1
|
Zhao ML, Lu ZJ, Yang L, Ding S, Gao F, Liu YZ, Yang XL, Li X, He SY. The cardiovascular system at high altitude: A bibliometric and visualization analysis. World J Cardiol 2024; 16:199-214. [PMID: 38690218 PMCID: PMC11056872 DOI: 10.4330/wjc.v16.i4.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 11/22/2023] [Revised: 02/14/2024] [Accepted: 04/01/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND When exposed to high-altitude environments, the cardiovascular system undergoes various changes, the performance and mechanisms of which remain controversial. AIM To summarize the latest research advancements and hot research points in the cardiovascular system at high altitude by conducting a bibliometric and visualization analysis. METHODS The literature was systematically retrieved and filtered using the Web of Science Core Collection of Science Citation Index Expanded. A visualization analysis of the identified publications was conducted employing CiteSpace and VOSviewer. RESULTS A total of 1674 publications were included in the study, with an observed annual increase in the number of publications spanning from 1990 to 2022. The United States of America emerged as the predominant contributor, while Universidad Peruana Cayetano Heredia stood out as the institution with the highest publication output. Notably, Jean-Paul Richalet demonstrated the highest productivity among researchers focusing on the cardiovascular system at high altitude. Furthermore, Peter Bärtsch emerged as the author with the highest number of cited articles. Keyword analysis identified hypoxia, exercise, acclimatization, acute and chronic mountain sickness, pulmonary hypertension, metabolism, and echocardiography as the primary research hot research points and emerging directions in the study of the cardiovascular system at high altitude. CONCLUSION Over the past 32 years, research on the cardiovascular system in high-altitude regions has been steadily increasing. Future research in this field may focus on areas such as hypoxia adaptation, metabolism, and cardiopulmonary exercise. Strengthening interdisciplinary and multi-team collaborations will facilitate further exploration of the pathophysiological mechanisms underlying cardiovascular changes in high-altitude environments and provide a theoretical basis for standardized disease diagnosis and treatment.
Collapse
Affiliation(s)
- Mao-Lin Zhao
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Zhong-Jie Lu
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Li Yang
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Sheng Ding
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Feng Gao
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Yuan-Zhang Liu
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Xue-Lin Yang
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Xia Li
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, College of Medicine, Southwest Jiaotong University, Chengdu 610083, Sichuan Province, China
| | - Si-Yi He
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China.
| |
Collapse
|
2
|
Rossetti GMK, Oliver SJ, Sandoo A, Macdonald JH. Hypoxia-induced endothelial dysfunction: Could targeting oxidative stress provide protection? Exp Physiol 2023; 108:1026-1028. [PMID: 37232510 PMCID: PMC10988425 DOI: 10.1113/ep091276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Affiliation(s)
| | - Samuel J. Oliver
- School of Human and Behavioural SciencesBangor UniversityBangorUK
| | - Aamer Sandoo
- School of Human and Behavioural SciencesBangor UniversityBangorUK
| | | |
Collapse
|
3
|
Vizcardo-Galindo GA, Howe CA, Hoiland RL, Carter HH, Willie CK, Ainslie PN, Tremblay JC. Impact of Oxygen Supplementation on Brachial Artery Hemodynamics and Vascular Function During Ascent to 5,050 m. High Alt Med Biol 2023; 24:27-36. [PMID: 36940101 DOI: 10.1089/ham.2022.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 03/21/2023] Open
Abstract
Vizcardo-Galindo, Gustavo A., Connor A. Howe, Ryan L. Hoiland, Howard H. Carter, Christopher K. Willie, Philip N. Ainslie, and Joshua C. Tremblay. Impact of oxygen supplementation on brachial artery hemodynamics and vascular function during ascent to 5,050 m. High Alt Med Biol. 24:27-36, 2023.-High-altitude trekking alters upper limb hemodynamics and reduces brachial artery vascular function in lowlanders. Whether these changes are reversible with the removal of hypoxia is unknown. We investigated the impact of 20 minutes of oxygen supplementation (O2) on brachial artery hemodynamics, reactive hyperemia (RH; microvascular function), and flow-mediated dilation (FMD; endothelial function). Participants (aged 21-42 years) were examined before and with O2 at 3,440 m (n = 7), 4,371 m (n = 7), and 5,050 m (n = 12) using Duplex ultrasound (days 4, 7, and 10 respectively). At 3,440 m, O2 decreased brachial artery diameter (-5% ± 5%; p = 0.04), baseline blood flow (-44% ± 15%; p < 0.001), oxygen delivery (-39 ± 16; p < 0.001), and peak RH (-8% ± 8%; p = 0.02), but not RH normalized for baseline blood flow. Elevated FMD (p = 0.04) with O2 at 3,440 m was attributed to the reduction in baseline diameter. At 5,050 m, a reduction in brachial artery blood flow (-17% ± 22%; p = 0.03), but not oxygen delivery, diameter, RH, or FMD occurred with O2. These findings suggest that during early trekking at high altitude, O2 causes vasoconstriction in the upper limb along the arterial tree (conduit and resistance arteries). With incremental high-altitude exposure, O2 reduces blood flow without compromising oxygen delivery, RH, or FMD, suggesting a differential impact on vascular function modulated by the duration and severity of high-altitude exposure.
