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Susceptibility of High Altitude Pulmonary

Research Project

Project/Area Number 01480235
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Respiratory organ internal medicine
Research InstitutionShinshu University School of Medicine

Principal Investigator

KOBAYASHI Toshio  Shinshu University School of Medicine First Department of Internal Medicine Assistant Professor, 医学部・附属病院, 講師 (80020775)

Co-Investigator(Kenkyū-buntansha) SAKAI Akio  Shinshu University School of Medicine Department of Environmental Physiology Ass, 医学部・附属心脈管研究施設, 助教授 (70020758)
KUBO Keishi  Shinshu University School of Medicine First Department of Internal Medicine Assi, 医学部, 講師 (80143965)
HANDA Kenjiro  Shinshu University School of Medicine First Department of Internal Medicine Asso, 医学部, 助教授 (70020724)
平山 二郎  信州大学, 医学部附属病院, 助手 (90156696)
Project Period (FY) 1989 – 1990
Project Status Completed (Fiscal Year 1990)
Budget Amount *help
¥8,500,000 (Direct Cost: ¥8,500,000)
Fiscal Year 1990: ¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1989: ¥5,500,000 (Direct Cost: ¥5,500,000)
KeywordsHigh altitude pulmonary edema / Hypoxic ventilatory response / 炭酸ガス換気応答 / 低酸素性肺血管収縮反応 / 右心カテ-テル法 / 超音波パルスドップラ-法 / 低酸素肺血管収縮反応
Research Abstract

(1) Blunted hypoxic ventilatory drive in subjects susceptible to high-altitude pulmonary edema
Some previous studies suggest the relationship between the blunted hypoxic ventilatory responses (HVR) and high-altitude pulmonary edema (HAPE). To examine whether all the HAPE-susceptible subjects consistently show blunted HVR at low altitude, we evaluated the conventional pulmonary function test, HVR and hypercapnic ventilatory responese (HCVR) in ten lowlanders who had a previous history of HAPE and compared these results with those of eight control lowlanders who had no history of HAPE. HVR was measured by the progressive isocapnic hypoxic method and was evaluated by the slope relating minute ventilation to arterial O2 saturation. HVCR was measured by the rebreathing method of Read. In HVCR, HAPE-susceptible subjects showed relatively lower S-value, but there was no significant difference between the two group. On the other hand, HAPE-susceptible subjects showed significantly lower HVR tha … More n control subjects. These results suggest that HAPE-susceptible subjects more frequently show low HVR at low altitude. It would seem therefore that low HVR alone need not be a critical factor for HAPE. This could be one of several contribruting factors.
(2) Hemodynamic responses to acute hypoxia, hypobaria, and exercise in subjects susceptible to high-altitude pulmonary edema.
To clarify the presence of the constitutional abnormality implicated in the pathogenesis of high-altitude pulmonary edema, we evaluated the hemodynamic responses to hypoxia, hypobaria, and exercise in HAPE-susceptible subjects (HAPE-S). HAPE-S were five males with a history of HAPE. Five healthy volunteers who had repeated experiences of mountain climbing without any history of altitude-related problems served as controls. HAPE-S showed much greater increase in pulmonary vascular resistance index (PVRI) than the controls subjects, resulting in a much higher level of pulmonary arterial pressur (Ppa), under both acute hypoxia 15%, and acute hypobaria of 515 Torr. Also PVRI in HAPE-S exhibited a tendency to increase even during light exercise with supine bicycle ergometer, whereas PVRI in HAPE-S in the control subjects significantly decreased, so that HAPE-S showed a greater increase in Ppa and a greater decrease in arterial oxygen tension. We thus conclude that HAPE-S have a constitutional abnormality, which can be evaluated at low altitude, in the pulmonary circulatory responses to possible causative factors of HAPE such as hypoxia, hypobaria, and exercise.
(3) Doppler assessment of pulmonary hypertension induced by hypoxic breathing in subjects susceptible to high altitude pulmonary edema.
We examined the hemodynamic responses to hypoxia in HAPE susceptible subjects (HAPE-S) by means of both right heart catheterization and pulsed Doppler echocardiography. The HAPE-S were seven men and one woman with a history of HAPE. Six healthy volunteers who had repeated experiences of mountain climbing without any history of altitude-related problems served as control subjects. The HAPE-S showed much greater increase in pulmonary vascular resistance (PVR) than the control subjects, resulting in a much higher level of pulmonary arterial pressure (Ppa) under acute hypoxia both of 15% O2 and 10% O2. We then evaluated the usefulness of pulsed Doppler echocardiography in the prediction of pulmonary hypertension. Acceleration time (AcT) and right ventricular ejection time (RVET) were measured from the flow velocity pattern in the right ventricular outflow tract. The ratio of AcT to RVET were measured was correlated to invasively determined mean Ppa and PVR. We conclude that pulsed Doppler echocardiography may be supportive to assess the pulmonary vascular pressor response in the HAPE-S. Less

