Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease. Issue 7 (9th December 2005)

• Record Type: Journal Article
• Authors: Schmid, J-P; Noveanu, M; Gaillet, R; Hellige, G; Wahl, A; Saner, H
• Is Part Of: Heart. Volume 92:Issue 7(2006)
• Page Start: 921
• Page End: 925
• Publication Date: 2005-12-09
• Subjects: chronic ischaemic heart disease -- exercise -- exercise testing -- rehabilitation -- high altitude; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2005.072520
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: To assess the safety and cardiopulmonary adaptation to high altitude exposure among patients with coronary artery disease. Methods: 22 patients (20 men and 2 women), mean age 57 (SD 7) years, underwent a maximal, symptom limited exercise stress test in Bern, Switzerland (540 m) and after a rapid ascent to the Jungfraujoch (3454 m). The study population comprised 15 patients after ST elevation myocardial infarction and 7 after a non-ST elevation myocardial infarction 12 (SD 4) months after the acute event. All patients were revascularised either by percutaneous coronary angioplasty (n = 15) or by coronary artery bypass surgery (n = 7). Ejection fraction was 60 (SD 8)%. β blocking agents were withheld for five days before exercise testing. Results: At 3454 m, peak oxygen uptake decreased by 19% (p < 0.001), maximum work capacity by 15% (p < 0.001) and exercise time by 16% (p < 0.001); heart rate, ventilation and lactate were significantly higher at every level of exercise, except at maximum exertion. No ECG signs of myocardial ischaemia or significant arrhythmias were noted. Conclusions: Although oxygen demand and lactate concentrations are higher during exercise at high altitude, a rapid ascent and submaximal exercise can be considered safe at an altitude of 3454 m for low risk patients six months after revascularisation for an acute coronary event and a normal exercise stress test at low altitude.