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  • 1
    Language: English
    In: The Journal of physiology, 2019-05-15, Vol.597 (10), p.2623-2638
    Description: Key points A physiological response to increase microcirculatory oxygen extraction capacity at high altitude is to recruit capillaries. In the present study, we report that high altitude‐induced sublingual capillary recruitment is an intrinsic mechanism of the sublingual microcirculation that is independent of changes in cardiac output, arterial blood pressure or systemic vascular hindrance. Using a topical nitroglycerin challenge to the sublingual microcirculation, we show that high altitude‐related capillary recruitment is a functional response of the sublingual microcirculation as opposed to an anatomical response associated with angiogenesis. The concurrent presence of a low capillary density and high microvascular reactivity to topical nitroglycerin at sea level was found to be associated with a failure to reach the summit, whereas the presence of a high baseline capillary density with the ability to further increase maximum recruitable capillary density upon ascent to an extreme altitude was associated with summit success. A high altitude (HA) stay is associated with an increase in sublingual capillary total vessel density (TVD), suggesting microvascular recruitment. We hypothesized that microvascular recruitment occurs independent of cardiac output changes, that it relies on haemodynamic changes within the microcirculation as opposed to structural changes and that microcirculatory function is related to individual performance at HA. In 41 healthy subjects, sublingual handheld vital microscopy and echocardiography were performed at sea level (SL), as well as at 6022 m (C2) and 7042 m (C3), during ascent to 7126 m within 21 days. Sublingual topical nitroglycerin was applied to measure microvascular reactivity and maximum recruitable TVD (TVDNG). HA exposure decreased resting cardiac output, whereas TVD (mean ± SD) increased from 18.81 ± 3.92 to 20.92 ± 3.66 and 21.25 ± 2.27 mm mm−2 (P 〈 0.01). The difference between TVD and TVDNG was 2.28 ± 4.59 mm mm−2 at SL (P 〈 0.01) but remained undetectable at HA. Maximal TVDNG was observed at C3. Those who reached the summit (n = 15) demonstrated higher TVD at SL (P 〈 0.01), comparable to TVDNG in non‐summiters (n = 21) at SL and in both groups at C2. Recruitment of sublingual capillary TVD to increase microcirculatory oxygen extraction capacity at HA was found to be an intrinsic mechanism of the microcirculation independent of cardiac output changes. Microvascular reactivity to topical nitroglycerin demonstrated that HA‐related capillary recruitment is a functional response as opposed to a structural change. The performance of the vascular microcirculation needed to reach the summit was found to be associated with a higher TVD at SL and the ability to further increase TVDNG upon ascent to extreme altitude. Key points A physiological response to increase microcirculatory oxygen extraction capacity at high altitude is to recruit capillaries. In the present study, we report that high altitude‐induced sublingual capillary recruitment is an intrinsic mechanism of the sublingual microcirculation that is independent of changes in cardiac output, arterial blood pressure or systemic vascular hindrance. Using a topical nitroglycerin challenge to the sublingual microcirculation, we show that high altitude‐related capillary recruitment is a functional response of the sublingual microcirculation as opposed to an anatomical response associated with angiogenesis. The concurrent presence of a low capillary density and high microvascular reactivity to topical nitroglycerin at sea level was found to be associated with a failure to reach the summit, whereas the presence of a high baseline capillary density with the ability to further increase maximum recruitable capillary density upon ascent to an extreme altitude was associated with summit success.