Report

(3 results)
  • 1990 Annual Research Report   Final Research Report Summary
  • 1989 Annual Research Report
  • Research Products

    (15 results)

All Other

All Publications (15 results)

  • [Publications] Matsuzawa Y,et al.: "Blunted hypoxic ventilaton in subjects susceptible to to high altitude pulmonary edema." J Appl Physiol. 66. 1152-1157 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Fujimoto K,et al.: "Irregular nocturnal breathing patters at at highーaltitude in susceptible to high altitude pulmonary edema (HAPE):a preliminary study." Aviat Spece Environ Med. 60. 786-791 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Kawashima A,et al.: "Plasma levels of atrial natriuretic peptide under acute hypoxia in normal subjects." Resp Physiol. 76. 79-92 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Kawashima A,et al.: "Hemodynamic responses to acute hypoxia,hypobaria,and exercise in subjects susceptible to highーaltitude pulmonary edema." J Appl Physiol. 67. 1982-1989 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Levine BD,et al.: "Dexamethasone in the treatment of acute mountain sickness" New Engl J Med. 321. 1707-1713 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Yagi H,et al.: "Doppler assessment of pulmonary hypertension induced by hypoxic breathing in subjects susceptible to high altitude pulmonary edema." Am Rev Respir Dis. 142. 796-801 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1990 Final Research Report Summary
  • [Publications] Hikaru Yagi et,al.: "Doppler assessment of pulmonary hypertension induced by hypoxic breathing in subjects susceptible to high altitude pulmonary edema." Am Rev Respin Dis. 142. 796-801 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] Sekiya Koyama et al.: "Physical performance of subjects suceptible to high altitude pulmonary edema" New Engl J.Med.

    • Related Report
      1990 Annual Research Report
  • [Publications] 吉村 一彦: "急性高山病" 現代医療. 22. 328-332 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] Kawashima A.,et al.: "Hemodynamic responses to acute hypoxia,hypobaria,and exercise in subjects susceptible to high-altitude pulmonary edema." J Appl Physiol. 67. 1982-1989 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Kawashima A.,et al.: "Plasma levels of atrial natriuretic peptide under acute hypoxia in normal subjects." Respir Physiol. 76. 79-92 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Matsuzawa Y.,et al.: "Blunted hypoxic ventilatory drive in subjects susceptible to high altitude pulmonary edema." J Appl Physiol. 66. 1152-1157 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Fujimoto K.,et al.: "Irregular nocturnal breathing patterns at high altitude in subjects to high-altitudepulmonary edema(HAPE):a preliminary study." Aviat Space Environ Med. 60. 786-791 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Levine BD.,et al.: "Dexamethasone in the treatment of acute mountain sickness." N Engl J Med. 321. 1707-1713 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 分担執筆久保恵嗣,小林俊夫: "Annal Review呼吸器1990," 中学医学社, 33-41/292 (1989)

    • Related Report
      1989 Annual Research Report

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Published: 1989-04-01   Modified: 2016-04-21  

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