Institute of Cardiovascular Diseases of PLA, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
Department of Cardiology, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
Biomed Res Int. 2020 Nov 10;2020:6028747. doi: 10.1155/2020/6028747. eCollection 2020.
The aims of this study were to explore the characteristics of left ventricular (LV) functional changes in subjects with or without acute mountain sickness (AMS) and their associations with AMS incidence.
A total of 589 healthy men were enrolled and took a trip from Chengdu (500 m, above sea level (asl)) to Lhasa (3700 m, asl) by airplane. Basic characteristics, physiological data, and echocardiographic parameters were collected both at Chengdu and Lhasa, respectively. AMS was identified by the Lake Louise Questionnaire Score.
The oxygen saturation (SpO), end-systolic volume index, end-diastolic volume index (EDVi), stroke volume index (SVi), E-wave velocity, and E/A ratio were decreased, whereas the heart rate (HR), ejection fraction, cardiac index (CI), and A-wave velocity were increased at the third day after arrival, as evaluated by an oximeter and echocardiography. However, AMS patients showed higher HR and lower EDVi, SVi, CI, E-wave velocity, and E/A ratio than AMS-free subjects. Among them, SVi, which is mainly correlated with the changes of EDVi and altered LV filling pattern, was the most valuable factor associated with AMS incidence following receiver-operator characteristic curves and linear and Poisson regression. Compared with subjects in the highest SVi tertile, subjects in the middle SVi tertile showed higher multivariable Incidence Rate Ratios (IRR) for AMS with higher incidences of mild headache and gastrointestinal symptoms, whereas subjects in the lowest SVi tertile showed even higher multivariable IRR with higher incidences of all the symptoms.
This relatively large-scale case-control study revealed that the reduction of SVi correlated with the altered LV filling pattern was associated with the incidence and clinical severity of AMS.
本研究旨在探讨有/无症状急性高原病（AMS）人群左心室（LV）功能变化的特点及其与 AMS 发病的关系。
共纳入 589 名健康男性，乘坐飞机从成都（海拔 500 米）前往拉萨（海拔 3700 米）。分别在成都和拉萨采集基本特征、生理数据和超声心动图参数。AMS 采用 Lake Louise 问卷评分法确定。
入住第 3 天，通过指脉氧仪和超声心动图评估，发现血氧饱和度（SpO）、收缩末期容积指数、舒张末期容积指数（EDVi）、每搏输出量指数（SVi）、E 波速度和 E/A 比值降低，而心率（HR）、射血分数、心输出量指数（CI）和 A 波速度升高。然而，与 AMS 无发病组相比，AMS 患者 HR 更高，EDVi、SVi、CI、E 波速度和 E/A 比值更低。其中，SVi 主要与 EDVi 的变化和 LV 充盈模式改变相关，是与 AMS 发病最相关的因素，ROC 曲线、线性和泊松回归分析均证实了这一点。与 SVi 最高三分位组相比，SVi 处于中三分位组的 AMS 多变量发病率比（IRR）更高，且轻头痛和胃肠道症状的发生率更高，而 SVi 最低三分位组的 AMS 多变量 IRR 更高，所有症状的发生率均更高。
本大规模病例对照研究表明，SVi 降低与 LV 充盈模式改变相关，与 AMS 的发病和临床严重程度有关。
