A novel echocardiographic parameter to identify individuals susceptible to acute mountain sickness. Issue 44 (November 2021)

• Record Type: Journal Article
• Authors: Ke, Jingbin; Yang, Jie; Liu, Chuan; Qin, Zhexue; Zhang, Jihang; Jin, Jun; Yu, Shiyong; Tan, Hu; Yang, Yuanqi; Zhang, Chen; Li, Jiabei; Yu, Jie; Bian, Shizhu; Ding, Xiaohan; He, Chunyan; Yuan, Fangzhengyuan; Tian, Jingdu; Li, Chun; Rao, Rongsheng; Huang, Lan
• Is Part Of: Travel medicine and infectious disease. Issue 44(2021)
• Publication Date: 2021-11
• Subjects: Tissue motion annular displacement -- Acute mountain sickness -- Prediction -- Echocardiography; AHAE acute high altitude exposure -- AMS acute mountain sickness -- CI 95% confidence interval -- ICC intra-class correlation coefficient -- E/A peak E to A velocity ratio -- IVCT isovolumic contraction time -- ET ejection time -- IVRT isovolumic relaxation time -- LV left ventricular -- LV ESV left ventricular end-systolic volume -- LV EDV left ventricular end-diastolic volume -- mPAP mean pulmonary arterial pressure -- MV mitral valve -- MV TMADlateral lateral mitral valve tissue motion annular displacement -- OR odds ratio -- PAAT pulmonary arterial acceleration time -- ROC receiver operating characteristic curves -- RV right ventricular -- RV EDA right ventricular end diastolic area -- RV ESA right ventricular end systolic area -- SL sea level -- TMAD tissue motion annular displacement -- TCO total valve closure opening time -- TRV tricuspid regurgitation velocity -- TV tricuspid valve; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2021.102166
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: Background: Acute mountain sickness (AMS) may cause life-threatening conditions. This study aimed to screen echocardiographic parameters at sea level (SL) to identify predictors of AMS development. Methods: Overall, 106 healthy men were recruited at SL and ascended to 4100 m within 7 days by bus. Basic characteristics, physiological data, and echocardiographic parameters were collected both at SL and 4100 m above SL. AMS was identified by 2018 Lake Louise Questionnaire Score. Results: After acute high altitude exposure (AHAE), 33 subjects were diagnosed with AMS and exhibited lower lateral mitral valve tissue motion annular displacement (MV TMADlateral ) at SL than AMS-free subjects (13.09 vs. 13.89 mm, p = 0.022). MV TMADlateral at SL was significantly correlated with AMS occurrence (OR = 0.717, 95% CI: 0.534–0.964, p = 0.028). The MV TMADlateral <13.30-mm group showed over 4-fold risk for AMS development versus the MV TMADlateral ≥13.30-mm group. After AHAE, the MV TMADlateral <13.30-mm group had increased HR (64 vs. 74 bpm, p = 0.001) and right-ventricular myocardial performance index (0.54 vs. 0.69, p = 0.009) and decreased left ventricular global longitudinal strain (−21.50 vs. −20.23%, p = 0.002), tricuspid valve E/A ratio (2.11 vs. 1.89, p = 0.019), and MV E-wave deceleration time (169.60 vs. 156.90 ms, p = 0.035). Conclusion: MV TMADlateral at SL was a potential predictor of AMS occurrence and might be associated with differential alterations of ventricular systolic and diastolic functions in subjects with different MV TMADlateral levels at SL after AHAE.