Plasma endothelin-1 and nitric oxide correlate with ligustrazine alleviation of pulmonary artery hypertension in patients of chronic cor pulmonale from high altitude plateau during acute exacerbation / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.</p><p><b>METHODS</b>Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.</p><p><b>RESULTS</b>Good clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).</p><p><b>CONCLUSION</b>Ligustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.</p>

Relationship of high altitude de-adaptation with acute high altitude response and cardiac function / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To assess the relationship of high altitude de-adaptation response (HADAR) with acute high altitude response (AHAR) and cardiac function.</p><p><b>METHODS</b>Ninety-six military personnel of rapid entering into high altitude (3 700 to 4 800 m) with strong physical work were analyzed, all subjects were male, aged 18 - 35 years. According to the symptomatic scores of AHAR were divided into 3 groups: sever AHAR (group A, 24), mild to moderate AHAR (group B, 47) and non-AHAR (group C, 25) at high altitude. According to the symptomatic scores of HADAR were divided into 3 groups: severe HADAR (group E, 19), mild to moderate HADAR (group F, 40) and non-HADAR (group G, 37) after return to lower altitude (1 500 m). Mean pulmonary arterial pressure (mPAP), right ventricular internal dimension (RVID), outflow tract of right ventricle (RVOT), left ventricular internal dimension (LVID), left ventricular ejection fraction (LVEF), cardiac muscle work index (Tei index), creatine kinase isoenzymes-MB (CK-MB), lactic dehydrogenase isoenzyme-1 (LDH-1) were measured at high altitude stayed 50 days and after return to lower altitude 12 h, 15 d, and 30 d. Fifty healthy volunteers (group D) at 1 500 m altitude served as control.</p><p><b>RESULTS</b>Level of mPAP, RVID, RVOT, RVID/LVID ratio, Tei index, CK-MB,and LDH-1 were higher, and LVEF was lower in group A than those in group B, C and D, there were significant differences between group B and C, C and D (all P < 0.01). AHAR scores were positively correlated with HADAR scores (r = 0.863, P < 0.01). Twelve hours after return to lower altitude, level of mPAP, RVID, RVOT, RVI/LVID ratio, Tei index, CK-MB, and LDH-1 were higher, and LVEF was lower in group E than those in group F, G and D, there were significant differences between group F and G, G and D (all P < 0.01). Fifteen days after return to lower altitude, level of mPAP, RVID, RVOT, RVID/LVID ratio were higher in group E than those in group F, G, and D, there were significant differences between group F and G, and D (P < 0.01 or P < 0.05), there were no significant differences between group G and D (all P > 0.05), LVEF, Tei index, CK-MB, LDH-1 showed no significant differences among groups (all P > 0.05). Thirty days after return to lower altitude, these parameters in group E, F, and G showed no significantly differences compared with those of group D (all P > 0.05).</p><p><b>CONCLUSION</b>The severity of HADAR is associated with severity of AHAR and cardiac injury, the more serious of AHAR and cardiac injury at high altitude, the more serious of HADAR and cardiac injury after return to lower altitude, the more long of restore of right cardiac morphologic injury.</p>

De-adaptation change in cardiac function of laborers engaged in physical labor at high altitude after returning to lower altitude / 解放军医学杂志

Objective To assess the effects of physical labor on cardiac function of laborers at high altitude and changes in cardiac function after returning to lower altitude. Methods According to symptomatic scores on Chinese acute high altitude reaction (AHAR), 96 male officers and soldiers, who rapidly entered high altitude areas (3700m altitude),and engaged in heavy physical work for 50 days, were be scored and graded. Levels of creatine kinase isoenzymes -MB (CK-MB) and lactic dehydrogenase isoenzyme -1 (LDH-1) in the serum, Tei index, left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS) were measured in the 96 servicemen at the 50th day of residing at high altitude, and the 2nd and 15th day after returning to lower altitude (1500m altitude), and the results were compared with that of 50 healthy controls residing at 1500m. Results Among the 96 male servicemen, 71 developed AHAR, and 24 of them had severe AHAR, 47 mild to moderate AHAR, and the rest 25 had no AHAR. Levels of serum CK-MB, LDH-1 and Tei index were higher in the severe AHAR group than in the mild to moderate AHAR group, higher in the mild to moderate AHAR group than in the no AHAR group and higher in the no AHAR group than in the healthy group. As far as the values of LVEF and LVFS were concerned, the severe AHAR group 0.05). Conclusion Heavy physical work at high altitude could obviously impair human cardiac function. The impairment may aggravate along with increase in severity of AHAR. However, cardiac function may be improved significantly after returning to low altitude for 2 days, and recover to normal status 15 days later.

