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High Altitude Pulmonary Edema

Prativa Pandey, Benu Lohani, Holly Murphy
Pandey, Prativa, Benu Lohani, and Holly Murphy. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 16:000-000, 2016.-Pulmonary embolism (PE) at high altitude is a rare entity that can masquerade as or occur in conjunction with high altitude pulmonary edema (HAPE) and can complicate the diagnosis and management. When HAPE cases do not improve rapidly with descent, other diagnoses, including PE, ought to be considered. From 2013 to 2015, we identified eight cases of PE among 303 patients with initial diagnosis of HAPE...
October 21, 2016: High Altitude Medicine & Biology
Tianbo Jin, Yongchao Ren, Xikai Zhu, Xun Li, Yongri Ouyang, Xue He, Zhiying Zhang, Yuan Zhang, Longli Kang, Dongya Yuan
Previous studies demonstrated that Angiotensin II Receptor 1 (AGTR1) may play an important role in the development of high-altitude pulmonary edema. We envisaged a role for AGTR1 gene variants in the pathogenesis of HAPE and investigated their potential associations with HAPE in a Han Chinese population. We genotyped seven AGTR1 polymorphisms in 267 patients with diagnosed HAPE and 304 controls and evaluated their association with risk of HAPE. Statistically significant associations were found for the single nucleotide polymorphisms (SNPs) rs275651 (p = 0...
October 6, 2016: Oncotarget
Ankit B Shah, Neil Coplan
Altitude plays an important role in cardiovascular performance and training for athletes. Whether it is mountaineers, skiers, or sea-level athletes trying to gain an edge by training or living at increased altitude, there are many potential benefits and harms of such endeavors. Echocardiographic studies done on athletes at increased altitude have shown evidence for right ventricular dysfunction and pulmonary hypertension, but no change in left ventricular ejection fraction. In addition, 10% of athletes are susceptible to pulmonary hypertension and high-altitude pulmonary edema...
2016: Reviews in Cardiovascular Medicine
Roberta Rosas Petrocinio, Elga Dias Gomes
BACKGROUND: High altitude retinopathy (HAR) includes a number of diseases related to high altitude such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE). High altitude retinopathy is mainly characterized by retinal hemorrhages, usually sparing the macular region, a condition specifically known as high altitude retinal hemorrhages (HARH). The pathogenesis of HARH is unclear. Many studies show that lack of oxygen causes an inadequate autoregulation of retinal circulation, causing vascular incompetence...
2016: Aerospace Medicine and Human Performance
Kimberly J Dunham-Snary, Danchen Wu, Edward A Sykes, Amar Thakrar, Leah Rg Parlow, Jeffrey D Mewburn, Joel L Parlow, Stephen L Archer
Hypoxic pulmonary vasoconstriction (HPV) is a homeostatic mechanism that is intrinsic to the pulmonary vasculature. Intrapulmonary arteries constrict in response to alveolar hypoxia, diverting blood to better-oxygenated lung segments, thereby optimizing ventilation-perfusion matching and systemic oxygen delivery. In response to alveolar hypoxia, a mitochondrial sensor dynamically changes reactive oxygen species and redox couples in PASMC. This inhibits potassium channels, depolarizes PASMC, activates voltage-gated calcium channels, and increases cytosolic calcium, causing vasoconstriction...
September 16, 2016: Chest
Srinivasa Bhattachar, Gaurav Sikri
No abstract text is available yet for this article.
October 2016: Indian Journal of Clinical Biochemistry: IJCB
Logan Mills, Chris Harper, Sophie Rozwadowski, Chris Imray
Mills, Logan, Chris Harper, Sophie Rozwadowski, and Chris Imray. High altitude pulmonary edema without appropriate action progresses to right ventricular strain: A case study. High Alt Med Biol. 16:000-000, 2016.-A 24-year-old male developed high altitude pulmonary edema (HAPE) after three ascents to 4061 m over 3 days, sleeping each night at 2735 m. He complained of exertional dyspnea, dry cough, chest pain, fever, nausea, vertigo, and a severe frontal headache. Inappropriate continuation of ascent despite symptoms led to functional impairment and forced a return to the valley, but dyspnea persisted in addition to new orthopnea...
