Overall and regional lung function in Andean natives after descent to low altitude

Overall lung volumes, regional residual volume to total lung capacity ratio (RVr/TLCr), regional ventilation (V/V) and perfusion (Q/V) were measured at 670 m in six Quechua Indians on days 2 and 37 after leaving their high-altitude homes (3500-4500 m). On day 2 the lung volumes averaged between 124 and 137% of those predicted for low-altitude residents (LAR) and there were no significant changes on day 37. Although overall RV/TLC was not different from the predicted value for LAR, RVr/TLCr on day 2 was higher at the top and lower at the bottom of the lungs compared to LAR. Regional Q/V and V/V were not different from LAR on day 2, or on day 37. However, the ratio of Q/V at the bottom to Q/V at the top was 2.36 on day 2 and 2.84 on day 37 (P less than 0.05). On day 2 hemoglobin- and volume-corrected diffusing capacity was 145% of the value predicted for LAR and this fell to 135% predicted on day 37 (P less than 0.05). Natives of high altitude reportedly have more alveoli that LAR and this could explain the greater vital capacity toward the bottom of the lung if the alveolar proliferation is concentrated there. This might also lower pulmonary vascular resistance at the bottom which would explain the normal Q/V distribution, even though pulmonary artery pressure may be increased.