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Original Research: CHRONIC MOUNTAIN SICKNESS |

Pulmonary Pressure and Cardiac Function in Chronic Mountain Sickness Patients

Maxime Maignan, MD; Maria Rivera-Ch, PhD; Catherine Privat, MSc; Fabiola León-Velarde, PhD; Jean-Paul Richalet, MD, PhD; Isabelle Pham, MD, PhD
Author and Funding Information

*From the Université Paris 13 (Drs. Maignan, Richalet, and Pham), EA 2363 “Réponses Cellulaires et Fonctionnelles à l'hypoxie,” Bobigny, France; and Facultad de Ciencias y Filosofia (Drs. Rivera-Ch and Léon-Velarde, and Ms. Privat), Departamento de Ciencas Biologicas y Fisiologicas, Laboratorio de Fisiologia Comparada, Universidad Peruana Cayetano Heredia, Lima, Peru.

Correspondence to: Maxime Maignan, MD, Laboratoire EA 2363, UFR SMBH, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France; e-mail: maxime.maignan@free.fr


The study was performed at the Instituto de Investigaciones de Altura, Cerro de Pasco, and at Universidad Peruana Cayetano Heredia, Lima, Peru.

This study was funded by grant from the Legs Poix, Chancellerie des Universités de Paris.

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(2):499-504. doi:10.1378/chest.08-1094
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Background:  Chronic mountain sickness (CMS) is characterized by a loss of adaptation to hypoxia in high-altitude (HA) dwellers. Chronic hypoxemia, excessive erythrocytosis and frequently pulmonary hypertension (PH), which may lead to cardiac failure, develop in patients. We sought to assess the determinants of cardiac function in CMS patients with hypoxia-induced PH.

Methods:  Fifteen healthy men living at sea level (SL) were compared to 15 healthy men living at HA and 55 patients with CMS from Cerro de Pasco, Peru (altitude, 4,300 m). Pulmonary pressures and cardiac function were estimated by echocardiography.

Results:  None of the subjects had overt cardiac failure symptoms. CMS patients exhibited elevated mean pulmonary pressures as assessed by high-tricuspid pressure gradients (CMS patients, 34 ± 10 mm Hg; HA subjects, 25 ± 4 mm Hg [p = 0.002]; and SL subjects, 19 ± 3 mm Hg [p < 0.001]). They also showed right ventricular (RV) dilation (mean end-diastolic RV area: CMS patients, 17 ± 2 cm2; HA subjects, 13 ± 2 cm2; SL subjects, 12 ± 2 cm2; p < 0.001) but did not display impaired systolic ventricular function. However, the RV Tei index was increased in CMS and HA subjects (CMS patients, 0.56 ± 0.15; HA subjects, 0.52 ± 0.12; SL subjects, 0.21 ± 0.12; p < 0.001).

Conclusion:  Despite obvious pulmonary arterial hypertension and right heart dilation, CMS patients did not show any symptom or echocardiographic parameter of heart failure.

Trial registration:  ClinicalTrials.gov. Identifier: NCT00424970


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