August 30, 2016: High Altitude Medicine & Biology
Yongjun He, Xiyang Zhang, Xun Li, Jieli Du, Xue He, Zhiying Zhang, Yuan Zhang, Longli Kang, Tianbo Jin, Dongya Yuan
BACKGROUND: High altitude pulmonary edema (HAPE) is a type of pneumonedema that mostly occurs under conditions such as high altitude, rapid ascent and hypoxia, amongst others. The ACYP2 polymorphism is suggested to be associated with mean telomere length, and telomere length is significantly longer at a moderate attitude than at sea-level or at simulated high attitude. The present study aimed to determine whethher there is any association between ACYP2 polymorphism and the risk of HAPE...
September 2016: Journal of Gene Medicine
Priyanka Pandey, Zahara Ali, Ghulam Mohammad, M A Qadar Pasha
Biomarkers are essential to unravel the locked pathophysiology of any disease. This study investigated the role of biomarkers and their interactions with each other and with the clinical parameters to study the physiology of high-altitude pulmonary edema (HAPE) in HAPE-patients (HAPE-p) against adapted highlanders (HLs) and healthy sojourners, HAPE-controls (HAPE-c). For this, seven circulatory biomarkers, namely, epinephrine, norepinephrine, tyrosine hydroxylase, transforming growth factor beta 1, tumor necrosis factor alpha (TNFα), platelet-derived growth factor beta beta, and C-reactive protein (CRP), were measured in blood plasma of the three study groups...
2016: Therapeutics and Clinical Risk Management
Gaurav Sikri, Srinivasa Bhattachar
No abstract text is available yet for this article.
2016: Application of Clinical Genetics
Martin J MacInnis, Michael S Koehle
MacInnis, Martin J., and Michael S. Koehle. Evidence for and against genetic predispositions to acute and chronic altitude illnesses. High Alt Med Biol 00:000-000, 2016.-Humans exhibit marked variation in their responses to hypoxia, with susceptibility to acute and chronic altitude illnesses being a prominent and medically important example. Many have hypothesized that genetic differences are the cause of these variable responses to hypoxia; however, until recently, these hypotheses were based primarily on small (and sometimes anecdotal) reports pertaining to apparent differences in altitude illness susceptibility between populations, the notion that a history of altitude illness is indicative of subsequent risk, the heritability of hypoxia-related traits, and candidate gene association studies...
August 8, 2016: High Altitude Medicine & Biology
Zhenlei Su, Lili Zhu, Jing Wu, Runzhen Zhao, Hong-Long Ji
Nasal potential difference (NPD), a well-established in vivo clinical test for cystic fibrosis, reflects transepithelial cation and anion transport in the respiratory epithelium. To analyze whether NPD can be applied to diagnose hypoxic lung injury, we searched PubMed, EMBASE, Scopus, Web of Science, Ovid MEDLINE, and Google Scholar, and analyzed data retrieved from eleven unbiased studies for high altitude pulmonary edema (HAPE) and respiratory distress syndrome (RDS) using the software RevMan and R. There was a significant reduction in overall basal (WMD -5...
2016: Scientific Reports
Andrew T Lovering, Jonathan E Elliott, James T Davis
The foramen ovale, which is part of the normal fetal cardiopulmonary circulation, fails to close after birth in ∼35% of the population and represents a potential source of right-to-left shunt. Despite the prevalence of patent foramen ovale (PFO) in the general population, cardiopulmonary, exercise, thermoregulatory, and altitude physiologists may have underestimated the potential effect of this shunted blood flow on normal physiological processes in otherwise healthy humans. Because this shunted blood bypasses the respiratory system, it would not participate in either gas exchange or respiratory system cooling and may have impacts on other physiological processes that remain undetermined...
August 1, 2016: Journal of Applied Physiology
Matthias Peter Hilty, Stefanie Zügel, Michele Schoeb, Katja Auinger, Christoph Dehnert, Marco Maggiorini
Introduction. Acute exposure to high altitude induces inflammation. However, the relationship between inflammation and high altitude related illness such as high altitude pulmonary edema (HAPE) and acute mountain sickness (AMS) is poorly understood. We tested if soluble urokinase-type plasminogen activator receptor (suPAR) plasma concentration, a prognostic factor for cardiovascular disease and marker for low grade activation of leukocytes, will predict susceptibility to HAPE and AMS. Methods. 41 healthy mountaineers were examined at sea level (SL, 446 m) and 24 h after rapid ascent to 4559 m (HA)...