    Subject(s): Adult ; Altitude ; Animals ; Capacity ; capillary density ; Cardiovascular ; Cohort Studies ; Female ; hand‐held video microscopy ; hemodynamic monitoring ; Humans ; hypoxia ; Life Sciences & Biomedicine ; Male ; Mice ; microcirculation ; Microcirculation - physiology ; Middle Aged ; Mouth Floor - blood supply ; Neurosciences ; Neurosciences & Neurology ; Nitrates ; Nitroglycerin - pharmacology ; Oxygen - metabolism ; Physiology ; Research Paper ; Science & Technology ; vascular reactivity ; Vasodilator Agents - pharmacology
    ISSN: 0022-3751
    E-ISSN: 1469-7793
    Source: Hellenic Academic Libraries Link
    Source: Web of Science - Science Citation Index Expanded - 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: PubMed Central
    Source: Web of Science - Social Sciences Citation Index – 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
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  • 2
    Language: English
    In: PloS one, 2015, Vol.10 (10), p.e0141097-e0141097
    Description: Findings of cerebral cortical atrophy, white matter lesions and microhemorrhages have been reported in high-altitude climbers. The aim of this study was to evaluate structural cerebral changes in a large cohort of climbers after an ascent to extreme altitudes and to correlate these findings with the severity of hypoxia and neurological signs during the climb. Magnetic resonance imaging (MRI) studies were performed in 38 mountaineers before and after participating in a high altitude (7126 m) climbing expedition. The imaging studies were assessed for occurrence of new WM hyperintensities and microhemorrhages. Changes of partial volume estimates of cerebrospinal fluid, grey matter, and white matter were evaluated by voxel-based morphometry. Arterial oxygen saturation and acute mountain sickness scores were recorded daily during the climb. On post-expedition imaging no new white matter hyperintensities were observed. Compared to baseline testing, we observed a significant cerebrospinal fluid fraction increase (0.34% [95% CI 0.10-0.58], p = 0.006) and a white matter fraction reduction (-0.18% [95% CI -0.32--0.04], p = 0.012), whereas the grey matter fraction remained stable (0.16% [95% CI -0.46-0.13], p = 0.278). Post-expedition imaging revealed new microhemorrhages in 3 of 15 climbers reaching an altitude of over 7000 m. Affected climbers had significantly lower oxygen saturation values but not higher acute mountain sickness scores than climbers without microhemorrhages. A single sojourn to extreme altitudes is not associated with development of focal white matter hyperintensities and grey matter atrophy but leads to a decrease in brain white matter fraction. Microhemorrhages indicative of substantial blood-brain barrier disruption occur in a significant number of climbers attaining extreme altitudes.
    Subject(s): Altitude ; Altitude Sickness ; Anorexia ; Ascent ; Atrophy ; Blood-brain barrier ; Brain ; Brain - cytology ; Brain research ; Cerebrospinal fluid ; Cohort Studies ; Cortex ; Edema ; Environmental aspects ; Expeditions ; Extreme values ; Fourier transforms ; Gray Matter - cytology ; High altitude ; High-altitude environments ; Hospitals ; Humans ; Hypoxia ; Illnesses ; Intensive care ; Lesions ; Magnetic resonance ; Magnetic Resonance Imaging ; Medicine ; Morphometry ; Mountaineering ; Neuroimaging ; Neurosciences ; NMR ; Nuclear magnetic resonance ; Oxidative stress ; Oxygen ; Oxygen content ; Physiological aspects ; Physiological research ; Physiology ; Prospective Studies ; Saturation ; Sleep apnea ; Studies ; Substantia alba ; Substantia grisea
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 3
    Language: English
    In: European journal of applied physiology, 2013-04-06, Vol.113 (8), p.2025-2037
    Description: Impairment of cognitive performance during and after high-altitude climbing has been described in numerous studies and has mostly been attributed to cerebral hypoxia and resulting functional and structural cerebral alterations. To investigate the hypothesis that high-altitude climbing leads to cognitive impairment, we used of neuropsychological tests and measurements of eye movement (EM) performance during different stimulus conditions. The study was conducted in 32 mountaineers participating in an expedition to Muztagh Ata (7,546 m). Neuropsychological tests comprised figural fluency, line bisection, letter and number cancellation, and a modified pegboard task. Saccadic performance was evaluated under three stimulus conditions with varying degrees of cortical involvement: visually guided pro- and anti-saccades, and visuo-visual interaction. Typical saccade parameters (latency, mean sequence, post-saccadic stability, and error rate) were computed off-line. Measurements were taken at a baseline level of 440 m and at altitudes of 4,497, 5,533, 6,265, and again at 440 m. All subjects reached 5,533 m, and 28 reached 6,265 m. The neuropsychological test results did not reveal any cognitive impairment. Complete eye movement recordings for all stimulus conditions were obtained in 24 subjects at baseline and at least two altitudes and in 10 subjects at baseline and all altitudes. Measurements of saccade performances showed no dependence on any altitude-related parameter and were well within normal limits. Our data indicates that acclimatized climbers do not seem to suffer from significant cognitive deficits during or after climbs to altitudes above 7,500 m. We demonstrated that investigation of EMs is feasible during high-altitude expeditions.
