Ventricular structure, function, and mechanics at high altitude: chronic remodeling in Sherpa vs. short-term lowlander adaptation

Research output: Contribution to journalArticleResearchpeer review

Authors

  • Mike Stembridge
  • Philip N. Ainslie
  • Michael G. Hughes
  • Eric J. Stöhr
  • James D. Cotter
  • Amanda Q.X. Nio
  • Rob Shave

External Research Organisations

  • Cardiff Metropolitan University
  • University of British Columbia
  • University of Otago
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Details

Original languageEnglish
Pages (from-to)334-343
Number of pages10
JournalJournal of applied physiology
Volume117
Issue number3
Early online date1 Aug 2014
Publication statusPublished - Aug 2014
Externally publishedYes

Abstract

Short-term, highaltitude (HA) exposure raises pulmonary artery systolic pressure (PASP) and decreases left-ventricular (LV) volumes. However, relatively little is known of the long-term cardiac consequences of prolonged exposure in Sherpa, a highly adapted HA population. To investigate short-term adaptation and potential long-term cardiac remodeling, we studied ventricular structure and function in Sherpa at 5,050 m (n = 11; 31 ± 13 yr; mass 68 ± 10 kg; height 169 ± 6 cm) and lowlanders at sea level (SL) and following 10 ± 3 days at 5,050 m (n = 9; 34 ± 7 yr; mass 82 ± 10 kg; height 177 ± 6 cm) using conventional and speckle-tracking echocardiography. At HA, PASP was higher in Sherpa and lowlanders compared with lowlanders at SL (both P < 0.05). Sherpa had smaller right-ventricular (RV) and LV stroke volumes than lowlanders at SL with lower RV systolic strain (P < 0.05) but similar LV systolic mechanics. In contrast to LV systolic mechanics, LV diastolic, untwisting velocity was significantly lower in Sherpa compared with lowlanders at both SL and HA. After partial acclimatization, lowlanders demonstrated no change in the RV end-diastolic area; however, both RV strain and LV end-diastolic volume were reduced. In conclusion, short-term hypoxia induced a reduction in RV systolic function that was also evident in Sherpa following chronic exposure. We propose that this was consequent to a persistently higher PASP. In contrast to the RV, remodeling of LV volumes and normalization of systolic mechanics indicate structural and functional adaptation to HA. However, altered LV diastolic relaxation after chronic hypoxic exposure may reflect differential remodeling of systolic and diastolic LV function.

Keywords

    Cardiac remodeling, Hypoxia, Sherpa, Ventricular mechanics

ASJC Scopus subject areas

Cite this

Ventricular structure, function, and mechanics at high altitude: chronic remodeling in Sherpa vs. short-term lowlander adaptation. / Stembridge, Mike; Ainslie, Philip N.; Hughes, Michael G. et al.
In: Journal of applied physiology, Vol. 117, No. 3, 08.2014, p. 334-343.

Research output: Contribution to journalArticleResearchpeer review

Stembridge M, Ainslie PN, Hughes MG, Stöhr EJ, Cotter JD, Nio AQX et al. Ventricular structure, function, and mechanics at high altitude: chronic remodeling in Sherpa vs. short-term lowlander adaptation. Journal of applied physiology. 2014 Aug;117(3):334-343. Epub 2014 Aug 1. doi: 10.1152/japplphysiol.00233.2014
Stembridge, Mike ; Ainslie, Philip N. ; Hughes, Michael G. et al. / Ventricular structure, function, and mechanics at high altitude : chronic remodeling in Sherpa vs. short-term lowlander adaptation. In: Journal of applied physiology. 2014 ; Vol. 117, No. 3. pp. 334-343.
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abstract = "Short-term, highaltitude (HA) exposure raises pulmonary artery systolic pressure (PASP) and decreases left-ventricular (LV) volumes. However, relatively little is known of the long-term cardiac consequences of prolonged exposure in Sherpa, a highly adapted HA population. To investigate short-term adaptation and potential long-term cardiac remodeling, we studied ventricular structure and function in Sherpa at 5,050 m (n = 11; 31 ± 13 yr; mass 68 ± 10 kg; height 169 ± 6 cm) and lowlanders at sea level (SL) and following 10 ± 3 days at 5,050 m (n = 9; 34 ± 7 yr; mass 82 ± 10 kg; height 177 ± 6 cm) using conventional and speckle-tracking echocardiography. At HA, PASP was higher in Sherpa and lowlanders compared with lowlanders at SL (both P < 0.05). Sherpa had smaller right-ventricular (RV) and LV stroke volumes than lowlanders at SL with lower RV systolic strain (P < 0.05) but similar LV systolic mechanics. In contrast to LV systolic mechanics, LV diastolic, untwisting velocity was significantly lower in Sherpa compared with lowlanders at both SL and HA. After partial acclimatization, lowlanders demonstrated no change in the RV end-diastolic area; however, both RV strain and LV end-diastolic volume were reduced. In conclusion, short-term hypoxia induced a reduction in RV systolic function that was also evident in Sherpa following chronic exposure. We propose that this was consequent to a persistently higher PASP. In contrast to the RV, remodeling of LV volumes and normalization of systolic mechanics indicate structural and functional adaptation to HA. However, altered LV diastolic relaxation after chronic hypoxic exposure may reflect differential remodeling of systolic and diastolic LV function.",
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T2 - chronic remodeling in Sherpa vs. short-term lowlander adaptation

AU - Stembridge, Mike

AU - Ainslie, Philip N.

AU - Hughes, Michael G.

AU - Stöhr, Eric J.

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AU - Nio, Amanda Q.X.

AU - Shave, Rob

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