The cardiovascular system at high altitude: A bibliometric and visualization analysis

Table 1 Summary of data source and selection

Date source	Web of Science
Citation index	SCIE
Searching period	January 1, 1990 to December 31, 2022
Searching	TS = ((“high altitude” OR “plateau” OR “mountain”) AND (“cardiovascular” OR “heart” OR “cardiac” OR “myocardial”))
Subject category	“Physiology”, “Cardiac Cardiovascular Systems”, “Sport Sciences”
Document type	“Articles” or “reviews”
Language	“English”
Sample size	1674

SCIE: Science citation index expanded.

Table 2 Descriptive statistics of the database

Criteria	Quantity
Publications	1674
Authors	7433
Journals	586
Institutions	2041
Countries	78
Cited references	44674

Table 3 Top 10 countries in the field of cardiovascular system at high altitude

Rank	Country	Publications	Citations	Average citations
1	United States	409	12146	29.70
2	People’s Republic of China	367	5268	14.35
3	England	156	4119	26.40
4	France	129	3296	25.55
5	Canada	124	3190	25.73
6	Italy	124	3065	24.72
7	Switzerland	113	3360	29.73
8	Germany	113	2330	20.62
9	Austria	79	1259	15.93
10	Peru	72	2431	33.76

Table 4 Top 10 countries with centrality value

Rank	Country	Centrality
1	United States	0.41
2	People’s Republic of China	0.21
3	England	0.20
4	Germany	0.16
5	Switzerland	0.13
6	Italy	0.11
7	Chile	0.09
8	France	0.08
9	Canada	0.08
10	Netherlands	0.07

Table 5 Top 10 institutions in the field of cardiovascular system at high altitude

Rank	Institution	Publications	Citations	Average citations
1	Universidad Peruana Cayetano Heredia	57	1704	29.90
2	University of British Columbia	51	1505	29.51
3	Chinese Academy of Sciences	48	1140	23.75
4	University of Innsbruck	48	819	17.07
5	University of Colorado	46	2311	50.24
6	Loma Linda University	39	1006	25.79
7	The Third Military Medical University	36	307	7.87
8	University of Cambridge	32	1335	42.34
9	Université Sorbonne Paris Nord	31	1300	41.94
10	University of California-San Diego	31	1119	36.10

Table 6 Most important authors in the field of cardiovascular system at high altitude

Rank	Author	Documents	Citations	Average citations
1	Jean-Paul Richalet	41	1616	39.41
2	Philip N Ainslie	31	565	18.23
3	Martin Burtscher	30	488	16.27
4	Lan Huang	25	216	8.64
5	Mike Stembridge	23	387	16.83
6	Gianfranco Parati	21	381	18.14
7	Michael M Tymko	18	214	11.89
8	Jie Yu	17	206	12.12
9	Leon-Velarde Fabiola	16	799	49.94
10	Francisco C Villafuerte	16	316	19.75
11	Frantisek Kolar	16	267	16.69
12	Jie Yang	16	71	4.44

Table 7 Top 10 journals in the field of cardiovascular system at high altitude

Rank	Source	Publications	Citations	Average citations
1	High Altitude Medicine & Biology	144	2982	20.71
2	Journal of Applied Physiology	81	3070	37.91
3	Frontiers in Physiology	55	399	7.25
4	Wilderness & Environmental Medicine	38	622	16.37
5	Journal of Physiology-London	29	1207	41.62
6	American Journal of Physiology-Heart and Circulatory Physiology	29	827	28.52
7	Plos One	27	692	25.63
8	European Journal of Applied Physiology	26	489	18.81
9	Experimental Physiology	22	406	18.45
10	American Journal of Physiology-Regulatory Integrative and Comparative	22	829	37.68

Table 8 Top 10 references with highest citations

Rank	Ref.	Citations
1	High-altitude illness	123
2	Physiological adaptation of the cardiovascular system to high altitude	107
3	The heart and pulmonary circulation at high altitudes: Healthy highlanders and chronic mountain sickness	107
4	Effect of altitude on the heart and the lungs	90
5	Genetic evidence for high-altitude adaptation in Tibet	78
6	Consensus statement on chronic subacute high altitude diseases	77
7	Operation Everest II: Preservation of cardiac function at extreme altitude	67
8	Sympathetic neural overactivity in healthy humans after prolonged exposure to hypobaric hypoxia	65
9	Guidelines for the echocardiographic assessment of the right heart in adults: A report from the American society of echocardiography	55
10	Two routes to functional adaptation: Tibetan and Andean high-altitude natives	52

Table 9 Top 10 highest cited journals

Rank	Journals	Citations
1	Journal of Applied Physiology	5586
2	High Altitude Medicine & Biology	2192
3	Circulation	2051
4	Journal of Physiology-London	1433
5	American Journal of Physiology-Heart and Circulatory	1138
6	American Journal of Physiology	1107
7	The New England Journal of Medicine	980
8	Circulation Research	891
9	Proceedings of the National Academy of Sciences of the United States of America -Physical sciences	886
10	American Journal of Physiology-Regulatory Integrative and Comparative Physiology	792

Table 10 Top 10 highest frequency cited authors

Rank	Authors	Citations
1	Peter Bärtsch	382
P	Martin Burtscher	378
3	John B West	358
4	Beall Cynthia M	352
5	Jean-Paul Richalet	352
6	Hackett Peter	330
7	Lorna G Moore	265
8	Robert C Roach	261
9	Robert Naeije	235
10	Dante Penaloza	222

Table 11 Top 20 highest frequency keywords

Rank	Keyword	Occurrences	Total link strength
1	High altitude	598	2537
2	Hypoxia	559	2391
3	Exercise	269	1254
4	Acute mountain sickness	214	971
5	Adaptation	209	994
6	Heart	167	746
7	Acclimatization	137	728
8	Pulmonary hypertension	133	655
9	Heart rate	117	507
10	Blood pressure	104	526
11	Hypobaric hypoxia	101	528
12	Nitric oxide	99	442
13	Chronic hypoxia	93	432
14	Oxidative stress	90	408
15	Chronic mountain-sickness	80	375
16	Cardiac output	71	365
17	Intermittent hypoxia	66	190
18	Oxygen	56	170
19	Metabolism	54	149
20	Echocardiography	53	217

Table 12 Critical aspects of the cardiovascular system at high altitude

Rank	Keyword	Significant points
1	Hypoxia	Hypoxia emerges as the predominant characteristic among individuals residing at high altitudes
2	Exercise at high altitude	Exercise training is advocated for enhancing adaptation to high altitude
3	Pulmonary hypertension	Pulmonary artery pressure increases at high altitude due to vasoconstriction
4	Oxidative stress	Oxidative stress is activity at high altitude
5	Metabolomics	Metabolomics has offered novel perspectives on the pathophysiological mechanisms that underlie adaptations to early hypobaric hypoxia, as well as other diseases associated with tissue hypoxia
6	Adaptation/acclimatization	Adaptation or acclimatization occurs in individuals residing at high altitudes for extended periods, including indigenous populations
7	Echocardiography	Echocardiography serves as a valuable diagnostic tool for identifying cardiac diseases in high-altitude environments