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Cardiopulmonary response to high‐altitude mountaineering in lung transplant recipients—The Jebel Toubkal experience
Author(s) -
Schrutka Lore,
Slama Alexis,
Muehlbacher Jakob,
Bessa Vasiliki,
Lichtenegger Paul,
Ghimessy Áron,
Ebenbichler Gerold,
Winkler Roland,
Faybik Peter,
Nachbaur Edith,
Aigner Clemens,
Hoetzenecker Konrad,
Jaksch Peter,
Benazzo Alberto
Publication year - 2021
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.14008
Subject(s) - medicine , lung , effects of high altitude on humans , cardiology , pulmonary function testing , lung transplantation , anatomy
Objectives Only a small proportion of lung transplant recipients achieve a physical status comparable to healthy individuals in the long term. It is reasonable to hypothesize that the necessary cardiopulmonary adaptation required for strenuous physical exercise may be impaired. Exposure to high altitude provides an optimal platform to study the physiological cardiopulmonary adaptation in lung transplant recipients under aerobic conditions. To gain a deeper understanding, 14 healthy lung transplant recipients and healthcare professionals climbed the highest peak in North Africa (Mount Jebel Toubkal; 4167 m) in September 2019. Methods Monitoring included daily assessment of vital signs, repeated transthoracic echocardiography, pulmonary function tests, and capillary blood sampling throughout the expedition. Results Eleven out of fourteen lung transplant recipients reached the summit. All recipients showed a stable lung function and vital parameters and physiological adaptation of blood gases. Similar results were found in healthy controls. Lung transplant recipients showed worse results in the 6‐minute walk test at low and high altitude compared to controls (day 1: 662 m vs. 725 m, p  < 0.001, day 5: 656 m vs. 700 m, p  = 0.033) and a lack of contractile adaptation of right ventricular function with increasing altitude as measured by tricuspid plane systolic excursion on echocardiography (day 2: 22 mm vs. 24 mm, p  = 0.202, day 5: 23 mm vs. 26 mm, p  = 0.035). Conclusions Strenuous exercise in healthy lung transplant recipients is safe. However, the poorer cardiopulmonary performance in the 6‐minute walk test and the lack of right ventricular cardiac adaptation may indicate underlying autonomic dysregulation.

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