HR, CI and SVI values of the AMS and non-AMS subjects at 120 m and 3775 m. #Indicates a statistically significant difference between the AMS and non-AMS subjects (p < 0.05). E The ΔSpO2, ΔHR, ΔCI and ΔSVI values of the AMS and non-AMS subjects at 120 m and 3775 m. #Indicates a statistically significant difference between the AMS and non-AMS subjects (p < 0.05). All values are expressed as the mean ± SD. AMS acute mountain sickness, CI cardiac index, dBP Diastolic blood pressure, HR heart rate, LLS Lake Louise Score, MAP Mean arterial pressure, MFRS Mt. Fuji Research Station, sBP Systolic blood pressure, SD standard deviation, SVI stroke volume index
Fig. 2
Fig. 2
Change in LLS, ΔSpO2, ΔHR, ΔCI and ΔSVI before and after sleeping at 3,775 m. A Change in LLS. B Changes in ΔSpO2, ΔHR, ΔCI and ΔSVI. *Indicates a significant difference in each value between before sleeping and after sleeping (p < 0.05). All values are expressed as the mean ± SD. AMS acute mountain sickness, CI cardiac index, HR heart rate, LLS Lake Louise Score, SD standard deviation, SVI stroke volume index
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