    Subject(s): Adult ; Altitude ; Biomedical and Life Sciences ; Biomedicine ; Cognition ; Cognitive function ; Female ; High altitude ; Human Physiology ; Humans ; Hypoxia ; Male ; Middle Aged ; Mountaineering - physiology ; Neuropsychological testing ; Neuropsychological Tests ; Occupational Medicine/Industrial Medicine ; Original Article ; Saccades ; Saccadic eye movement ; Sports Medicine
    ISSN: 1439-6319
    E-ISSN: 1439-6327
    Source: Alma/SFX Local Collection
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  • 4
    Language: English
    In: American journal of respiratory and critical care medicine, 2010, Vol.182 (4), p.562-568
    Description: Quantitative data on ventilation during acclimatization at very high altitude are scant. Therefore, we monitored nocturnal ventilation and oxygen saturation in mountaineers ascending Mt. Muztagh Ata (7,546 m). To investigate whether periodic breathing persists during prolonged stay at very high altitude. A total of 34 mountaineers (median age, 46 yr; 7 women) climbed from 3,750 m within 19-20 days to the summit at 7,546 m. During ascent, repeated nocturnal recordings of calibrated respiratory inductive plethysmography, pulse oximetry, and scores of acute mountain sickness were obtained. Nocturnal oxygen saturation decreased, whereas minute ventilation and the number of periodic breathing cycles increased with increasing altitude. At the highest camp (6,850 m), median nocturnal oxygen saturation, minute ventilation, and the number of periodic breathing cycles were 64%, 11.3 L/min, and 132.3 cycles/h. Repeated recordings within 5-8 days at 4,497 m and 5,533 m, respectively, revealed increased oxygen saturation, but no decrease in periodic breathing. The number of periodic breathing cycles was positively correlated with days of acclimatization, even when controlled for altitude, oxygen saturation, and other potential confounders, whereas symptoms of acute mountain sickness had no independent effect on periodic breathing. Our field study provides novel data on nocturnal oxygen saturation, breathing patterns, and ventilation at very high altitude. It demonstrates that periodic breathing increases during acclimatization over 2 weeks at altitudes greater than 3,730 m, despite improved oxygen saturation consistent with a progressive increase in loop gain of the respiratory control system. Clinical trial registered with www.clinicaltrials.gov (NCT00514826).
    Subject(s): Abridged Index Medicus ; Acclimatization - physiology ; Adult ; Aged ; Altitude Sickness - complications ; Altitude Sickness - diagnosis ; Altitude Sickness - physiopathology ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; China ; Emergency and intensive respiratory care ; Female ; Humans ; Hypoxia - complications ; Hypoxia - diagnosis ; Hypoxia - physiopathology ; Intensive care medicine ; Male ; Medical sciences ; Middle Aged ; Mountaineering - physiology ; Oximetry - methods ; Oxygen Consumption - physiology ; Plethysmography - methods ; Plethysmography - statistics & numerical data ; Polysomnography - methods ; Polysomnography - statistics & numerical data ; Respiration ; Sleep Apnea, Central - complications ; Sleep Apnea, Central - diagnosis ; Sleep Apnea, Central - physiopathology
    ISSN: 1073-449X
    E-ISSN: 1535-4970
    Source: ProQuest Central
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  • 5
    Language: English
    In: European journal of applied physiology, 2016-01-28, Vol.116 (4), p.739-748
    Description: Purpose Hypoxia and oxidative stress affect endothelial function. Endothelial microparticles (MP) are established measures of endothelial dysfunction and influence vascular reactivity. To evaluate the effects of hypoxia and antioxidant supplementation on endothelial MP profiles, a double-blind, placebo-controlled trial, during a high altitude expedition was performed. Methods 29 participants were randomly assigned to a treatment group ( n  = 14), receiving vitamin E, C, A, and N -acetylcysteine daily, and a control group ( n  = 15), receiving placebo. Blood samples were obtained at 490 m (baseline), 3530, 4590, and 6210 m. A sensitive tandem mass spectrometry method was used to measure 8-iso-prostaglandin F 2α and hydroxyoctadecadienoic acids as markers of oxidative stress. Assessment of MP profiles including endothelial activation markers (CD62+MP and CD144+MP) and cell apoptosis markers (phosphatidylserine+MP and CD31+MP) was performed using a standardized flow cytometry-based protocol. Results 15 subjects reached all altitudes and were included in the final analysis. Oxidative stress increased significantly at altitude. No statistically significant changes were observed comparing baseline to altitude measurements of phosphatidylserine expressing MP ( p  = 0.1718) and CD31+MP ( p  = 0.1305). Compared to baseline measurements, a significant increase in CD62+MP ( p  = 0.0079) and of CD144+MP was detected ( p  = 0.0315) at high altitudes. No significant difference in any MP level or oxidative stress markers were found between the treatment and the control group. Conclusion Hypobaric hypoxia is associated with increased oxidative stress and induces a significant increase in CD62+ and CD144+MP, whereas phosphatidylserine+MP and CD31+MP remain unchanged. This indicates that endothelial activation rather than an apoptosis is the primary factor of hypoxia induced endothelial dysfunction.
