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高海拔迁移对心脏结构和功能的影响:一项为期1年的前瞻性研究。

The impact of high-altitude migration on cardiac structure and function: a 1-year prospective study.

作者信息

Deng Ming-Dan, Zhang Xin-Jie, Feng Qin, Wang Rui, He Fen, Yang Feng-Wu, Liu Xian-Mei, Sun Fei-Fei, Tao Jie, Li Shuang, Chen Zhong

机构信息

Department of Ultrasound, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.

Department of Cardiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.

出版信息

Front Physiol. 2024 Aug 30;15:1459031. doi: 10.3389/fphys.2024.1459031. eCollection 2024.

Abstract

INTRODUCTION

The trend of human migration to terrestrial high altitudes (HA) has been increasing over the years. However, no published prospective studies exist with follow-up periods exceeding 1 month to investigate the cardiac change. This prospective study aimed to investigate the changes in cardiac structure and function in healthy young male lowlanders following long-term migration to HA.

METHODS

A total of 122 Chinese healthy young males were divided into 2 groups: those migrating to altitudes between 3600 m and 4000 m (low HA group, n = 65) and those migrating to altitudes between 4000 m and 4700 m (high HA group, n = 57). Traditional echocardiographic parameters were measured at sea level, 1 month and 1 year after migration to HA.

RESULTS

All 4 cardiac chamber dimensions, areas, and volumes decreased after both 1 month and 1 year of HA exposure. This reduction was more pronounced in the high HA group than in the low HA group. Bi-ventricular diastolic function decreased after 1 month of HA exposure, while systolic function decreased after 1 year. Notably, these functional changes were not significantly influenced by altitude differences. Dilation of the pulmonary artery and a progressive increase in pulmonary artery systolic pressure were observed with both increasing exposure time and altitude. Additionally, a decreased diameter of the inferior vena cava and reduced bicuspid and tricuspid blood flow velocity indicated reduced blood flow following migration to the HA.

DISCUSSION

1 year of migration to HA is associated with decreased blood volume and enhanced hypoxic pulmonary vasoconstriction. These factors contribute to reduced cardiac chamber size and slight declines in bi-ventricular function.

摘要

引言

多年来,人类向陆地高海拔地区(HA)迁移的趋势一直在增加。然而,目前尚无随访期超过1个月的前瞻性研究来调查心脏变化。这项前瞻性研究旨在调查健康年轻男性低地居民长期迁移到高海拔地区后心脏结构和功能的变化。

方法

总共122名中国健康年轻男性被分为两组:迁移到海拔3600米至4000米之间的人群(低海拔组,n = 65)和迁移到海拔4000米至4700米之间的人群(高海拔组,n = 57)。在迁移到高海拔地区后的海平面、1个月和1年时测量传统超声心动图参数。

结果

暴露于高海拔地区1个月和1年后,所有4个心腔的尺寸、面积和容积均减小。这种减小在高海拔组比低海拔组更明显。暴露于高海拔地区1个月后双心室舒张功能下降,而1年后收缩功能下降。值得注意的是,这些功能变化并未受到海拔差异的显著影响。随着暴露时间和海拔的增加,观察到肺动脉扩张和肺动脉收缩压逐渐升高。此外,下腔静脉直径减小以及二尖瓣和三尖瓣血流速度降低表明迁移到高海拔地区后血流量减少。

讨论

迁移到高海拔地区1年与血容量减少和缺氧性肺血管收缩增强有关。这些因素导致心腔尺寸减小和双心室功能略有下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f3/11392884/d7737599c497/fphys-15-1459031-g001.jpg

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