Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany.
German Center for Cardiovascular Research (DZHK), Berlin, Germany.
High Alt Med Biol. 2020 Dec;21(4):417-422. doi: 10.1089/ham.2020.0131. Epub 2020 Nov 4.
Hamm, Wolfgang, Sari Kassem, Lukas von Stülpnagel, Florian Maier, Mathias Klemm, Dominik Schüttler, Felix Grabher, Ludwig T. Weckbach, Bruno C. Huber, Axel Bauer, Konstantinos D. Rizas, and Stefan Brunner. Deceleration capacity and periodic repolarization dynamics as predictors of acute mountain sickness. . 21:417-422, 2020. The autonomic nervous system plays an important role in adaptive changes after acute altitude exposure. Periodic repolarization dynamics (PRD) and deceleration capacity (DC) of heart rate are advanced electrocardiogram (ECG)-based parameters reflecting sympathetic (PRD) and parasympathetic (DC) tone. These parameters have not been investigated in the context of acute mountain sickness (AMS) yet. In 23 healthy individuals (13 women), a high-resolution digital 30-minute ECG in Frank leads configuration was performed in a resting supine position at baseline (521 m altitude) and after a sojourn of 24 hours at the Environmental Research Station Schneefernerhaus (UFS) at Zugspitze (2,650 m altitude). PRD and DC were assessed using validated software. Symptoms of AMS were assessed with the Lake Louise Acute Mountain Sickness Score (LLS). During altitude exposure, PRD significantly increased from 1.50 ± 1.01 (mean ± standard deviation) deg to 3.51 ± 4.46 deg ( = 0.03). DC significantly decreased from 11.48 ± 2.91 ms to 9.94 ± 2.78 ms ( = 0.001). An increase of PRD a decrease of DC correlated significantly with the level of LLS. The combined finding of an increase of PRD a decrease of DC had a sensitivity of 100% and a specificity of 76.5% to diagnose AMS (LLS ≥3). Receiver operating characteristic (ROC) analysis showed an AUC (area under the ROC curve) of 0.77. Linear regression analysis revealed a significant association between LLS and an increase in PRD during high-altitude exposure. Our findings show an increase of PRD and a decrease of DC during altitude exposure. Combined PRD and DC analysis may have potential for the diagnosis of AMS.
哈姆、萨里·卡塞姆、卢卡斯·冯·施图尔彭纳格尔、弗洛里安·迈尔、马蒂亚斯·克莱姆、多米尼克·舒特勒、费利克斯·格拉伯、路德维希·T·魏克巴赫、布鲁诺·C·胡贝尔、阿克塞尔·鲍尔、康斯坦丁诺斯·D·里扎斯和斯特凡·布鲁纳。减速能力和周期性复极动力学作为急性高原病的预测因子。. 21:417-422, 2020. 自主神经系统在急性高原暴露后的适应性变化中起着重要作用。心率的周期性复极动力学（PRD）和减速能力（DC）是先进的心电图（ECG）基于参数反映交感神经（PRD）和副交感神经（DC）音。这些参数尚未在急性高原病（AMS）的背景下进行研究。 在 23 名健康个体（13 名女性）中，在基线（海拔 521 米）和在 Zugspitze 的 Schneefernerhaus 环境研究站（UFS）停留 24 小时后，在仰卧位进行了 30 分钟的高分辨率数字 30 分钟心电图 Frank 导联配置。使用经过验证的软件评估 PRD 和 DC。使用路易斯湖急性高原病评分（LLS）评估 AMS 症状。 在海拔升高期间，PRD 从 1.50±1.01（均值±标准差）度显着增加到 3.51±4.46 度（=0.03）。DC 从 11.48±2.91ms 显着降低至 9.94±2.78ms（=0.001）。PRD 的增加与 DC 的减少与 LLS 的水平显着相关。PRD 的增加和 DC 的减少的组合发现具有诊断 AMS 的 100%的灵敏度和 76.5%的特异性（LLS≥3）。接收者操作特征（ROC）分析显示 ROC 曲线下面积（AUC）为 0.77。线性回归分析显示，在高海拔暴露期间，LLS 与 PRD 的增加之间存在显著关联。 我们的研究结果表明，在海拔升高期间，PRD 增加，DC 减少。PRD 和 DC 的联合分析可能具有诊断 AMS 的潜力。
