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Micro- and macrovascular function in the highest city in the world: a cross sectional study

Title: Micro- and macrovascular function in the highest city in the world: a cross sectional study
Authors: Savina Y.; Pichon A. P.; Lemaire L.; Howe C. A.; Ulliel-Roche M.; Skinner S.; Nader E.; Guillot N.; Stauffer E.; Roustit M.; Hancco I.; Robach P.; Esteve F.; Pialoux V.; Perger E.; Parati G.; Ainslie P. N.; Doutreleau S.; Connes P.; Verges S.; Brugniaux J. V.
Contributors: Savina, Y; Pichon, A; Lemaire, L; Howe, C; Ulliel-Roche, M; Skinner, S; Nader, E; Guillot, N; Stauffer, E; Roustit, M; Hancco, I; Robach, P; Esteve, F; Pialoux, V; Perger, E; Parati, G; Ainslie, P; Doutreleau, S; Connes, P; Verges, S; Brugniaux, J
Publisher Information: GB; The Lancet Publishing Group
Publication Year: 2024
Collection: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
Subject Terms: Altitude; Chronic mountain sickne; Flow-mediated dilation; Inflammation; Microcirculation
Description: Background: Since vascular responses to hypoxia in both healthy high-altitude natives and chronic mountain sickness (a maladaptive high-altitude pathology characterised by excessive erythrocytosis and the presence of symptoms—CMS) remain unclear, the role of inflammation and oxidative/nitrosative stress on the endothelium-dependent and -independent responses in both the micro- and macrocirculation, in healthy Andeans at different altitudes and in CMS patients, was examined. Methods: 94 men were included: 18 lowlanders (LL), 38 healthy highlanders permanently living at 3800 m (n = 21—HL-3800) or in La Rinconada, the highest city in the world (5100–5300 m) (n = 17—HL-5100/No CMS). Moreover, 14 participants with mild (Mild CMS) and 24 with moderate to severe CMS (Mod/Sev CMS) were recruited. All undertook two reactivity tests: i) local thermal hyperaemia (microcirculation) and ii) flow-mediated dilation (macrocirculation). Endothelium-independent function (glyceryl trinitrate) was also assessed only in La Rinconada. Findings: Conductance and skin blood flow velocity during the microcirculation test, as well as macrocirculation progressively decreased with altitude (LL > HL-3800 > HL-5100/No CMS). CMS also induced a decrease in macrocirculation (HL-5100/No CMS > Mild CMS = Mod/Sev CMS), while glyceryl trinitrate restored vascular function. Both oxidative stress and nitric oxide metabolites increased with altitude only. Principal component analysis revealed that increasing inflammation with altitude was associated with a progressive decline in both micro- and macrovascular function in healthy highlanders. Interpretation: Both micro and macrovascular function are affected by chronic exposure to hypoxia, the latter being further compounded by CMS. Funding: The “Fonds de dotation AGIR pour les maladies chroniques”, the “Air Liquide Foundation”, and the “French National Research Agency”.
Document Type: article in journal/newspaper
File Description: ELETTRONICO
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/39381083; info:eu-repo/semantics/altIdentifier/wos/WOS:001324631900001; volume:38; journal:THE LANCET REGIONAL HEALTH. AMERICAS; https://hdl.handle.net/10281/516940
DOI: 10.1016/j.lana.2024.100887
Availability: https://hdl.handle.net/10281/516940; https://doi.org/10.1016/j.lana.2024.100887
Accession Number: edsbas.6BA18BAB
Database: BASE