Systemic vascular dysfunction in patients with chronic mountain sickness.

Détails

ID Serval
serval:BIB_B453AF9EFF4C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Systemic vascular dysfunction in patients with chronic mountain sickness.
Périodique
Chest
Auteur(s)
Rimoldi S.F., Rexhaj E., Pratali L., Bailey D.M., Hutter D., Faita F., Salmòn C.S., Villena M., Nicod P., Allemann Y., Scherrer U., Sartori C.
ISSN
1931-3543 (Electronic)
ISSN-L
0012-3692
Statut éditorial
Publié
Date de publication
2012
Volume
141
Numéro
1
Pages
139-46
Langue
anglais
Résumé
ABSTRACT BACKGROUND: Chronic mountain sickness (CMS) is a major public health problem characterized by exaggerated hypoxemia and erythrocytosis. In more advanced stages, these patients often present functional and structural changes of the pulmonary circulation, but there is little information on the systemic circulation. In patients suffering from diseases associated with chronic hypoxemia at low altitude, systemic vascular function is altered. We hypothesized that patients with CMS display systemic vascular dysfunction that may predispose them to increased systemic cardiovascular morbidity. METHODS: To test this hypothesis, we assessed systemic endothelial function (by flow- mediated dilation, FMD), arterial stiffness and carotid intima-media thickness and arterial oxygenation (SaO(2)) in 23 patients with CMS without additional classical cardiovascular risk factors and 27 age-matched healthy mountain dwellers born and permanently living at 3600 m. For some analyses subjects were classified according to baseline SaO(2) quartiles; FMD of the highest quartile subgroup (SaO(2) ≥90%) was used as reference value for post-hoc comparisons. RESULTS: Patients with CMS displayed marked systemic vascular dysfunction, as evidenced by impaired FMD (4.6±1.2 vs. 7.6±1.9%, CMS vs. controls, P<0.0001), greater pulse wave velocity (10.6±2.1 vs. 8.4±1.0 m/s, P<0.001) and carotid intima-media thickness (690±120 vs. 570±110 μm, P=0.001). A positive relationship existed between SaO(2) and FMD (r=0.62, P<0.0001). Oxygen inhalation improved (P<0.001), but did not normalize FMD in patients with CMS; whereas it normalized FMD in hypoxemic controls (SaO(2) <90%) and had no detectable effect in normoxemic (SaO(2) ≥90%) control subjects. CONCLUSIONS: Patients with CMS display marked systemic vascular dysfunction. Structural and functional alterations contribute to this problem that may predispose these patients to premature cardiovascular disease. Clinical Trials Gov Registration # NCT01182792.
Pubmed
Web of science
Création de la notice
11/09/2011 13:25
Dernière modification de la notice
20/08/2019 15:22
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