12 research outputs found

    Selected contribution: Peripheral chemoreflex function in high-altitude natives and patients with chronic mountain sickness.

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    Peripheral chemoreflex function was studied in high-altitude (HA) natives at HA, in patients with chronic mountain sickness (CMS) at HA, and in sea-level (SL) natives at SL. Results were as follows. 1) Acute ventilatory responses to hypoxia (AHVR) in the HA and CMS groups were approximately one-third of those of the SL group. 2) In CMS patients, some indexes of AHVR were modestly, but significantly, lower than in healthy HA natives. 3) Prior oxygenation increased AHVR in all subject groups. 4) Neither low-dose dopamine nor somatostatin suppressed any component of ventilation that could not be suppressed by acute hyperoxia. 5) In all subject groups, the ventilatory response to hyperoxia was biphasic. Initially, ventilation fell but subsequently rose so that, by 20 min, ventilation was higher in hyperoxia than hypoxia for both HA and CMS subjects. 6) Peripheral chemoreflex stimulation of ventilation was modestly greater in HA and CMS subjects at an end-tidal Po(2) = 52.5 Torr than in SL natives at an end-tidal Po(2) = 100 Torr. 7) For the HA and CMS subjects combined, there was a strong correlation between end-tidal Pco(2) and hematocrit, which persisted after controlling for AHVR

    Selected contribution: High-altitude natives living at sea level acclimatize to high altitude like sea-level natives.

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    Sea-level (SL) natives acclimatizing to high altitude (HA) increase their acute ventilatory response to hypoxia (AHVR), but HA natives have values for AHVR below those for SL natives at SL (blunting). HA natives who live at SL retain some blunting of AHVR and have more marked blunting to sustained (20-min) hypoxia. This study addressed the question of what happens when HA natives resident at SL return to HA: do they acclimatize like SL natives or revert to the characteristics of HA natives? Fifteen HA natives resident at SL were studied, together with 15 SL natives as controls. Air-breathing end-tidal Pco(2) and AHVR were determined at SL. Subjects were then transported to 4,300 m, where these measurements were repeated on each of the following 5 days. There were no significant differences in the magnitude or time course of the changes in end-tidal Pco(2) and AHVR between the two groups. We conclude that HA natives normally resident at SL undergo ventilatory acclimatization to HA in the same manner as SL natives

    Selected contribution: Ventilatory response to CO2 in high-altitude natives and patients with chronic mountain sickness.

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    The ventilatory responses to CO(2) of high-altitude (HA) natives and patients with chronic mountain sickness (CMS) were studied and compared with sea-level (SL) natives living at SL. A multifrequency binary sequence (MFBS) in end-tidal Pco(2) was employed to separate the fast (peripheral) and slow (central) components of the chemoreflex response. MFBS was imposed against a background of both euoxia (end-tidal Po(2) of 100 Torr) and hypoxia (52.5 Torr). Both total and central chemoreflex sensitivity to CO(2) in euoxia were higher in HA and CMS subjects compared with SL subjects. Peripheral chemoreflex sensitivity to CO(2) in euoxia was higher in HA subjects than in SL subjects. Hypoxia induced a greater increase in total chemoreflex sensitivity to CO(2) in SL subjects than in HA and CMS subjects, but peripheral chemoreflex sensitivity to CO(2) in hypoxia was no greater in SL subjects than in HA and CMS subjects. Values for the slow (central) time constant were significantly greater for HA and CMS subjects than for SL subjects

    Selected contribution: Acute and sustained ventilatory responses to hypoxia in high-altitude natives living at sea level.

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    High-altitude (HA) natives have blunted ventilatory responses to hypoxia (HVR), but studies differ as to whether this blunting is lost when HA natives migrate to live at sea level (SL), possibly because HVR has been assessed with different durations of hypoxic exposure (acute vs. sustained). To investigate this, 50 HA natives (>3,500 m, for >20 yr) now resident at SL were compared with 50 SL natives as controls. Isocapnic HVR was assessed by using two protocols: protocol 1, progressive stepwise induction of hypoxia over 5-6 min; and protocol 2, sustained (20-min) hypoxia (end-tidal Po(2) = 50 Torr). Acute HVR was assessed from both protocols, and sustained HVR from protocol 2. For HA natives, acute HVR was 79% [95% confidence interval (CI): 52-106%, P = not significant] of SL controls for protocol 1 and 74% (95% CI: 52-96%, P < 0.05) for protocol 2. By contrast, sustained HVR after 20-min hypoxia was only 30% (95% CI: -7-67%, P < 0.001) of SL control values. The persistent blunting of HVR of HA natives resident at SL is substantially less to acute than to sustained hypoxia, when hypoxic ventilatory depression can develop

    Exercise pathophysiology in patients with chronic mountain sickness exercise in chronic mountain sickness

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    ABSTRACT: BACKGROUND:Chronic mountain sickness is characterized by a combination of excessive erythrocytosis, severe hypoxemia and pulmonary hypertension, all of which affect exercise capacity. METHODS:Thirteen chronic mountain sickness patients and 15 healthy highlander and 15 newcomer lowlander controls were investigated at an altitude of 4350m (Cerro de Pasco). All of them underwent measurements of lung diffusing capacity for nitric oxide and carbon monoxide at rest, echocardiography for estimation of mean pulmonary arterial pressure and cardiac output at rest and at exercise, and an incremental cycle ergometer cardiopulmonary exercise test. RESULTS:The chronic mountain sickness patients, the healthy highlanders and the newcomer lowlanders reached a similar maximal oxygen uptake, at 32±1, 32±2 and 33±2 ml.min(-1).kg(-1) respectively, mean ± SE, p=0.8, with ventilatory equivalents for CO(2) versus end-tidal PCO(2), measured at the anaerobic threshold, of 0.9±0.1, 1.2±0.1 and 1.4±0.1 mmHg(-1), p<0.001, arterial O(2) content of 26±1, 21±2 and 16±1 ml.dl(-1), p<0.001, diffusing capacity for carbon monoxide corrected for alveolar volume of 155±4, 150±5 and 120±3% predicted, p<0.001, with diffusing capacity for nitric oxide and carbon monoxide ratios of 4.7±0.1 at sea-level decreased to 3.6±0.1, 3.7±0.1 and 3.9±0.1, p<0.05 and a maximal exercise mean pulmonary arterial pressure at 56±4, 42±3, and 31±2 mmHg, p<0.001. CONCLUSIONS:The aerobic exercise capacity of chronic mountain sickness patients is preserved in spite of severe pulmonary hypertension and relative hypoventilation, probably by a combination of increased oxygen carrying capacity of the blood and lung diffusion, the latter being predominantly due to an increased capillary blood volume.JOURNAL ARTICLESCOPUS: ar.jinfo:eu-repo/semantics/publishe
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