title: Elevated pulmonary artery pressure and brain natriuretic peptide in high altitude pulmonary edema susceptible non-mountaineers.
abstract: Exaggerated pulmonary pressor response to hypoxia is a pathgonomic feature observed in high altitude pulmonary edema (HAPE) susceptible mountaineers. It was investigated whether measurement of basal pulmonary artery pressure (Ppa) and brain natriuretic peptide (BNP) could improve identification of HAPE susceptible subjects in a non-mountaineer population. We studied BNP levels, baseline hemodynamics and the response to hypoxia (FIo2 = 0.12 for 30 min duration at sea level) in 11 HAPE resistant (no past history of HAPE, Control) and 11 HAPE susceptible (past history of HAPE, HAPE-S) subjects. Baseline Ppa (19.31 ± 3.63 vs 15.68 ± 2.79 mm Hg, p < 0.05) and plasma BNP levels (52.39 ± 32.9 vs 15.05 ± 9.6 pg/ml, p < 0.05) were high and stroke volume was less (p < 0.05) in HAPE-S subjects compared to control. Acute hypoxia produced an exaggerated increase in heart rate (p < 0.05), mean arterial pressure (p < 0.05) and Ppa (28.2 ± 5.8 vs 19.33 ± 3.74 mm Hg, p < 0.05) and fall in peripheral oxygen saturation (p < 0.05) in HAPE-S compared to control. Receiver operating characteristic (ROC) curves showed that Ppa response to acute hypoxia was the best variable to identify HAPE susceptibility (AUC 0.92) but BNP levels provided comparable information (AUC 0.85). BNP levels are easy to determine and may represent an important marker for the determination of HAPE susceptibility.
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Rajinder K
authors.initials: RK
authors.lastname: Gupta
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: G
authors.initials: G
authors.lastname: Himashree
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Krishan
authors.initials: K
authors.lastname: Singh
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Poonam
authors.initials: P
authors.lastname: Soree
authors.affiliation: CSIR Institute of Genomics and Integrated Biology, Mall Road, Delhi 110007, India.
authors.forename: Koundinya
authors.initials: K
authors.lastname: Desiraju
authors.affiliation: CSIR Institute of Genomics and Integrated Biology, Mall Road, Delhi 110007, India.
authors.forename: Anurag
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Dishari
authors.initials: D
authors.lastname: Ghosh
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Dass
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Prassana K
authors.initials: PK
authors.lastname: Reddy
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Panjwani
authors.affiliation: Defence Institute of Physiology and Allied Sciences. Timarpur, Delhi-110054, India.
authors.forename: Shashi Bala
authors.initials: SB
authors.lastname: Singh
mesh_terms: D000328:Adult; D000532:Altitude Sickness / Q000378:metabolism* / Q000503:physiopathology*; D000886:Anthropometry; D001794:Blood Pressure; D016022:Case-Control Studies; D004198:Disease Susceptibility; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism* / Q000503:physiopathology*; D000860:Hypoxia / Q000378:metabolism / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011651:Pulmonary Artery / Q000503:physiopathology*; D012129:Respiratory Function Tests
chemical_list: D020097:Natriuretic Peptide, Brain