Adaptation to Living at High Altitude in Patients with COPD. Comparative Study of Exercise Capacity and Ventilatory Variables between Patients Residing at High and Low Altitudes in the Andes.

IF 1.6 4区 医学 Q4 BIOPHYSICS High altitude medicine & biology Pub Date : 2024-03-25 DOI:10.1089/ham.2023.0111
Mauricio González-García, Luis Ernesto Téllez
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Abstract

González-García, Mauricio and Luis Ernesto Téllez. Adaptation to living at high altitude in patients with COPD. Comparative study of exercise capacity and ventilatory variables between patients residing at high and low altitudes in the Andes. High Alt Med Biol. 00:000-000, 2024. Introduction: Although some variables related to oxygen transport and utilization such as ventilation, pulmonary vascular responses to hypoxia, heart rate (HR), cardiac output, hemoglobin (Hb), and oxygen saturation (SpO2) are used to compare adaptation to altitude between populations, peak oxygen consumption (VO2) constitutes an integrative measure of total oxygen transport that may reflect successful adaptation to altitude. We designed this study to make a direct comparison of VO2 in a cardiopulmonary exercise test (CPET) between chronic obstructive pulmonary disease (COPD) patients residing at high altitude (Bogotá, Colombia: 2,640 m) (COPD-HA) and those living at low altitude (Bucaramanga, Colombia: 959 m) (COPD-LA). Methods: All patients performed a CPET with measurements of VO2, minute ventilation (VE), HR, oxygen pulse (VO2/HR), ventilatory equivalents (VE/VCO2), and SpO2. Unpaired T-test or Mann-Whitney U test were used for comparisons between COPD-HA and COPD-LA. Results: We included 71 patients with COPD, 53 COPD-HA, and 18 COPD-LA. There were no differences between groups in age, sex, or forced expiratory volume in 1 second. The means ± SD of Hb, g/dl was slightly higher in COPD-HA (15.9 ± 1.9 vs. 14.7 ± 1.8, p = 0.048), without differences in VO2, % pred (71.6 ± 17.9 vs. 69.0 ± 17.0, p = 0.584), VO2/HR, % pred (92.1 ± 22.0 vs. 89.7 ± 19.8, p = 0.733) or VE/MVV, % (75.5 ± 14.1 vs. 76.5 ± 14.3, p = 0.790) at peak exercise between groups. Median (IQR) of VE/VCO2 nadir [38.0 (37.0-42.0) vs. 32.5 (31.0-39.0), p = 0.005] was significantly higher, and SpO2, % at rest [88.0 (86.0-91.0) vs. 95.0 (94.0-96.0), p < 0.001] and at peak exercise [84.0 (77.0-90.0) vs. 93.0 (92.0-95.0), p < 0.001] were significantly lower in COPD-HA. Conclusions: Despite higher desaturation at rest and during exercise in COPD-HA, there were no differences in VO2 peak between COPD-HA and COPD-LA, suggesting a potential altitude adaptation in those patients chronically exposed to hypoxia.

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慢性阻塞性肺病患者对高海拔生活的适应。安第斯山脉高海拔地区和低海拔地区患者运动能力和通气变量的比较研究。
冈萨雷斯-加西亚(González-García)、毛里西奥(Mauricio)和路易斯-埃内斯托-泰莱斯(Luis Ernesto Téllez)。慢性阻塞性肺病患者对高海拔生活的适应。安第斯山脉高海拔地区和低海拔地区患者运动能力和通气变量的比较研究。00:000-000, 2024.导言:尽管一些与氧气运输和利用有关的变量,如通气、肺血管对缺氧的反应、心率(HR)、心输出量、血红蛋白(Hb)和血氧饱和度(SpO2),被用于比较不同人群对高海拔的适应情况,但峰值耗氧量(VO2)是氧气运输总量的综合测量指标,可反映对高海拔的成功适应。本研究旨在直接比较居住在高海拔地区(哥伦比亚波哥大:2640 米)的慢性阻塞性肺病(COPD)患者(COPD-HA)和居住在低海拔地区(哥伦比亚布卡拉曼加:959 米)的慢性阻塞性肺病患者(COPD-LA)在心肺运动测试(CPET)中的 VO2 值。研究方法所有患者都进行了 CPET,测量了 VO2、分钟通气量 (VE)、心率、氧脉搏 (VO2/HR)、通气当量 (VE/VCO2) 和 SpO2。COPD-HA 和 COPD-LA 之间的比较采用非配对 T 检验或 Mann-Whitney U 检验。结果我们共纳入了 71 名 COPD 患者,其中 53 名 COPD-HA,18 名 COPD-LA。组间在年龄、性别和 1 秒用力呼气量方面无差异。COPD-HA 患者的 Hb(克/分升)平均值(± SD)略高(15.9 ± 1.9 vs. 14.7 ± 1.8,p = 0.048),而 VO2(预测值的百分比)无差异(71.6 ± 17.9 vs. 69.0 ± 17.0,p = 0.584)、VO2/HR,预测值百分比(92.1 ± 22.0 vs. 89.7 ± 19.8,p = 0.733)或峰值运动时 VE/MVV,百分比(75.5 ± 14.1 vs. 76.5 ± 14.3,p = 0.790)在组间无差异。VE/VCO2 nadir [38.0 (37.0-42.0) vs. 32.5 (31.0-39.0), p = 0.005]的中位数(IQR)明显更高,静息时的 SpO2, % [88.0 (86.0-91. 0 vs. 95.0 (86.0-91.0), p = 0.005]也明显更高。0) vs. 95.0 (94.0-96.0), p < 0.001]和运动高峰时的 SpO2, % [84.0 (77.0-90.0) vs. 93.0 (92.0-95.0), p < 0.001]在 COPD-HA 中明显较低。结论尽管 COPD-HA 患者在静息和运动时的饱和度较高,但 COPD-HA 和 COPD-LA 患者的 VO2 峰值没有差异,这表明长期暴露于缺氧环境的患者有可能适应高原环境。
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来源期刊
High altitude medicine & biology
High altitude medicine & biology 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
9.50%
发文量
44
审稿时长
>12 weeks
期刊介绍: High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.
期刊最新文献
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