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The role of abnormal control of breathing in the pathogenesis of high-altitude pulmonary edema

Research Project

Project/Area Number 02670340
Research Category

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

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

Principal Investigator

MATSUZAWA Yukinori  Shinshu Univ., Sch. of Med., Assistant, 医学部附属病院, 助手 (40219423)

Co-Investigator(Kenkyū-buntansha) SAKAI Akio  Shinshu Univ., Sch. of Med., Associate Professor, 医学部附属心脈管研究施設, 助教授 (70020758)
UEDA Gou  Shinshu Univ., Sch. of Med., Professor, 医学部附属心脈管研究施設, 教授 (10020702)
SEKIGUCHI Morie  Shinshu Univ., Sch. of Med., Professor, 医学部, 教授 (70075232)
KUBO Keishi  Shinshu Univ., Sch. of Med., Assistant Professor, 医学部, 講師 (80143965)
KOBAYASHI Toshio  Shinshu Univ., Sch. of Med., Assistant Professor, 医学部附属病院, 講師 (80020775)
Project Period (FY) 1990 – 1991
Project Status Completed (Fiscal Year 1991)
Budget Amount *help
¥2,700,000 (Direct Cost: ¥2,700,000)
Fiscal Year 1991: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1990: ¥1,900,000 (Direct Cost: ¥1,900,000)
KeywordsHigh-altitude pulmonary edema / Respiratory control / Acute mountain sickness / Hypoxic ventilatory response / Hypoxic ventilatory depression / Sleep apnea / High-altitude cerebral edema / 急性高山急 / 高地脳浮腫 / 核磁気共鳴 / 肺ガス多換 / 低酸素性換気抑制
Research Abstract

In this project we have performed the two main studies. First study was to investigate the role of hypoxic ventilatory response (HVR) in the pathogenesis of acute mountain sickness (AMS). Nine healthy male lowlanders were exposed to a simulated altitude of 3, 700m for 24h in a hypobaric chamber. Those subjects with lower alveolar ventilation on arrival at 3, 700m subsequently developed more severe AMS 24h after the exposure. They also showed lower HVR at low altitude. These results suggest that low HVR contributes to the development of AMS. We have also examined impaired pulmonary gas exchange, cerebral edema, and sleep apnea in the pathogenesis of AMS.
Secondly we investigated the role of low HVR in the pathophysiology of high-altitude pulmonary edema (HAPE). Nine subjects with a history of HAPE (HAPE-S) and six control subjects were exposed to a simulated altitude of 3, 200m. At low altitude HVR in HAPE-S was significantly lower than that of controls. At high-altitude HAPE-S showed lesser increase in V_E, lower P_A, lower PaO2 and higher PaCO2 compared with control subjects. In one of the HAPE-S, who showed the lowest PaO2 at the simulated altitude, 100% oxygen breathing developed a paradoxical increase in ventilation, suggesting hypoxic ventilatory depression (HVD). These results suggest that relative hypoveritilation, which may be due to low HVR and/or HVD, may contribute to the exaggerated hypoxemia occurred during exposure to high altitude in HAPE-S.
These two studies suggest that low HVR could be one of the contributing factors in AMS and even in HAPE. However, the exact mechanism which may lead to pulmonary edema remains unclear. Moreover, not all HAPE-S showed low HVR. We need further studies on abnormal control of ventilation in HAPE or AMS, such as respiratory control in exercise and sleep at altitude, relationship between cerebral edema and HAPE, and the role of HVD in HAPE.

Report

(3 results)
  • 1991 Annual Research Report   Final Research Report Summary
  • 1990 Annual Research Report
  • Research Products

    (31 results)

All Other

All Publications (31 results)

