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Right and Left Heart Function in Lowlanders with COPD at Altitude: Data from a Randomized Study.

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Traveling to altitude increases pulmonary artery pressure and affects cardiac function in patients with chronic obstructive pulmonary disease (COPD). Despite these changes, short-term altitude exposure was well tolerated by participants.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Altitude Medicine

Background:

  • Prevalence of chronic obstructive pulmonary disease (COPD) is increasing globally.
  • Limited data exists on the cardiopulmonary response of COPD patients to altitude exposure.
  • Understanding these changes is crucial for patient safety during travel.

Purpose of the Study:

  • To investigate the impact of moderate altitude exposure on pulmonary hemodynamics and cardiac function in COPD patients.
  • To test the hypothesis that pulmonary artery pressure (PAP) increases and cardiac function deteriorates at altitude.
  • To assess the tolerance of COPD patients to short-term altitude sojourns.

Main Methods:

  • 37 patients with COPD (GOLD grade 2-3) living below 800m participated.
  • Echocardiography was performed at low altitude (490m) and after one night at moderate altitude (2,590m).
  • A randomized order of allocation was used for the altitude exposures.

Main Results:

  • Pulmonary artery pressure (PAP) significantly increased (23 to 32 mm Hg, p < 0.0001).
  • Right ventricular function decreased (fractional area change from 45% to 38%, p = 0.002).
  • Heart rate, blood pressure, and prevalence of left ventricular diastolic dysfunction also increased.

Conclusions:

  • This is the first study to evaluate pulmonary hemodynamics and cardiac function in COPD patients at altitude.
  • Altitude exposure led to increased PAP and altered cardiac function but was generally well tolerated.
  • No patients required descent due to altitude-related symptoms, suggesting a degree of acclimatization or resilience.