High Altitude Pulmonary Hypertension
Conditions
Keywords
Pulmonary Hypertension, Hypoxia, High Altitude, Pulmonal Arterial Pressure
Brief summary
To study the effect of relocation from 3200 m (Aksay) to 760 m (Bishkek) in patients with high altitude pulmonary hypertension (HAPH) who permanently live \>2500 m on pulmonary artery pressure (PAP)
Detailed description
This research in highlanders with HAPH diagnosed by echocardiography and defined by a RV/RA \>30 mmHg who permanently live at HA \>2500 m will have pulmonary arterial pressure (PAP) assessed by echocardiography near their living altitude in Aksay at 3200 m and at 760 m in Bishkek the day after the first and the seventh night after relocation.
Interventions
OTHEREchocardiography
Echocardiography will be performed according to clinical standards
Sponsors
University of Zurich
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Each highlander with HAPH will perform a echocardiography at high altitude (HA, 3200 m) and day 2 and day 7 at low altitude (LA, 760 m) according to a prospective study design
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Permanently living \>2500 m * HAPH diagnosed with a minimum RV/RA of 30 mmHg assessed by echocardiography at an altitude of 3200 m * Written informed consent
Exclusion criteria
* Highlanders who cannot follow the study investigations, * Patients with moderate to severe concomitant lung disease (FEV1\<70% or forced vital capacity \<70%), severe parenchymal lung disease, heavy smoking \>20 cigarettes/day or \>20 pack-years. * Coexistent unstable systemic hypertension or coronary artery disease that required adjustment of medication within the last 2 months * Regular use of medication that affects control of breathing (benzodiazepines, opioids, acetazolamide)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pulmonary artery Pressure (PAP) after the first night at 760 m (LA) vs at 3200 m (HA) | day 2 at 760 m vs. 3200 m | Change in RV/RA in mmHg assessed by echocardiography between LA (760 m) vs High altitude (3200 m) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pulmonary artery Pressure (PAP) after seven nights at 760 m (LA) vs at 3200 m (HA) | day 7 at 760 m vs. 3200 m | Change in RV/RA in mmHg assessed by echocardiography between LA (760 m) vs High altitude (3200 m) |
| Cardiac output at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in cardiac output in l/min assessed by echocardiography between LA (760 m) vs HA (3200 m) |
| Tricuspid pressure gradient by echocardiography at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Tricuspid pressure gradient assessed by echocardiography between LA (760 m) vs HA (3200 m) |
| Tricupsid annular plane systolic excursion by echocardiography at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Tricupsid annular plane systolic excursion assessed by echocardiography between LA (760 m) vs HA (3200 m) |
| pH by arterial blood gases at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in pH by arterial blood gases assessed between LA (760 m) vs HA (3200 m) |
| partial pressure of oxygen (PaO2) by arterial blood gases at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in partial pressure of oxygen (PaO2) assessed by arterial blood gases between LA (760 m) vs HA (3200 m) |
| partial pressure of carbon dioxide (PaCO2) by arterial blood gases at 760 m (LA) vs at 3200 m (HA) | after the first and seventh night at LA | Change in partial pressure of carbon dioxide (PaCO2) assessed by arterial blood gases partial pressure of carbon dioxide (PaCO2) between LA (760 m) vs HA (3200 m) |
| Change in right to left heart diameter ratio at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in right to left heart diameter ratio assessed by echocardiography between LA (760 m) vs HA (3200 m) |
| Change in right atrial area at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in right atrial area by echocardiography between LA (760 m) vs HA (3200 m) |
| Change in right heart strain at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in right heart strain by echocardiography between LA (760 m) vs HA (3200 m) |
| Change in ECG morphology at 760 m (LA) vs at 3200 m (HA) | day 2 and 7 at 760 m vs. 3200 m | Change in ECG morphology and QT-interval by 12-lead ECG between LA (760 m) vs HA (3200 m) |
Countries
Kyrgyzstan
Contacts
PRINCIPAL_INVESTIGATORTalant M Sooronbaev, Prof. Dr.
National Center of Cardiology and Internal Medicine named after academician M.Mirrakhimov
PRINCIPAL_INVESTIGATORSilvia Ulrich, Prof. Dr.
University Hospital Zurich, Department of Pulmonology
Outcome results
None listed