PMID- 29623044
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 1664-042X (Print)
IS  - 1664-042X (Electronic)
IS  - 1664-042X (Linking)
VI  - 9
DP  - 2018
TI  - Long-Term Intermittent Work at High Altitude: Right Heart Functional and 
      Morphological Status and Associated Cardiometabolic Factors.
PG  - 248
LID - 10.3389/fphys.2018.00248 [doi]
LID - 248
AB  - Background: Living at high altitude or with chronic hypoxia implies functional 
      and morphological changes in the right ventricle and pulmonary vasculature with a 
      10% prevalence of high-altitude pulmonary hypertension (HAPH). The implications 
      of working intermittently (day shifts) at high altitude (hypobaric hypoxia) over 
      the long term are still not well-defined. The aim of this study was to evaluate 
      the right cardiac circuit status along with potentially contributory metabolic 
      variables and distinctive responses after long exposure to the latter condition. 
      Methods: A cross-sectional study of 120 healthy miners working at an altitude of 
      4,400-4,800 m for over 5 years in 7-day commuting shifts was designed. 
      Echocardiography was performed on day 2 at sea level. Additionally, biomedical 
      and biochemical variables, Lake Louise scores (LLSs), sleep disturbances and 
      physiological variables were measured at altitude and at sea level. Results: The 
      population was 41.8 +/- 0.7 years old, with an average of 14 +/- 0.5 (range 5-29) 
      years spent at altitude. Most subjects still suffered from mild to moderate 
      symptoms of acute mountain sickness (mild was an LLS of 3-5 points, including 
      cephalea; moderate was LLS of 6-10 points) (38.3%) at the end of day 1 of the 
      shift. Echocardiography showed a 23% mean pulmonary artery pressure (mPAP) >25 
      mmHg, 9% HAPH (>/=30 mmHg), 85% mild increase in right ventricle wall thickness (>/=5 
      mm), 64% mild right ventricle dilation, low pulmonary vascular resistance (PVR) 
      and fairly good ventricle performance. Asymmetric dimethylarginine (ADMA) (OR 
      8.84 (1.18-66.39); p < 0.05) and insulin (OR: 1.11 (1.02-1.20); p < 0.05) were 
      associated with elevated mPAP and were defined as a cut-off. Interestingly, the 
      correspondence analysis identified association patterns of several other 
      variables (metabolic, labor, and biomedical) with higher mPAP. Conclusions: 
      Working intermittently at high altitude involves a distinctive pattern. The most 
      relevant and novel characteristics are a greater prevalence of elevated mPAP and 
      HAPH than previously reported at chronic intermittent hypobaric hypoxia (CIHH), 
      which is accompanied by subsequent morphological characteristics. These findings 
      are associated with cardiometabolic factors (insulin and ADMA). However, the 
      functional repercussions seem to be minor or negligible. This research 
      contributes to our understanding and surveillance of this unique model of chronic 
      intermittent high-altitude exposure.
FAU - Brito, Julio
AU  - Brito J
AD  - Institute of Health Studies, University Arturo Prat, Iquique, Chile.
FAU - Siques, Patricia
AU  - Siques P
AD  - Institute of Health Studies, University Arturo Prat, Iquique, Chile.
FAU - Lopez, Rosario
AU  - Lopez R
AD  - Department of Preventive Medicine and Public Health, University Autonoma of 
      Madrid, Madrid, Spain.
FAU - Romero, Raul
AU  - Romero R
AD  - Institute of Health Studies, University Arturo Prat, Iquique, Chile.
FAU - Leon-Velarde, Fabiola
AU  - Leon-Velarde F
AD  - Department of Biological and Physiological Sciences, Facultad de Ciencias y 
      Filosofia/IIA, University Peruana Cayetano Heredia, Lima, Peru.
FAU - Flores, Karen
AU  - Flores K
AD  - Institute of Health Studies, University Arturo Prat, Iquique, Chile.
FAU - Luneburg, Nicole
AU  - Luneburg N
AD  - Institute of Clinical Pharmacology and Toxicology, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Hannemann, Juliane
AU  - Hannemann J
AD  - Institute of Clinical Pharmacology and Toxicology, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
FAU - Boger, Rainer H
AU  - Boger RH
AD  - Institute of Clinical Pharmacology and Toxicology, University Medical Center 
      Hamburg-Eppendorf, Hamburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20180322
PL  - Switzerland
TA  - Front Physiol
JT  - Frontiers in physiology
JID - 101549006
PMC - PMC5874329
OTO - NOTNLM
OT  - altitude
OT  - chronic intermittent hypobaric hypoxia
OT  - high-altitude pulmonary hypertension
OT  - insulin and ADMA
OT  - right heart
EDAT- 2018/04/07 06:00
MHDA- 2018/04/07 06:01
PMCR- 2018/03/22
CRDT- 2018/04/07 06:00
PHST- 2017/12/05 00:00 [received]
PHST- 2018/03/06 00:00 [accepted]
PHST- 2018/04/07 06:00 [entrez]
PHST- 2018/04/07 06:00 [pubmed]
PHST- 2018/04/07 06:01 [medline]
PHST- 2018/03/22 00:00 [pmc-release]
AID - 10.3389/fphys.2018.00248 [doi]
PST - epublish
SO  - Front Physiol. 2018 Mar 22;9:248. doi: 10.3389/fphys.2018.00248. eCollection 
      2018.