2016: Mediators of Inflammation
Poonam Soree, Rajinder K Gupta, Krishan Singh, Koundinya Desiraju, Anurag Agrawal, Praveen Vats, Abhishek Bharadwaj, T P Baburaj, Pooja Chaudhary, Vijay K Singh, Saroj Verma, Amir Chand Bajaj, Shashi Bala Singh
High altitude pulmonary edema (HAPE) susceptibility is associated with EGLN1 polymorphisms, we hypothesized that HAPE-susceptible (HAPE-S, had HAPE episode in past) subjects may exhibit abnormal HIF1α levels in normoxic conditions. We measured HIF1α levels in HAPE-S and HAPE resistant (HAPE-R, no HAPE episode) individuals with similar pulmonary functions. Hemodynamic responses were also measured before and after normobaric hypoxia (Fi02 = 0.12 for 30 min duration at sea level) in both groups. . HIF1α was higher in HAPE-S (320...
2016: Scientific Reports
Zahara Ali, Mohammad Waseem, Rahul Kumar, Priyanka Pandey, Ghulam Mohammad, M A Qadar Pasha
CONTEXT: Few potential candidate genes coding for type I and II receptors of transforming growth factor beta signaling pathway and the serotonin transporter have been associated with pulmonary hypertension (PH). The latter being a phenotype for high altitude pulmonary edema (HAPE), these genes are hypothesized to be crucial markers to investigate under the hypobaric hypoxic environment of high altitude. AIMS: We hence aimed to investigate bone-morphogenetic protein-2 (BMP2), bone morphogenetic protein receptor type-II (BMPR-2), activin receptor-like kinase-1 (ALK-1), serotonin transporter (5-HTT) and serotonin (5-HT) for their contribution, individually/epistatically, to clinical endpoints by altering downstream signaling molecules...
August 22, 2016: Gene
Yu Sh Khalimov, O V Vetryakov, R G Makiev, V G Kuzmich
The authors present an analysis of adverse climatic factors mid- and high mountains, which have a significant negative impact on fighting facility and capacity for work in military servicemen that may cause an acute mountain sickness and severe complications (high altitude pulmonary edema and high-altitude cerebral edema). Complicated mechanisms of organism disorder are shown. Sophisticated medical and tactical factors of mountain theatre of war, defining the nature of actions of troops, require special approaches to organisation of medical support...
January 2016: Voenno-medit︠s︡inskiĭ Zhurnal
L J Wu
The object in this study was a Han Chinese population in Lhasa, with 3658 m in altitude from Chengdu, which has 505 m in altitude by air. Within 24 to 48 h before the subjects arrived in the plateau, they completed a basic situation questionnaire, under the guidance of medical staff. Within 24 to 48 h after they reached the plateau, the subjects completed an acute plateau disease questionnaire. The diagnostic standard of HAPE and the diagnosis of acute plateau disease were adopted by the Lake Louise diagnostic standards in 1991 and the Chinese Medical Association promulgated the domestic diagnostic criteria on the Third National Plateau Medical Academic Seminar...
2016: Genetics and Molecular Research: GMR
Nasiruddin Jamal, Mubina Rajhy, Mustaafa Bapumia
An individual experiencing dyspnoea or syncope at high altitude is commonly diagnosed to have high-altitude pulmonary edema or cerebral edema. Acute myocardial infarction (AMI) is generally not considered in the differential diagnosis. There have been very rare cases of AMI reported only from Mount Everest. We report a case of painless ST segment elevation myocardial infarction (STEMI) that occurred while climbing Mount Kilimanjaro. A 51-year-old man suffered dyspnoea and loss of consciousness near the mountain peak, at about 5600 m...
2016: BMJ Case Reports
Kevin R Barker, Andrea L Conroy, Michael Hawkes, Holly Murphy, Prativa Pandey, Kevin C Kain
BACKGROUND: The mechanisms underlying acute mountain sickness (AMS) and high-altitude pulmonary edema (HAPE) are not fully understood. We hypothesized that regulators of endothelial function, circulatory homeostasis, hypoxia and cell stress contribute to the pathobiology of AMS and HAPE. METHODS: We conducted a prospective case-control study of climbers developing altitude illness who were evacuated to the CIWEC clinic in Kathmandu, compared to healthy acclimatized climbers...
March 2016: Journal of Travel Medicine
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