    Subject(s): Acetylcysteine - administration & dosage ; Acetylcysteine - therapeutic use ; Adult ; Altitude ; Antioxidants - administration & dosage ; Antioxidants - therapeutic use ; Apoptosis ; Biomarkers - blood ; Biomedical and Life Sciences ; Biomedicine ; Cell-Derived Microparticles - pathology ; Double-Blind Method ; Endothelial dysfunction ; Endothelium, Vascular - pathology ; Endothelium, Vascular - physiopathology ; Extreme altitude ; Female ; Human Physiology ; Humans ; Hypoxia ; Hypoxia - blood ; Hypoxia - drug therapy ; Hypoxia - etiology ; Male ; Microparticles ; Middle Aged ; Occupational Medicine/Industrial Medicine ; Original Article ; Oxidative Stress ; Prostaglandins - blood ; Sports Medicine ; Vitamins - administration & dosage ; Vitamins - therapeutic use
    ISSN: 1439-6319
    E-ISSN: 1439-6327
    Source: Alma/SFX Local Collection
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  • 6
    Language: English
    In: PloS one, 2019-08-01, Vol.14 (8), p.e0220133-e0220133
    Description: BACKGROUNDHypobaric hypoxia has been reported to cause endothelial cell and platelet dysfunction implicated in the formation of microvascular lesions, and in its extremes may contribute to vascular leakage in high altitude pulmonary edema or blood brain barrier disruption leading to cerebral micro-hemorrhage (MH). Platelet function in the development of microvascular lesions remained ill defined, and is still incompletely understood. In this study platelet- and endothelial cell-derived extracellular vesicles (PEV and EEV, respectively) and cell adhesion molecules were characterized in plasma samples of members of a high altitude expedition to delineate the contribution of platelets and endothelial cells to hypobaric hypoxia-induced vascular dysfunction. METHODS AND FINDINGSIn this observational study, platelet and endothelial cell-derived extracellular vesicles were analysed by flow-cytometry in plasma samples from 39 mountaineers participating in a medical research climbing expedition to Himlung Himal, Nepal, 7,050m asl. Megakaryocyte/platelet-derived AnnexinVpos, PECAM-1 (CD31) and glycoprotein-1b (GP1b, CD42b) positive extracellular vesicles (PEV) constituted the predominant fraction of EV in plasma samples up to 6,050m asl. Exposure to an altitude of 7,050m led to a marked decline of CD31pos CD42neg EEV as well as of CD31pos CD42bpos PEV at the same time giving rise to a quantitatively prevailing CD31neg CD42blow/neg subpopulation of AnnexinVpos EV. An almost hundredfold increase in the numbers of this previously unrecognized population of CD31neg CD42blow/neg EV was observed in all participants reaching 7,050m asl. CONCLUSIONSThe emergence of CD31neg CD42blow/neg EV was observed in all participants and thus represents an early hypoxic marker at extreme altitude. Since CD31 and CD42b are required for platelet-endothelial cell interactions, these hypobaric hypoxia-dependent quantitative and phenotypic changes of AnnexinVpos EV subpopulations may serve as early and sensitive indicators of compromised vascular homeostasis.