Collapse
Affiliation(s)
- Gustavo A Vizcardo-Galindo
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
| | - Connor A Howe
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
| | - Ryan L Hoiland
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Howard H Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Christopher K Willie
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
| | - Joshua C Tremblay
- Centre for Heart, Lung & Vascular Health, Faculty of Health and Social Development, University of British Columbia-Okanagan, Kelowna, Canada
| |
Collapse
|
4
|
Hansen AB, Moralez G, Amin SB, Hofstätter F, Simpson LL, Gasho C, Tymko MM, Ainslie PN, Lawley JS, Hearon CM. Global REACH 2018: increased adrenergic restraint of blood flow preserves coupling of oxygen delivery and demand during exercise at high-altitude. J Physiol 2022; 600:3483-3495. [PMID: 35738560 PMCID: PMC9357095 DOI: 10.1113/jp282972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 02/13/2022] [Accepted: 06/16/2022] [Indexed: 01/05/2023] Open
Abstract
Chronic exposure to hypoxia (high-altitude, HA; >4000 m) attenuates the vasodilatory response to exercise and is associated with a persistent increase in basal sympathetic nerve activity (SNA). The mechanism(s) responsible for the reduced vasodilatation and exercise hyperaemia at HA remains unknown. We hypothesized that heightened adrenergic signalling restrains skeletal muscle blood flow during handgrip exercise in lowlanders acclimatizing to HA. We tested nine adult males (n = 9) at sea-level (SL; 344 m) and following 21-28 days at HA (∼4300 m). Forearm blood flow (FBF; duplex ultrasonography), mean arterial pressure (MAP; brachial artery catheter), forearm vascular conductance (FVC; FBF/MAP), and arterial and venous blood sampling (O2 delivery ( DO2${D}_{{{\rm{O}}}_{\rm{2}}}$ ) and uptake ( V̇O2${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ )) were measured at rest and during graded rhythmic handgrip exercise (5%, 15% and 25% of maximum voluntary isometric contraction; MVC) before and after local α- and β-adrenergic blockade (intra-arterial phentolamine and propranolol). HA reduced ΔFBF (25% MVC: SL: 138.3 ± 47.6 vs. HA: 113.4 ± 37.1 ml min-1 ; P = 0.022) and Δ V̇O2${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ (25% MVC: SL: 20.3 ± 7.5 vs. HA: 14.3 ± 6.2 ml min-1 ; P = 0.014) during exercise. Local adrenoreceptor blockade at HA restored FBF during exercise (25% MVC: SLα-β blockade : 164.1 ± 71.7 vs. HAα-β blockade : 185.4 ± 66.6 ml min-1 ; P = 0.947) but resulted in an exaggerated relationship between DO2${D}_{{{\rm{O}}}_{\rm{2}}}$ and V̇O2${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ ( DO2${D}_{{{\rm{O}}}_{\rm{2}}}$ / V̇O2${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ slope: SL: 1.32; HA: slope: 1.86; P = 0.037). These results indicate that tonic adrenergic signalling restrains exercise hyperaemia in lowlanders acclimatizing to HA. The increase in adrenergic restraint is necessary to match oxygen delivery to demand and prevent over perfusion of contracting muscle at HA. KEY POINTS: In exercising skeletal muscle, local vasodilatory signalling and sympathetic vasoconstriction integrate to match oxygen delivery to demand and maintain arterial blood pressure. Exposure to chronic hypoxia (altitude, >4000 m) causes a persistent increase in sympathetic nervous system activity that is associated with impaired functional capacity and diminished vasodilatation during exercise. In healthy male lowlanders exposed to chronic hypoxia (21-28 days; ∼4300 m), local adrenoreceptor blockade (combined α- and β-adrenergic blockade) restored skeletal muscle blood flow during handgrip exercise. However, removal of tonic adrenergic restraint at high altitude caused an excessive rise in blood flow and subsequently oxygen delivery for any given metabolic demand. This investigation is the first to identify greater adrenergic restraint of blood flow during acclimatization to high altitude and provides evidence of a functional role for this adaptive response in regulating oxygen delivery and demand.
Collapse
Affiliation(s)
| | - Gilbert Moralez
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, TX, USA
| | - Sachin B. Amin
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Florian Hofstätter
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Lydia L. Simpson
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Christopher Gasho
- Department of Medicine, Division of Pulmonary and Critical Care, University of Loma Linda, Loma Linda, California, USA
| | - Michael M. Tymko
- Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada.,Centre of Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, British Columbia, Canada
| | - Philip N. Ainslie
- Centre of Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia – Okanagan, Kelowna, British Columbia, Canada
| | - Justin S. Lawley
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Christopher M. Hearon
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, TX, USA.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,Correspondence: Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX, 75231, USA.
| |
Collapse
|
5
|
Sabouhanian A, Bagherichimeh S. Effect of vitamin C infusion on altitude-related vasodilatory dysfunction. J Physiol 2022; 600:1587-1589. [PMID: 35218563 DOI: 10.1113/jp282705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 01/22/2022] [Accepted: 02/18/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Amir Sabouhanian
- Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Sareh Bagherichimeh
- Department of Pathology and Laboratory Medicine, Schulich Medicine & Dentistry, University of Western, London, ON, N6A 5C1
| |
Collapse
|
6
|
Swenson ER. High altitude vascular dysfunction- can we 'C' our way to a remedy? J Physiol 2021; 600:1271-1272. [PMID: 34951481 DOI: 10.1113/jp282578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Erik R Swenson
- VA Puget Health Care System, University of Washington, Seattle, WA, USA
| |
Collapse
|