Acute mountain sickness relates to sea-level partial pressure of oxygen

The aim of this study was to clarify the relationships between acute mountain sickness (AMS), studied during an expedition in the Andes, and some physiological parameters determined before the expedition, i.e. biometrical characteristics of the subjects [maximal oxygen consumption (VO2max), body fat content, body mass index], functional pulmonary tests (forced vital capacity, forced expiratory volume at the first second), ventilatory or cardiac responses measured at 4,500 m [hypoxic ventilatory responses (HVR) 4,500 and hypoxic cardiac responses (HCR) 4,500, respectively), cold pressor responses. To achieve this objective, 11 subjects were firstly submitted to a hypobaric poïkilocapnic hypoxic test (589 hPa, 4,500 m) at rest and during exercise to study minute volume, respiratory frequency, end tidal partial pressure of O2 (PETO2) and CO2, HVR 4,500, HCR 4,500 and to a cold pressor test of the hand (5 min in 5 degrees C cold water) to study heart rate, blood pressure and skin temperature changes. The AMS was assessed daily by questionnaire during a 12-day expedition in the Andes following both Hackett's method and Environmental Symptoms Questionnaire (modified ESQ II). Maximal AMS-Hackett score, maximal AMS-ESQ score and mean AMS-ESQ score were defined. The quantifications of AMS following the two methods were correlated. No significant relationships were observed between mean AMS-ESQ score and the biometrical characteristics of the subjects, the functional pulmonary tests, HVR 4,500, HCR 4,500 or the cold pressor responses. However, it appeared that the mean AMS-ESQ score was correlated with PETO2 measured at rest and during exercise (50% VO2max) both in hypoxia and normoxia. A closer linear relationship was observed during the exercise in normoxia (r = -0.92, P < 0.0001). These results could suggest that AMS was related to a relative alveolar hypoventilation more in relation to breathing pattern than HVR.