title: [Relationship of high altitude de-adaptation with acute high altitude response and cardiac function].
abstract: OBJECTIVE
  To assess the relationship of high altitude de-adaptation response (HADAR) with acute high altitude response (AHAR) and cardiac function.
  
  
  METHODS
  Ninety-six military personnel of rapid entering into high altitude (3 700 to 4 800 m) with strong physical work were analyzed, all subjects were male, aged 18 - 35 years. According to the symptomatic scores of AHAR were divided into 3 groups: sever AHAR (group A, 24), mild to moderate AHAR (group B, 47) and non-AHAR (group C, 25) at high altitude. According to the symptomatic scores of HADAR were divided into 3 groups: severe HADAR (group E, 19), mild to moderate HADAR (group F, 40) and non-HADAR (group G, 37) after return to lower altitude (1 500 m). Mean pulmonary arterial pressure (mPAP), right ventricular internal dimension (RVID), outflow tract of right ventricle (RVOT), left ventricular internal dimension (LVID), left ventricular ejection fraction (LVEF), cardiac muscle work index (Tei index), creatine kinase isoenzymes-MB (CK-MB), lactic dehydrogenase isoenzyme-1 (LDH-1) were measured at high altitude stayed 50 days and after return to lower altitude 12 h, 15 d, and 30 d. Fifty healthy volunteers (group D) at 1 500 m altitude served as control.
  
  
  RESULTS
  Level of mPAP, RVID, RVOT, RVID/LVID ratio, Tei index, CK-MB,and LDH-1 were higher, and LVEF was lower in group A than those in group B, C and D, there were significant differences between group B and C, C and D (all P < 0.01). AHAR scores were positively correlated with HADAR scores (r = 0.863, P < 0.01). Twelve hours after return to lower altitude, level of mPAP, RVID, RVOT, RVI/LVID ratio, Tei index, CK-MB, and LDH-1 were higher, and LVEF was lower in group E than those in group F, G and D, there were significant differences between group F and G, G and D (all P < 0.01). Fifteen days after return to lower altitude, level of mPAP, RVID, RVOT, RVID/LVID ratio were higher in group E than those in group F, G, and D, there were significant differences between group F and G, and D (P < 0.01 or P < 0.05), there were no significant differences between group G and D (all P > 0.05), LVEF, Tei index, CK-MB, LDH-1 showed no significant differences among groups (all P > 0.05). Thirty days after return to lower altitude, these parameters in group E, F, and G showed no significantly differences compared with those of group D (all P > 0.05).
  
  
  CONCLUSIONS
  The severity of HADAR is associated with severity of AHAR and cardiac injury, the more serious of AHAR and cardiac injury at high altitude, the more serious of HADAR and cardiac injury after return to lower altitude, the more long of restore of right cardiac morphologic injury.
authors.affiliation: Center of Respiratory Medicine, 4th Hospital, Lanzhou Command, PLA, Xining 810007, China.
authors.forename: Sheng-Yue
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Department of Plateau Military Medicine, Third Military Medical University, Chongqing 400037, China.
authors.forename: Qi-Quan
authors.initials: QQ
authors.lastname: Zhou
authors.affiliation: Center of Respiratory Medicine, 4th Hospital, Lanzhou Command, PLA, Xining 810007, China.
authors.forename: En-Zhi
authors.initials: EZ
authors.lastname: Feng
authors.affiliation: Center of Respiratory Medicine, 4th Hospital, Lanzhou Command, PLA, Xining 810007, China.
authors.forename: Zi-Qiang
authors.initials: ZQ
authors.lastname: Yan
authors.affiliation: Center of Respiratory Medicine, 4th Hospital, Lanzhou Command, PLA, Xining 810007, China.
authors.forename: Zhong-Xin
authors.initials: ZX
authors.lastname: Tian
authors.affiliation: Center of Respiratory Medicine, 4th Hospital, Lanzhou Command, PLA, Xining 810007, China.
authors.forename: He
authors.initials: H
authors.lastname: Yin
authors.affiliation: 68303 Armed Hospital PLA, Wuwei 733000, China.
authors.forename: Zi-Fu
authors.initials: ZF
authors.lastname: Shi
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000378:metabolism* / Q000503:physiopathology*; D016022:Case-Control Studies; D006321:Heart / Q000503:physiopathology; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D009206:Myocardium / Q000201:enzymology*; D055815:Young Adult