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Exaggerated pulmonary hypertension during mild exercise in chronic mountain sickness
Thomas Stuber1, Claudio Sartori, Marcos Schwab
1University Hospital of Bern, Cardiology, Bern, Switzerland.
Chest
|September 29, 2009
Summary
Pulmonary hypertension in chronic mountain sickness (CMS) significantly worsens during mild exercise. Resting measurements underestimate this exercise-induced increase, highlighting its importance in CMS morbidity and mortality.
Area of Science:
- Cardiology
- Pulmonology
- Altitude Medicine
Background:
- Chronic mountain sickness (CMS) presents with hypoxemia, erythrocytosis, and pulmonary hypertension.
- Pulmonary hypertension is a key factor in CMS morbidity and mortality.
- Mechanisms of pulmonary hypertension in CMS, especially during activity, remain unclear.
Purpose of the Study:
- To investigate the impact of mild exercise on pulmonary artery pressure in CMS patients.
- To compare exercise-induced pulmonary hypertension in CMS patients versus healthy controls.
Main Methods:
- Echocardiography was used to measure pulmonary artery pressure.
- Measurements were taken at rest and during 50 W bicycle exercise.
- Study included 30 male CMS patients and 32 healthy controls living at 3,600 m.
Main Results:
- A significant difference in systolic right-ventricular-to-right-atrial pressure gradient existed at rest.
- This pressure gradient increased over threefold during mild exercise in CMS patients compared to controls.
- Exercise significantly exacerbated pulmonary hypertension in CMS patients.
Conclusions:
- Resting pulmonary artery pressure measurements underestimate the severity during daily activities in CMS.
- Marked pulmonary hypertension during mild exercise likely contributes to CMS morbidity and mortality.
- Assessing pulmonary artery pressure during exercise is crucial for understanding CMS pathophysiology.
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