No heartbreak at high altitude; preserved cardiac function in chronic hypoxia

High altitude hypoxia presents a series of challenges to the human heart due to concomitant changes in preload, afterload and contractility. This challenge is characterised by a decrease in blood volume due to plasma volume constriction, an increase in right ventricular afterload via hypoxic pulmonary vasoconstriction, and an increase in sympathetic nerve activity . As such, understanding how the heart adapts to this multifaceted challenge has been a topic of interest to physiologists and clinicians for decades. In the current issue of Experimental Physiology, Maufrais et al. (2019) use modern speckle tracking technology to investigate region-specific cardiac performance in chronic hypoxia.