    Subject(s): Aging ; Altitude ; Biology and Life Sciences ; Blood platelets ; Blood-brain barrier ; Brain ; CD31 antigen ; Cell adhesion ; Cell adhesion & migration ; Cell adhesion molecules ; Cell interactions ; Climbing ; Cytometry ; Diabetes ; Disruption ; Edema ; Emergence ; Endothelial cells ; Expeditions ; Glycoproteins ; Hemorrhage ; High altitude ; High-altitude environments ; Homeostasis ; Hospitals ; Hygiene ; Hypoxia ; Immunology ; Intensive care ; Lesions ; Medical research ; Medicine ; Medicine and Health Sciences ; Microvasculature ; NMR ; Nuclear magnetic resonance ; Platelets ; Research and Analysis Methods ; Subpopulations ; Tumor necrosis factor-TNF ; Vesicles
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 7
    Language: English
    In: Sports medicine and health science, 2021-06-01, Vol.3 (2), p.59-69
    Description: Areas at high-altitude, annually attract millions of tourists, skiers, trekkers, and climbers. If not adequately prepared and not considering certain ascent rules, a considerable proportion of those people will suffer from acute mountain sickness (AMS) or even from life-threatening high-altitude cerebral (HACE) or/and pulmonary edema (HAPE). Reduced inspired oxygen partial pressure with gain in altitude and consequently reduced oxygen availability is primarily responsible for getting sick in this setting. Appropriate acclimatization by slowly raising the hypoxic stimulus (e.g., slow ascent to high altitude) and/or repeated exposures to altitude or artificial, normobaric hypoxia will largely prevent those illnesses. Understanding physiological mechanisms of acclimatization and pathophysiological mechanisms of high-altitude diseases, knowledge of symptoms and signs, treatment and prevention strategies will largely contribute to the risk reduction and increased safety, success and enjoyment at high altitude. Thus, this review is intended to provide a sound basis for both physicians counseling high-altitude visitors and high-altitude visitors themselves.
    Subject(s): Acute mountain sickness ; Altitude ; Climbing ; Disease ; Hypoxia ; Trekking
    ISSN: 2666-3376
    E-ISSN: 2666-3376
    Source: Alma/SFX Local Collection
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  • 8
    Language: English
    In: American journal of physiology: endocrinology and metabolism, 2020-02-01, Vol.318 (2), p.E297-E309
    Description: As a model of extreme conditions, eight healthy women, part of a 40-member Nepal mountain-climbing expedition, were monitored for dynamic endocrine adaptations. Endocrine measurements were made at frequent intervals over a 6-10-h period at four altitudes: 450 m, 4,800 m (base camp), 6,050 m, and again at 4,800 m (on descent) after an acclimatization (A) period (4,800 mA). Quantified hormones were growth hormone (GH), prolactin (PROL), cortisol (Cort), thyroid-stimulating hormone (TSH), and free thyroxine. These hormones are important to the anabolic/catabolic balance of the body, and are vital to growth, homeostasis, hypothalamic inhibition, regulation of stress, and metabolism. A key secondary question was the degree to which acclimatization can stabilize hormonal disruption. On the basis of statistical false discovery rates, the present analyses unveil marked adaptive changes in the thyroid axis at the level of pulsatile secretion of the pituitary hormone TSH and its downstream product, free thyroxine; strong effects on the mass of GH, TSH, Cort, and PROL secretion per burst; and prominent pulsatile frequency disruption and recovery for PROL and Cort. Because pulsatility changes reflect de facto perturbations in hypothalamo-pituitary control mechanisms, the present data introduce the concept of both frequency- and amplitude-dependent adaptive control of brain-pituitary neuroendocrine signals under conditions of extreme altitude exertion and exposure.