  • [Publications] 松沢 幸範,他: "急性高山病発症における呼吸調節障害の関与" 登山医学. 10. 151-154 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Yagi H.et al: "Doppler assessment of pulmonary hypertension indueed by hypoxic breathing in subjects susceptible to high altitude pulmonary elema" Am.Rev.Respir.Des.142. 796-801 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 小林 俊夫: "中高年登山者の諸問題ー呼吸器疾患ー" 登山医学. 10. 17-20 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 上田 五雨,他: "急性高山病の成因,症状のファジ-論的解釈" 登山医学. 10. 145-149 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 吉村 一彦,他: "急性高山病" 現代医学. 22. 1702-1706 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 上田 五雨: "高山病" 循環制御. 11. 251-254 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 山口 伸二,他: "高地循化ならびに脱順化の低酸素換気応答に及ぼす影響" 登山医学.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 久保 恵嗣: "高所登山における循環動態ー高地肺水腫の肺循環動態" 登山医学.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 上田 五雨,他: "高地肺水腫遭難例" 登山医学.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Asano,K.et al.: "Acclimatization to high-altitude in lowlanders:assessment with EEG and exercise test in 1990 Qinghai plateau expedition.In,High-Altitude Medicine" Ueda,G.,Reeves,J.T.and Sekiguchi,M., 259-262 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ueda,G.et al.: "Tibetan Medical Expedition and climatic chamber test.In;High-Altitude Medicine" Ueda,G.,Reeves,J.T.and Sekiguchi,M., 3-9 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Matsuzawa,Y.et al.: "Cerebral edsma in acute mountain sickness.In;High-Altitude Medicine" Ueda,G.,Reeves,J.T.and Sekiguchi,M., 300-304 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Yamaguchi,et: "MRI findings in patients with high-altitude pulmonary edema.In;High-Altitude Medicine" Ueda,G.,Reeves,J.T.and Sekiguchi,M., 305-308 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Sakai,A.et al.: "Relation between breathing pattern and Sal_2 at high altitude.In,High-Altitude Medicine" Ueda,G.,Reeves,J.T.and Sekiguchi,M., 116-122 (1992)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Matsuzawa Y, Kobayashi T, Shinozaki S, Yoshikawa, S, Fujimoto K, Kawashima A, Kubo K, Sekiguchi M, Hayashi R, Sakai A, Ueda G: "Low hypoxic ventilatory response and relative hyperventilation in acute mountain sickness." Jpn J Mount Med. 10. 151-154 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Yagi H, Yamada H, Kobayashi T, Sekiguchi M: "Doppler assessment of pulmonary hypertension induced by hypoxic breathing in subjects susceptible to high altitude pulmonary ecema." Am Rev Respir Dis. 142. 796-801 (1991)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ueda G, Sakai A, Asano K, Takeoka M, Fujiwara T, Kobayashi T, Matsuzawa Y: "Fazzy theoretical interpretation of cause and symptoms in acute mountain sickness." Jpn J Mount Med. 10. 145-149 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Yamaguchi S, Matsuzawa Y, Shinozaki S, Fujimoto K, Kobayashi T, Sekiguchi M, Asano k, Yanagidaira Y, Sakai A, Ueda G: "Effect of acclimatization and deacclimatization on hypoxic ventilatory response." Jpn J Mount Med.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Matsuzawa Y, Kobayashi T, Fujimoto K, Shinozaki S, Yoshikawa S, Yamaguchi S, Kubo K, Sekiguchi M, Hayashi R, Sakai A, Ueda G: "Cerebral edema in acute mountain sickness." High-altitude Medicine. Shinshu Univ., Matsumoto. 300-304 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Yamaguchi S, Kobayashi T, Matsuzawa Y, Koizumi T, Shinozaki S, Fujimoto K, Fukushima M, Kubo K, Sekiguchi M: "MRI findings in patients with high-altitude pulmonary edema." High-altitude Medicine. Shinshu Univ., Matsumoto. 305-308 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Asano K, Sakai A, Yanagidaira Y, Fujiwara T, Yanagisawa K, Ueda G, Takeoka M, Kashimura O, Terasawa K, Kohara K. Matsuzawa Y, Hayashi R, Wu T, Zhang Y: "Acclimatization to high-altitude in lowlanders ; assessment with EEG and exercise test in 1990 Qinghai plateau expedition." High-altitude Medicine. Shishu Univ., Matsumoto. 259-262 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Sakai A, Yanagidaira Y, Fujiwara T, Asano K, Yanagisawa K, Takeoka M, Matsuzawa Y, Kashimura O, Terasawa K, Ueda G: "Relation between breathing pattern and SaO2 at high altitude." High-altitude Medicine. Shinshu Univ., Matsumoto. 116-122 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ueda G, Sakai A, Yanagidaira Y, Fujiwara T, Yanagisawa K, Asano K, Takeoka M, Matsuzawa M, Kashimura O, Terasawa K, Zhang Y: "Tibetan Medical Expedition and climatic chamber test." High-altitude Medicine. Shinshu Univ., Matsumoto. 3-9 (1992)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 山口 伸二,他: "高地順化ならびに脱順化の低酸素換気応答能に及ぼす影響" 登山医学.

    • Related Report
      1991 Annual Research Report
  • [Publications] 久保 恵嗣,他: "高所登山における循環動態ー高地肺水腫の肺循環動態ー" 登山医学.

    • Related Report
      1991 Annual Research Report
  • [Publications] 上田 五雨,他: "高地肺水腫遭難例" 登山医学.

    • Related Report
      1991 Annual Research Report
  • [Publications] 上田 五雨,他: "高地環境の住民調査(中国青蔵高原における)" 信州大学環境科学年報. 13. 60-65 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Matsuzawa,Y.et al.: "Cerebral edema in acute mountoin sickness.Highーalfitude Mechicine" Ueda,G.Reeres,J.T.,&Sekiguchi,M., (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] Yamaguchi,S.et al.: "MRI findings in patients with bighーaltitude palmonary edema.Highーaltifude Medine" Ueda,G.,Reeves,J.T.and Selcigachi,M., (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] 松沢 幸範: "急性高山病発症における呼吸調節障害の関与" 登山医学. 10. 151-154 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 上田 五雨: "急性高山病の成因.症状のファジ-論的解釈" 登山医学. 10. 145-149 (1990)

    • Related Report
      1990 Annual Research Report

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Published: 1990-04-01   Modified: 2016-04-21  

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