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Pulmonary arterial systolic pressure and susceptibility to high altitude pulmonary edema

Abstract : There is evidence that pulmonary arterial hypertension plays a major role in the occurrence of high altitude pulmonary edema (HAPE). We tested the hypothesis that the pulmonary arterial systolic pressure response to a challenge associated with hypoxia and mild exercise may be considered a predictive factor of HAPE. Pulmonary arterial systolic pressure was measured by Doppler echocardiography in 8 HAPE susceptible (HAPE-S) subjects and 8 HAPE resistant mountaineers (HAPE-R) during a hypoxic exercise challenge established by the French Association for Sport Medicine (Richalet's test). Pulmonary arterial systolic pressure during hypoxic exercise allowed a significant discrimination between the groups, although an overlap of values was observed. When expressed as individual variations from baseline to hypoxic exercise level however, we found a highly significant difference. No overlap was observed between HAPE-R (range: 6.7-18.5 mmHg) and HAPE-S (range: 19.2-30.4 mmHg) groups, with a cut-off value at 19 mmHg. Plasma Vascular Endothelial growth factor (VEGF) and malondialdehyde (MDA) increased in response to hypoxic exercise only in HAPE-S group. Individual increases in pulmonary arterial systolic pressure during hypoxic exercise from basal resting normoxic values seem relevant to estimate HAPE susceptibility when measured during the Richalet's test.
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Submitted on : Saturday, September 29, 2018 - 9:25:13 AM
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Rémi Mounier, Aimé Amonchot, Nicolas Caillot, Cécile Gladine, Bernard Citron, et al.. Pulmonary arterial systolic pressure and susceptibility to high altitude pulmonary edema. Respiratory Physiology & Neurobiology, 2011, 179 (2-3), pp.294 - 299. ⟨10.1016/j.resp.2011.09.011⟩. ⟨hal-01883949⟩



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