    Subject(s): Acclimatization ; Adaptation, Physiological ; Adult ; Altitude ; Endocrine System - physiology ; Female ; Human Growth Hormone - blood ; Humans ; Hydrocortisone - blood ; Hypothalamo-Hypophyseal System - metabolism ; Hypothalamo-Hypophyseal System - physiology ; Hypoxia - metabolism ; Mountaineering ; Pituitary-Adrenal System - metabolism ; Pituitary-Adrenal System - physiology ; Prolactin - blood ; Thyroid Hormones - blood
    ISSN: 0193-1849
    E-ISSN: 1522-1555
    Source: HighWire Press (Free Journals)
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 9
    Language: English
    In: American journal of physiology. Lung cellular and molecular physiology, 2018-01-01, Vol.314 (1), p.L157-L164
    Description: In vitro and animal studies revealed micro-RNAs (miRs) to be involved in modulation of hypoxia-induced pulmonary hypertension (HPH). However, knowledge of circulating miRs in humans in the context of HPH is very limited. Since symptoms of HPH are nonspecific and noninvasive diagnostic parameters do not exist, a disease-specific and hypoxemia-independent biomarker indicating HPH would be of clinical value. To examine whether plasma miR levels correlate with hypoxia-induced increase in pulmonary artery pressures, plasma miRs were assessed in a model of hypoxia-related pulmonary hypertension in humans exposed to extreme altitude. Forty healthy volunteers were repetitively examined during a high-altitude expedition up to an altitude of 7,050 m. Plasma levels of miR-17, -21, and -190 were measured by real-time quantitative PCR and correlated with systolic pulmonary artery pressure (SPAP), which was assessed by echocardiography. A significant altitude-dependent increase in circulating miR expression was found (all P values 〈 0.0001). Compared with baseline at 500 m, miR-17 changed by 4.72 ± 0.57-fold, miR-21 changed by 1.91 ± 0.33-fold, and miR-190 changed by 3.61 ± 0.54-fold at 7,050 m (means ± SD). Even after adjusting for hypoxemia, miR-17 and miR-190 were found to be independently correlated with increased SPAP. Progressive hypobaric hypoxia significantly affects levels of circulating miR-17, -21, and -190. Independently from the extent of hypoxemia, miR-17 and -190 significantly correlate with increased SPAP. These novel findings provide evidence for an epigenetic modulation of hypoxia-induced increase in pulmonary artery pressures by miR-17 and -190 and suggest the potential value of these miRs as biomarkers for HPH.
    Subject(s): Adolescent ; Adult ; Aged ; Altitude ; Altitude Sickness - complications ; Female ; Humans ; Hypertension, Pulmonary - blood ; Hypertension, Pulmonary - etiology ; Hypertension, Pulmonary - pathology ; Hypoxia - physiopathology ; Male ; MicroRNAs - blood ; MicroRNAs - genetics ; Middle Aged ; Pulmonary Artery - metabolism ; Pulmonary Artery - pathology ; Young Adult
    ISSN: 1040-0605
    E-ISSN: 1522-1504
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 10
    Language: English
    In: Sleep medicine, 2017, Vol.37, p.201-207
    Description: Abstract Background In May 2015, the results of the SERVE-HF trial - addressing adaptive servoventilation (ASV) in chronic heart failure (CHF) patients with central sleep apnea (CSA) - prompted a field safety notice. It was recommended to identify CHF patients treated with ASV and to advise the discontinuation of the treatment. We aimed to analyze the identification process and effect of ASV discontinuation on affected patients. Methods 126 patients treated with ASV on May 13th , 2015 at our institution were retrospectively analyzed. Treatment decisions, effect of ASV discontinuation and clinical course were followed for a year. Patients on ASV with CHF were compared to those without CHF. Results The risk criteria of the safety notice were fulfilled by 10.3% of patients (13/126). Additional echocardiographies were performed in 38%. ASV was discontinued in 93% of patients without adverse events (emergency hospitalization in n=1). CSA reappeared immediately. Day- or nighttime symptoms were reported by 61%. Symptomatic patients were started on alternative treatments. CHF and non-CHF patients differed in cardiac function and type of SDB. CHF patients had shorter overall treatment duration. Compliance to ASV was similar in both groups with a median usage of 412 min. (269; 495)/night in the CHF group and 414.5 min. (347; 480) in the non-CHF group. Conclusion Identification of patients “at risk” is feasible but outcome of discontinuation of ASV cannot be evaluated based on these data. ASV withdrawal in patients with stable chronic CHF and CSA leads to an immediate return of sleep disordered breathing. Symptomatic patients may ask for alternative treatment options.
    Subject(s): Adaptive servoventilation ; Aged ; Aged, 80 and over ; ASV discontinuation ; Cardiac patients ; Central sleep apnea ; Feasibility Studies ; Female ; Follow-Up Studies ; Heart failure ; Heart Failure - complications ; Heart Failure - therapy ; Humans ; Interactive Ventilatory Support - adverse effects ; Male ; Middle Aged ; Neurology ; Patient Safety ; Positive-Pressure Respiration - adverse effects ; Retrospective Studies ; Risk Assessment ; Safety and security measures ; SERVE-HF ; Sleep ; Sleep apnea syndromes ; Sleep Apnea, Central - complications ; Sleep Apnea, Central - therapy ; Sleep disordered breathing ; Sleep Medicine ; Treatment Outcome
    ISSN: 1389-9457
    E-ISSN: 1878-5506
    Source: ScienceDirect Journals
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