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A four-way comparison of cardiac function with normobaric normoxia, normobaric hypoxia, hypobaric hypoxia and genuine high altitude.

Boos, C. J., O'Hara, J.P., Mellor, A., Hodkinson, P.D., Tsakirides, C., Reeve, N., Gallagher, L., Green, N.D.C. and Woods, D.R., 2016. A four-way comparison of cardiac function with normobaric normoxia, normobaric hypoxia, hypobaric hypoxia and genuine high altitude. PLoS ONE, 11 (4), e0152868.

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A Four-Way Comparison of Cardiac Function with Normobaric Normoxia, Normobaric Hypoxia, Hypobaric Hypoxia and Genuine High A.pdf - Published Version
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DOI: 10.1371/journal.pone.0152868


Background: There has been considerable debate as to whether different modalities of simulated hypoxia induce similar cardiac responses. Materials and Methods: This was a prospective observational study of 14 healthy subjects aged 22-35 years. Echocardiography was performed at rest and at 15 and 120 minutes following two hours exercise under normobaric normoxia (NN) and under similar PiO2 following genuine high altitude (GHA) at 3,375m, normobaric hypoxia (NH) and hypobaric hypoxia (HH) to simulate the equivalent hypoxic stimulus to GHA. Results: All 14 subjects completed the experiment at GHA, 11 at NN, 12 under NH, and 6 under HH. The four groups were similar in age, sex and baseline demographics. At baseline rest right ventricular (RV) systolic pressure (RVSP, p = 0.0002), pulmonary vascular resistance (p = 0.0002) and acute mountain sickness (AMS) scores were higher and the SpO2 lower (p<0.0001) among all three hypoxic groups (GHA, NH and HH) compared with NN. At both 15 minutes and 120 minutes post exercise, AMS scores, Cardiac output, septal S', lateral S', tricuspid S' and A' velocities and RVSP were higher and SpO2 lower with all forms of hypoxia compared with NN. On post-test analysis, among the three hypoxia groups, SpO2 was lower at baseline and 15 minutes post exercise with GHA (89.3±3.4% and 89.3±2.2%) and HH (89.0±3.1 and (89.8±5.0) compared with NH (92.9±1.7 and 93.6±2.5%). The RV Myocardial Performance (Tei) Index and RVSP were significantly higher with HH than NH at 15 and 120 minutes post exercise respectively and tricuspid A' was higher with GHA compared with NH at 15 minutes post exercise. Conclusions: GHA, NH and HH produce similar cardiac adaptations over short duration rest despite lower SpO2 levels with GHA and HH compared with NH. Notable differences emerge following exercise in SpO2, RVSP and RV cardiac function.

Item Type:Article
Additional Information:Funding: Research reported in this study was supported by the Surgeon General, UK and the Drummond Foundation and Leeds Beckett University.
Uncontrolled Keywords:Acclimatization; Adult; Altitude; Altitude Sickness; Atmospheric Pressure; Cardiac Output;Exercise;Female;Humans;Hypoxia;Male;Oxygen;Prospective Studies;Vascular Resistance;Ventricular Function, Right;Young Adult
Group:Faculty of Health & Social Sciences
ID Code:37108
Deposited By: Symplectic RT2
Deposited On:27 Jun 2022 13:06
Last Modified:27 Jun 2022 13:06


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