Journal article
Altered Left Ventricular Geometry and Torsional Mechanics in High Altitude-Induced Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study.
- De Boeck BW Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
- Toma A Universitäres Herzzentrum Bad Krozingen, Bad Krozingen, Germany.
- Kiencke S Department of Cardiology, Bruderholz Hospital, Basel, Switzerland.
- Dehnert C Internal Medicine II, Section of Sports and Rehabilitation Medicine, University Hospital Ulm, Ulm, Germany.
- Zügel S Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, Marburg, Germany.
- Siebenmann C Medical Intensive Care Unit, University Hospital Zürich, Zürich, Switzerland.
- Auinger K Medical Intensive Care Unit, University Hospital Zürich, Zürich, Switzerland.
- Buser PT Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
- Maggiorini M Medical Intensive Care Unit, University Hospital Zürich, Zürich, Switzerland.
- Kaufmann BA Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland. Electronic address: Beat.kaufmann@usb.ch.
- 2018-01-08
Published in:
- Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. - 2018
3D echocardiography
Altitude physiology
Left ventricular geometry
Left ventricular torsion
Adolescent
Adult
Aged
Altitude
Diastole
Echocardiography, Doppler
Echocardiography, Three-Dimensional
Female
Healthy Volunteers
Heart Ventricles
Humans
Hypertension, Pulmonary
Male
Middle Aged
Prospective Studies
Systole
Ventricular Function, Left
Young Adult
English
BACKGROUND
Changes in left ventricular (LV) torsion have been related to LV geometry in patients with concomitant long-standing myocardial disease or pulmonary hypertension (PH). We evaluated the effect of acute high altitude-induced isolated PH on LV geometry, volumes, systolic function, and torsional mechanics.
METHODS
Twenty-three volunteers were prospectively studied at low altitude and after the second (D3) and third night (D4) at high altitude (4,559 m). LV ejection fraction, multidirectional strains and torsion, LV volumes, sphericity, and eccentricity were derived by speckle-tracking on three-dimensional echocardiographic data sets. Pulmonary pressure was estimated from the transtricuspid pressure gradient (TRPG), LV preload from end-diastolic LV volume, and transmitral over mitral annular E velocity (E/e').
RESULTS
At high altitude, oxygen saturation decreased by 15%-20%, heart rate and cardiac index increased by 15%-20%, and TRPG increased from 21 ± 2 to 37 ± 9 mm Hg (P < .01). LV volumes, preload, ejection fraction, multidirectional strains, and sphericity remained unaffected, but diastolic (1.04 ± 0.07 to 1.09 ± 0.09 on D3/D4, P < .05) and systolic (1.00 ± 0.06 to 1.08 ± 0.1 [D3] and 1.06 ± 0.07 [D4], P < .05) eccentricity slightly increased, indicating mild septal flattening. LV torsion decreased from 2.14 ± 0.85 to 1.34 ± 0.68 (P < .05) and 1.65 ± 0.54 (P = .08) degrees/cm on D3/D4, respectively. Changes in torsion showed a weak inverse relationship to changes in systolic (r = -0.369, P = .013) and diastolic (r = -0.329, P = .032) eccentricity but not to changes in TRPG, heart rate or preload.
CONCLUSIONS
High-altitude exposure was associated with mild septal flattening of the LV and reduced ventricular torsion at unchanged global LV function and preload, suggesting a relation between LV geometry and torsional mechanics.
Changes in left ventricular (LV) torsion have been related to LV geometry in patients with concomitant long-standing myocardial disease or pulmonary hypertension (PH). We evaluated the effect of acute high altitude-induced isolated PH on LV geometry, volumes, systolic function, and torsional mechanics.
METHODS
Twenty-three volunteers were prospectively studied at low altitude and after the second (D3) and third night (D4) at high altitude (4,559 m). LV ejection fraction, multidirectional strains and torsion, LV volumes, sphericity, and eccentricity were derived by speckle-tracking on three-dimensional echocardiographic data sets. Pulmonary pressure was estimated from the transtricuspid pressure gradient (TRPG), LV preload from end-diastolic LV volume, and transmitral over mitral annular E velocity (E/e').
RESULTS
At high altitude, oxygen saturation decreased by 15%-20%, heart rate and cardiac index increased by 15%-20%, and TRPG increased from 21 ± 2 to 37 ± 9 mm Hg (P < .01). LV volumes, preload, ejection fraction, multidirectional strains, and sphericity remained unaffected, but diastolic (1.04 ± 0.07 to 1.09 ± 0.09 on D3/D4, P < .05) and systolic (1.00 ± 0.06 to 1.08 ± 0.1 [D3] and 1.06 ± 0.07 [D4], P < .05) eccentricity slightly increased, indicating mild septal flattening. LV torsion decreased from 2.14 ± 0.85 to 1.34 ± 0.68 (P < .05) and 1.65 ± 0.54 (P = .08) degrees/cm on D3/D4, respectively. Changes in torsion showed a weak inverse relationship to changes in systolic (r = -0.369, P = .013) and diastolic (r = -0.329, P = .032) eccentricity but not to changes in TRPG, heart rate or preload.
CONCLUSIONS
High-altitude exposure was associated with mild septal flattening of the LV and reduced ventricular torsion at unchanged global LV function and preload, suggesting a relation between LV geometry and torsional mechanics.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.echo.2017.12.001
- PMID 29306544
- Persistent URL
- https://sonar.ch/global/documents/48121
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