Robinson Jeffrey C, Abbott Cheryl, Meadows Christina A, Roach Robert C, Honigman Benjamin, Bull Todd M
1 Colorado Pulmonary Vascular Disease Center, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine , Aurora, Colorado.
2 Altitude Research Center and Department of Emergency Medicine, University of Colorado School of Medicine , Aurora, Colorado.
High Alt Med Biol. 2017 Mar;18(1):61-66. doi: 10.1089/ham.2016.0098. Epub 2017 Jan 6.
Robinson, Jeffrey C., Cheryl Abbott, Christina A. Meadows, Robert C. Roach, Benjamin Honigman, and Todd M. Bull. Long-term health outcomes in high-altitude pulmonary hypertension. High Alt Med Biol. 18:61-66, 2017.
High-altitude pulmonary hypertension (HAPH) is one of several known comorbidities that effect populations living at high altitude, but there have been no studies looking at long-term health consequences of HAPH. We aimed to determine whether HAPH during adolescence predisposes to significant pulmonary hypertension (PH) later in life, as well as identify how altitude exposure and HAPH correlate with functional class and medical comorbidities.
We utilized a previously published cohort of 28 adolescents from Leadville, Colorado, that underwent right heart catheterization at 10,150 ft (3094 m) in 1962, with many demonstrating PH as defined by resting mean pulmonary arterial pressure ≥25 mmHg. We located participants of the original study and had living subjects complete demographic and health surveys to assess for the presence of PH and other medical comorbidities, along with current functional status.
Seventy-five percent of the individuals who participated in the original study were located. Those with HAPH in the past were more prone to have exertional limitation corresponding to WHO functional class >1. Fifty-five years following the original study, we found no significant differences in prevalence of medical comorbidities, including PH, among those with and without HAPH in their youth.
Surveyed individuals did not report significant PH, but those with HAPH in their youth were more likely to report functional limitation. With a significant worldwide population living at moderate and high altitudes, further study of long-term health consequences is warranted.
杰弗里·C·罗宾逊、谢丽尔·阿博特、克里斯蒂娜·A·梅多斯、罗伯特·C·罗奇、本杰明·霍尼格曼和托德·M·布尔。高原肺动脉高压的长期健康结局。《高原医学与生物学》。2017年第18卷,第61 - 66页。
高原肺动脉高压(HAPH)是影响高原居民的几种已知合并症之一,但尚无关于HAPH长期健康后果的研究。我们旨在确定青少年时期的HAPH是否会使个体在晚年易患重度肺动脉高压(PH),并确定海拔暴露和HAPH与功能分级及合并症之间的关系。
我们利用了先前发表的一组来自科罗拉多州莱德维尔的28名青少年队列,他们于1962年在海拔10,150英尺(3094米)处接受了右心导管检查,许多人表现出静息平均肺动脉压≥25 mmHg所定义的PH。我们找到了原始研究的参与者,并让在世的受试者完成人口统计学和健康调查,以评估PH和其他合并症的存在情况以及当前的功能状态。
找到了参与原始研究的75%的个体。过去患有HAPH的个体更易出现与世界卫生组织功能分级>1相对应的运动受限。在原始研究55年后,我们发现年轻时患有和未患有HAPH的个体在包括PH在内的合并症患病率方面没有显著差异。
接受调查的个体未报告有显著的PH,但年轻时患有HAPH的个体更有可能报告功能受限。鉴于全球有大量人口生活在中高海拔地区,有必要对长期健康后果进行进一步研究。