title: Pulmonary arterial systolic pressure and susceptibility to high altitude pulmonary edema.
abstract: There is evidence that pulmonary arterial hypertension plays a major role in the occurrence of high altitude pulmonary edema (HAPE). We tested the hypothesis that the pulmonary arterial systolic pressure response to a challenge associated with hypoxia and mild exercise may be considered a predictive factor of HAPE. Pulmonary arterial systolic pressure was measured by Doppler echocardiography in 8 HAPE susceptible (HAPE-S) subjects and 8 HAPE resistant mountaineers (HAPE-R) during a hypoxic exercise challenge established by the French Association for Sport Medicine (Richalet's test). Pulmonary arterial systolic pressure during hypoxic exercise allowed a significant discrimination between the groups, although an overlap of values was observed. When expressed as individual variations from baseline to hypoxic exercise level however, we found a highly significant difference. No overlap was observed between HAPE-R (range: 6.7-18.5 mmHg) and HAPE-S (range: 19.2-30.4 mmHg) groups, with a cut-off value at 19 mmHg. Plasma Vascular Endothelial growth factor (VEGF) and malondialdehyde (MDA) increased in response to hypoxic exercise only in HAPE-S group. Individual increases in pulmonary arterial systolic pressure during hypoxic exercise from basal resting normoxic values seem relevant to estimate HAPE susceptibility when measured during the Richalet's test.
authors.affiliation: Institut Cochin, Université Paris Descartes, CNRS (UMR 8104), Paris, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Mounier
authors.forename: Aimé
authors.initials: A
authors.lastname: Amonchot
authors.forename: Nicolas
authors.initials: N
authors.lastname: Caillot
authors.forename: Cécile
authors.initials: C
authors.lastname: Gladine
authors.forename: Bernard
authors.initials: B
authors.lastname: Citron
authors.forename: Mario
authors.initials: M
authors.lastname: Bedu
authors.forename: Erica
authors.initials: E
authors.lastname: Chirico
authors.forename: Jean
authors.initials: J
authors.lastname: Coudert
authors.forename: Vincent
authors.initials: V
authors.lastname: Pialoux
mesh_terms: D000328:Adult; D000532:Altitude Sickness / Q000378:metabolism / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D004198:Disease Susceptibility / Q000378:metabolism / Q000503:physiopathology; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism / Q000503:physiopathology*; D000860:Hypoxia / Q000503:physiopathology; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000096:biosynthesis; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D011651:Pulmonary Artery / Q000502:physiology*; D012333:RNA, Messenger / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D055815:Young Adult
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D009566:Nitrates; D009573:Nitrites; D012333:RNA, Messenger; D042461:Vascular Endothelial Growth Factor A; D008315:Malondialdehyde