De-adaptation change in cardiac function of laborers engaged in physical labor at high altitude after returning to lower altitude / 解放军医学杂志

Objective To assess the effects of physical labor on cardiac function of laborers at high altitude and changes in cardiac function after returning to lower altitude. Methods According to symptomatic scores on Chinese acute high altitude reaction (AHAR), 96 male officers and soldiers, who rapidly entered high altitude areas (3700m altitude),and engaged in heavy physical work for 50 days, were be scored and graded. Levels of creatine kinase isoenzymes -MB (CK-MB) and lactic dehydrogenase isoenzyme -1 (LDH-1) in the serum, Tei index, left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS) were measured in the 96 servicemen at the 50th day of residing at high altitude, and the 2nd and 15th day after returning to lower altitude (1500m altitude), and the results were compared with that of 50 healthy controls residing at 1500m. Results Among the 96 male servicemen, 71 developed AHAR, and 24 of them had severe AHAR, 47 mild to moderate AHAR, and the rest 25 had no AHAR. Levels of serum CK-MB, LDH-1 and Tei index were higher in the severe AHAR group than in the mild to moderate AHAR group, higher in the mild to moderate AHAR group than in the no AHAR group and higher in the no AHAR group than in the healthy group. As far as the values of LVEF and LVFS were concerned, the severe AHAR group 0.05). Conclusion Heavy physical work at high altitude could obviously impair human cardiac function. The impairment may aggravate along with increase in severity of AHAR. However, cardiac function may be improved significantly after returning to low altitude for 2 days, and recover to normal status 15 days later.

Effect of oxidative stress in development of acute high altitude response during the process of strong physical work at high altitude / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To assess the effect of oxidative stress in development of acute high altitude response (AHAR) during the process of strong physical work at high altitude and its change after return to lower altitude.</p><p><b>METHODS</b>Ninety-six officers and soldiers of rapid entering into high altitude (3 700 m) with strong physical work were analyzed, all subjects were male, aged 18-35 years. According to the symptomatic scores of AHAR were divided into 3 groups: severe AHAR (group A, n = 24), mild AHAR (group B, n = 47) and without AHAR (group C, n = 25). Levels in serum 8-iso prostaglandinF2alpha(8-iso-PGF2alpha), superoxide dismutase (SOD) and malonaldehyde (MDA) were measured at higher altitude stayed 50 d and after return to lower altitude (1 500 m) 12 h and 15 d, and 50 healthy volunteers (group D) at 1 500 m altitude served as controll.</p><p><b>RESULTS</b>Levels of serum 8-iso-PGF2alpha and MDA [(9.53 +/- 0.47) microg/L, (8.91 +/- 0.39) micromol/L] were significantly higher in group A than those in group B [(8.34 +/- 0.42) microg/L, (7.31 +/- 0.32) micromol/L] , group C [(7.02 +/- 0.48) microg/L, (6.41 +/- 0.23) micromol/L] and group D [(5.13 +/- 0.56) microg/L, (5.48 +/- 0.33) micromol/L], (all P < 0.01), and serum SOD [(52.08 +/- 3.44) micro/ml] was significantly lower in group A than that in group B [62.27 +/- 2.54) micro/ml], group C [(71.99 +/- 3.35) micro/ml] and group D [(80.78 +/- 3.44) micro/ ml] (all P < 0.01), there were significant differences between group B and C, C and D (all P < 0.01). At altitude 3 700 m 50 d, AHAR scores was positively correlated with serum 8-iso-PGF2alpha and MDA (all P < 0.01), negatively correlated with SOD (P < 0.01). Serum 8-iso-PGF2alpha and MDA were negatively correlated with SOD (all P < 0.01). Levels of serum 8-iso-PGF2alpha and MDA were significantly higher at altitude of 3 700 m 50 d than those at altitude of 1 500 m 12 h,15 d in group D (all P < 0.01), and serum SOD was significantly lower than that at 1 500 m 12 h,15 d in group D (all P < 0.01), there were significantly difference between at 1 500 m 12 h and 15 d (all P < 0.01), there were no difference between at 15 d in group D (all P > 0.05).</p><p><b>CONCLUSION</b>The more serious of oxidative stress and oxidative/antioxidative imbalance, the more serious of AHAR, oxidative stress and oxidative/antioxidative imbalance may be involved in the development of AHAR. The changes were obviously improved after return to lower altitude 12 h, and recovered to normal after 15 d.</p>