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Altitude‐Induced Pulmonary Hypertension on One‐Day Rapid Ascent of Mount Fuji: Incidence and Therapeutic Effects of Sildenafil
Author(s) -
Iwase Masatsugu,
Itou Yoshihiro,
Takada Kayoko,
Shiino Kenji,
Kato Yasuchika,
Ozaki Yukio
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13189
Subject(s) - sildenafil , high altitude pulmonary edema , medicine , pulmonary hypertension , pulmonary artery , cardiology , effects of high altitude on humans , anesthesia , pulmonary edema , lung , anatomy
Aims Exposure to high altitudes especially with rapid ascent may induce hypoxic pulmonary vasoconstriction ( HPV ) and pulmonary hypertension ( PH ) possibly leading to life‐threatening high‐altitude pulmonary edema ( HAPE ). The aim of the study was to evaluate the incidence of PH on a 1‐day rapid ascent up Mount Fuji (3775 m) in recreational climbers and also to determine the effectiveness of sildenafil for this rapid ascent‐induced PH as measured by echocardiography. Methods and results Twenty‐five subjects who climbed Mount Fuji showed significantly increased pulmonary artery systolic pressure ( PASP ) from 22.3 ± 5.3 mmHg at sea level to 29.4 ± 8.7 mmHg at 3775 m. Five subjects showed PASP >35 mmHg (35.6–46.2 mmHg, average 42.0 ± 3.9 mmHg) and took oral sildenafil 50 mg after which PASP decreased significantly to 24.5 ± 4.6 mmHg (18.7–31.0 mmHg) after 30 minutes. Conclusions One‐day rapid ascent of Mount Fuji may induce mild‐to‐moderate PH and intervention with sildenafil can reduce this PH , suggesting that the therapeutic use of sildenafil would be more reasonable for the relatively infrequent occurrence of altitude‐induced PH than its prophylactic use.