PMID- 27014374
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160325
LR  - 20201001
IS  - 1874-1924 (Print)
IS  - 1874-1924 (Electronic)
IS  - 1874-1924 (Linking)
VI  - 10
DP  - 2016
TI  - High-altitude Pulmonary Hypertension: an Update on Disease Pathogenesis and 
      Management.
PG  - 19-27
LID - 10.2174/1874192401610010019 [doi]
AB  - High-altitude pulmonary hypertension (HAPH) affects individuals residing at 
      altitudes of 2,500 meters and higher. Numerous pathogenic variables play a role 
      in disease inception and progression and include low oxygen concentration in 
      inspired air, vasculopathy, and metabolic abnormalities. Since HAPH affects only 
      some people living at high altitude genetic factors play a significant role in 
      its pathogenesis. The clinical presentation of HAPH is nonspecific and includes 
      fatigue, shortness of breath, cognitive deficits, cough, and in advanced cases 
      hepatosplenomegaly and overt right-sided heart failure. A thorough history is 
      important and should include a search for additional risk factors for lung 
      disease and pulmonary hypertension (PH) such as smoking, indoor air pollution, 
      left-sided cardiac disease and sleep disordered breathing. Twelve-lead 
      electrocardiogram, chest X-ray and echocardiography can be used as screening 
      tools. A definitive diagnosis should be made with right-sided heart 
      catheterization using a modified mean pulmonary artery pressure of at least 30 mm 
      Hg, differing from the 25 mm Hg used for other types of PH. Treatment of HAPH 
      includes descent to a lower altitude whenever possible, oxygen therapy and the 
      use of medications such as endothelin receptor antagonists, phosphodiesterase 5 
      blockers, fasudil and acetazolamide. Some recent evidence suggests that iron 
      supplementation may also be beneficial. However, it is important to note that the 
      scientific literature lacks long-term randomized controlled data on the 
      pharmacologic treatment of HAPH. Thus, an individualized approach to treatment 
      and informing the patients regarding the benefits and risks of the selected 
      treatment regimen are essential.
FAU - Mirrakhimov, Aibek E
AU  - Mirrakhimov AE
AD  - University of Kentucky College of Medicine, Department of Medicine, Lexington, 
      Kentucky, 40508, USA.
FAU - Strohl, Kingman P
AU  - Strohl KP
AD  - Case Western Reserve University, Division of Pulmonary, Critical Care and Sleep 
      Medicine, 11100 Euclid Ave, Cleve-land, Ohio 44106, USA.
LA  - eng
PT  - Journal Article
DEP - 20160208
PL  - United Arab Emirates
TA  - Open Cardiovasc Med J
JT  - The open cardiovascular medicine journal
JID - 101480504
PMC - PMC4780514
OTO - NOTNLM
OT  - Altitude physiology
OT  - cardiac failure
OT  - epidemiology
OT  - treatment
EDAT- 2016/03/26 06:00
MHDA- 2016/03/26 06:01
PMCR- 2016/01/01
CRDT- 2016/03/26 06:00
PHST- 2015/08/22 00:00 [received]
PHST- 2015/09/20 00:00 [revised]
PHST- 2015/10/22 00:00 [accepted]
PHST- 2016/03/26 06:00 [entrez]
PHST- 2016/03/26 06:00 [pubmed]
PHST- 2016/03/26 06:01 [medline]
PHST- 2016/01/01 00:00 [pmc-release]
AID - TOCMJ-10-19 [pii]
AID - 10.2174/1874192401610010019 [doi]
PST - epublish
SO  - Open Cardiovasc Med J. 2016 Feb 8;10:19-27. doi: 10.2174/1874192401610010019. 
      eCollection 2016.