Supine Bicycle Stress Echocardiography at Low Altitude for Identification of Susceptibility to Acute Mountain Sickness - 03/03/25
Abstract |
Background |
Exposure to high altitude may unpredictably lead to acute mountain sickness (AMS). The purpose of this study was to identify the predictors of AMS at low altitude using exercise stress echocardiography (ESE).
Methods |
A total of 40 healthy adults were enrolled and underwent comprehensive supine bicycle ESE at low altitude, including pulmonary vascular resistance (PVR), right ventricular area index at the end of diastole, B-lines, and inferior vena cava (IVC) diameter. All subjects ascended to 3,600 m within 24 hours. The risk factors for AMS were screened using least absolute shrinkage and selection operator regression analysis. A novel nomogram model was then established using multivariable logistic regression analysis, and a clinical impact curve was constructed.
Results |
At the altitude of 3,600 m, 20 of 40 subjects had AMS (AMS group). On least absolute shrinkage and selection operator regression analyses, PVR, IVC, and B-lines at peak exercise were all independent factors influencing AMS. The nomogram built on the basis of these factors predicted AMS with sensitivity of 0.950 and specificity of 0.804, which outperformed the individual predictive C indexes of each indicator (nomogram: cutoff, 59.3; area under the curve [AUC], 0.90 [95% CI, 0.80-1.00]; PVR at peak exercise: cutoff, 1.55; AUC, 0.81 [95% CI, 0.70-0.91]; B-lines at peak exercise: cutoff, 1; AUC, 0.78 [95% CI, 0.69-0.92]; IVC at peak exercise: cutoff, 13.8; AUC, 0.74 [95% CI, 0.65-0.87]). The established model was validated by plotting the clinical decision curve analysis and clinical impact curve.
Conclusions |
Supine bicycle ESE is a useful technique to identify subjects susceptible to AMS. This study established a nomogram to predict the development to AMS with high discrimination and accuracy.
Le texte complet de cet article est disponible en PDF.Central Illustration |
Comprehensive exercise stress echocardiography, which combined pulmonary vascular resistance, B-lines, and inferior vena cava diameter at peak exercise, provides an accurate prediction of acute mountain sickness vulnerability. The predictive nomogram model outperformed the individual predictive C indexes of each indicator.
Comprehensive exercise stress echocardiography, which combined pulmonary vascular resistance, B-lines, and inferior vena cava diameter at peak exercise, provides an accurate prediction of acute mountain sickness vulnerability. The predictive nomogram model outperformed the individual predictive C indexes of each indicator.
Central IllustrationComprehensive exercise stress echocardiography, which combined pulmonary vascular resistance, B-lines, and inferior vena cava diameter at peak exercise, provides an accurate prediction of acute mountain sickness vulnerability. The predictive nomogram model outperformed the individual predictive C indexes of each indicator.Le texte complet de cet article est disponible en PDF.
Highlights |
• | Comprehensive ESE has the potential to identify susceptibility to AMS. |
• | Comprehensive ESE integrates lung–pulmonary circulation–central venous system. |
• | ESE offers a unified “RV–pulmonary circulation unit” assessment in a single shot. |
Keywords : Acute mountain sickness, Stress echocardiography, Right ventricular function, Pulmonary artery pressure, Pulmonary vascular resistance
Abbreviations : AMS, AUC, CIC, DCA, ESE, HAPE, IVC, LS, LV, mPAP, PVR, RV, RVEDA, RVEDAi, RVESA, RVESAi, sPAP, TRV, WU
Plan
| Dr. Zhang is supported by the Natural Science Foundation of Sichuan Provincial Health Commission (2023NSFSC0641). Dr. Shang is supported by the Sichuan Provincial Cadre Health Research Project (2021-230) and Liangshan Science and Technology Bureau (21ZDY0069). Dr. Deng is supported by the Science and Technology Department of Sichuan Province Project (23NSFSC0118). |
|
| Drs. Y. Wang and Zhang contributed equally to this work and are joint first authors. |
|
| Yun Xu is a co-corresponding author. Email: xuyunyun915@163.com |
Vol 38 - N° 3
P. 262-272 - mars 2025 Retour au numéro
Article précédent
- The Right Ventricle and Exercise Capacity in Adults with Repaired Tetralogy of Fallot: Passive Bystander or Active Participant?
- Zachary Barrett-O’Keefe, Chera L. Maarouf, Jessica A. Narum, Timothy J. Fuller, James M. Welper, William R. Miranda, C. Charles Jain, Heidi M. Connolly, Luke J. Burchill, Alexander C. Egbe
- Sex-Specific Differences in Echocardiographic Parameters of Risk Stratification in Pulmonary Arterial Hypertension
- Nicola Benjamin, Veronika Schiffer, Carolin Resag, Panagiota Xanthouli, Moritz Braun, Satenik Harutyunova, Christina A. Eichstaedt, Benjamin Egenlauf, Alberto M. Marra, Eduardo Bossone, Antonio Cittadini, David G. Kiely, Ekkehard Grünig
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?