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High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart

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Right Ventricular Free Wall Strain in Healthy Lowlanders and Highlanders-A Case-Control Study.

Helga Preiss¹, Talant Sooronbaev^2,3, Stéphanie Saxer^1,4

¹Clinic of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland.

Journal of Clinical Medicine

|February 27, 2026

Summary

Healthy highlanders maintain right ventricular (RV) systolic function despite higher pulmonary arterial pressure (PAP). This suggests elevated PAP is an adaptation to altitude, not RV dysfunction, necessitating new diagnostic criteria for high-altitude pulmonary hypertension.

Keywords:

RVFWS high-altitude pulmonary hypertension right ventricular strain analysis

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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

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Published on: October 20, 2016

Area of Science:

Cardiology
Pulmonology
Altitude Physiology

Background:

Healthy highlanders (HL) exhibit higher pulmonary arterial pressure (PAP) than lowlanders (LL).
The cause of elevated PAP in HL (hypoxia response vs. right ventricular (RV) dysfunction) remains unclear.

Purpose of the Study:

To assess RV systolic function in HL and LL using speckle-tracking echocardiography.
To determine if elevated PAP in HL is associated with RV dysfunction or physiological adaptation.

Main Methods:

Case-control study comparing RV free wall strain (RVFWS) in 38 HL and 21 LL in Kyrgyzstan.
Echocardiography used to measure RVFWS, RV FAC, TAPSE, and TDI S'.
Subgroup analysis for individuals with and without risk for pulmonary hypertension (PH).

Main Results:

No significant difference in RVFWS between HL (-27.3% ± 4.7) and LL (-27.0% ± 6.0).
Conventional RV indices (RV FAC, TAPSE, TDI S') showed significant differences between HL and LL.
No differences in RVFWS or conventional RV indices were observed in HL with or without PH risk.

Conclusions:

Healthy highlanders generally maintain normal RV systolic function, as indicated by RVFWS.
Elevated PAP in HL appears to be an adaptive response to high altitude, not RV dysfunction.
Current diagnostic criteria for high-altitude pulmonary hypertension may need refinement.