Supine bicycle exercise stress echocardiographic assessment of the right heart-pulmonary circulation unit after high-altitude exposure in healthy adults
10.3760/cma.j.cn131148-20240702-00357
- VernacularTitle:踏车运动负荷超声心动图评价健康成人高海拔地区暴露后右心-肺循环单元的改变
- Author:
Yun XU
1
;
Yi WANG
;
Qingfeng ZHANG
;
Kai WANG
;
Sijia WANG
;
Lixue YIN
;
Yong JING
Author Information
1. 四川省医学科学院·四川省人民医院（电子科技大学附属医院）心血管超声及心功能科，超声心脏电生理学与生物力学四川省重点实验室，四川省心血管病临床医学研究中心（国家心血管疾病临床医学研究中心四川分中心），成都 610000
- Publication Type:Journal Article
- Keywords:
Exercise stress echocardiography;
Right ventricular contraction;
Reserve;
High altitude
- From:
Chinese Journal of Ultrasonography
2025;34(1):33-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the adaptive changes in the cardiovascular system after travelling to high altitude in healthy people using supine bicycle exercise stress echocardiography（SE），and to reveal the changes in right heart function，pulmonary vascular reserve and right ventricular systolic reserve in healthy people after acute high altitude exposure.Methods:Thirty-six healthy adults were prospectively collected to undergo SE at low altitude（500 m）and high altitude（3 600 m）. Offline analysis was conducted to acquire resting and peak exercise ultrasound parameters at high and low altitudes：tricuspid regurgitant velocity（TRV），tricuspid annular peak systolic velocity（TV-s′），right ventricular end-diastolic area（RVEDA），right ventricular end-systolic area（RVESA），right ventricular fractional area change（RVFAC），right ventricular basal transverse dimension（RVD1），right ventricular mid-ventricular transverse dimension（RVD2），right ventricular longitudinal dimension（RVD3），right ventricular free wall longitudinal strain（RVFWS），right ventricular global longitudinal strain（RVGLS），left ventricular cardiac output（CO），pulmonary artery systolic pressure（PASP），mean pulmonary artery pressure（mPAP），pulmonary resistance（PVR）and the ratio of tricuspid annular systolic displacement（TAPSE）to PASP（TAPSE/PASP）. The pulmonary vascular reserve and right ventricular systolic reserve indices including pulmonary vascular reserve and right ventricular systolic reserve indices（mPAP/CO slope，change in tricuspid annular systolic displacement（ΔTAPSE），change in fractional area change（ΔRVFAC），change in overall long-axis strain of the right ventricle（ΔRVGLS），and change in peak velocity of the lateral wall of the tricuspid annulus（ΔTV-s′）were calculated. The differences of these parameters betweet high and low altitudes were compared.Results:During the resting period，the values of TRV，PASP，mPAP，PVR，RVD2，and RVD3 were higher at high altitude than at low altitude（all P<0.05）. TAPSE/PASP，RVFAC，RVGLS，and RVFWS were lower at high altitude than at low altitude（all P<0.05）. During the peak exercise period，TRV，PASP，mPAP，PVR，RVAD，RVAS，RVD2，and RVD3 were all higher at high altitude than at low altitude（all P<0.05），and RVFAC at high altitude was lower than at low altitude（ P<0.05）. Right ventricular systolic reserve and pulmonary vascular reserve：mPAP/CO slope at high altitude was higher than at low altitude，ΔTV-s′ and RVFAC were lower than at low altitude（all P<0.05），there were no significant differences in ΔTAPSE and ΔRVGLS between the two altitudes（all P>0.05）. Conclusions:Acute high altitude exposure causes adaptive dilatation of the right ventricle accompanied by a reduction in pulmonary vascular reserve and right ventricular contractile reserve function.
