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  • Chronic Hypoxemia Alone Induces Major Vascular Dysfunction in The Absence of Additional Cardiovascular Risk Factors

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    Joseph Irwanto
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    This study examined the effects of chronic hypoxemia on systemic vascular function in subjects living at high altitude in Bolivia. The researchers found that subjects with chronic mountain sickness exhibited significantly impaired endothelial function, increased arterial stiffness, and greater intima-media thickness compared to healthy controls, despite an absence of other cardiovascular risk factors. Chronic hypoxemia alone was shown to induce marked vascular dysfunction. Administration of oxygen was found to improve endothelial function, suggesting chronic hypoxemia represents an independent risk factor for cardiovascular disease.

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    This study examined the effects of chronic hypoxemia on systemic vascular function in subjects living at high altitude in Bolivia. The researchers found that subjects with chronic mountain sickness exhibited significantly impaired endothelial function, increased arterial stiffness, and greater intima-media thickness compared to healthy controls, despite an absence of other cardiovascular risk factors. Chronic hypoxemia alone was shown to induce marked vascular dysfunction. Administration of oxygen was found to improve endothelial function, suggesting chronic hypoxemia represents an independent risk factor for cardiovascular disease.

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    6 views20 pages

    Chronic Hypoxemia Alone Induces Major Vascular Dysfunction in The Absence of Additional Cardiovascular Risk Factors

    Uploaded by

    Joseph Irwanto
    This study examined the effects of chronic hypoxemia on systemic vascular function in subjects living at high altitude in Bolivia. The researchers found that subjects with chronic mountain sickness exhibited significantly impaired endothelial function, increased arterial stiffness, and greater intima-media thickness compared to healthy controls, despite an absence of other cardiovascular risk factors. Chronic hypoxemia alone was shown to induce marked vascular dysfunction. Administration of oxygen was found to improve endothelial function, suggesting chronic hypoxemia represents an independent risk factor for cardiovascular disease.

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    of 20

    Chronic hypoxemia alone induces major

    vascular dysfunction in the absence of


    additional cardiovascular risk factors
    Rimoldi SF
    1
    , Rexhaj E
    2
    , Villena M
    3
    , Scherrer U
    2
    ,
    Sartori C
    2
    , Allemann Y
    1
    .
    1
    Swiss Cardiovascular Center Bern, University Hospital, Bern,
    2
    Department of Internal Medicine, CHUV, Lausanne, both in Switzerland
    3
    Instituto Bolivano de Biologia de Altura, La Paz, Bolivia.
    Chronic pulmonary diseases
    (COPD, Emphysema)
    BACKGROUND
    Increased cardiovascular
    morbidity and mortality
    Systemic vascular dysfunction
    Systemic vascular dysfunction
    BACKGROUND
    Cardiovascular risk
    factors (i.e. smoking)
    Chronic
    Hypoxemia
    ?
    BACKGROUND
    Chronic Mountain Sickness
    Chronic hypoxemia
    absence of cardiovascular risk factors
    HYPOTHESIS
    Chronic Mountain Sickness
    Hypoxemia-induced systemic vascular
    dysfunction ?
    La Paz, Bolivia, 3600m
    Setting: La Paz, Bolivia, 3600m
    Subjects:
    23 male subjects with chronic mountain sickness
    (CMS) and without cardiovascular risk factors
    27 matched healthy control subjects
    Assessment of systemic vascular function
    METHODS
    Flow-mediated
    dilation
    Pulse wave
    velocity
    Intima-media
    thickness
    Endothelial
    function
    Arterial
    stiffness
    Structural
    changes
    METHODS
    RESULTS
    Clinical characteristics
    Variable CH Controls P-value
    Age [y] 52 11 49 10 0.20
    BP sys [mmHg] 125 13 125 10 0.90
    BP dia [mmHg] 81 8 79 8 0.38
    SaO2 [%] 82.6 3.4 90.0 2.9 < 0.001
    Hemoglobin, g/dl 21.5 1.3 16.9 1.1 < 0.001
    RESULTS
    Flow-mediated vasodilation of the
    brachial artery
    RESULTS
    Endothelium-independent
    nitroglycerin-mediated vasodilation
    RESULTS
    Arterial Stiffness
    RESULTS
    Carotid intima-media thickness
    HYPOTHESIS
    Chronic hypoxemia
    Systemic vascular dysfunction
    Beneficial effects of O
    2
    administration ?
    RESULTS
    Relationships between
    vascular function and SaO
    2
    PWV IMT FMD
    RESULTS
    Effects of O
    2
    administration on
    flow-mediated vasodilation
    This study provides the first evidence in humans
    that chronic hypoxemia itself induces marked
    functional and morphological vascular dysfunction
    in the systemic circulation.
    Chronic hypoxemia represents a novel
    cardiovascular risk factor.
    CONCLUSION
    Treatment of chronic hypoxemia may have a
    favorable effect on cardiovascular morbidity and
    mortality in diseases associated with chronic
    hypoxemia.
    SPECULATION
    Grant support:
    - Swiss National Science Foundation
    - Leenards Foundation
    - Placide Nicod Foundation

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