[Comparison of echocardiographic parameters in healthy Chinese children born and living at high altitude or at sea-level].

OBJECTIVE: Chronic hypoxia at high altitude might result in cardiopulmonary adaptations including pulmonary arterial hypertension and cardiac remodeling. But little is known about the adaptive changes in healthy children born and living at high altitude. We compared the echocardiographic measurements between the healthy children living at 16 m (Shanghai, n = 220) and 3 700 m (Qinghai, total 257, Han children 117, Tibetan children 140). METHODS: Children's age ranged from 15 d to 14 years. Echocardiography measurements were performed, values of the left and right ventricular dimensions and wall thickness, systolic and diastolic function including cardiac output index (CI), as well as mean pulmonary arterial pressure (mPAP) were obtained. RESULTS: mPAP and right heart dimension, CI, right ventricular anterior wall thickness were significantly higher while ventricular systolic and diastolic function were significantly lower in 3 700 m group than in 16 m group (all P < 0.05). Left ventricular dimension was similar between the two groups. There were no differences on above measured parameters between the Han and Tibetan children from 3 700 m group (all P > 0.05). CONCLUSIONS: Children born and living at high altitude in China have significantly higher mPAP, dilated right heart and lower systolic and diastolic function of both ventricles and higher CI compared to children born and living at see-level. Above parameters were similar between the Han and the Tibetan childen born and living at high altitude. Present study provides reference values for the healthy children living at high altitude.

Anatomical and hemodynamic evaluations of the heart and pulmonary arterial pressure in healthy children residing at high altitude in China.

OBJECTIVES: Altitude-hypoxia induces pulmonary arterial hypertension and altered cardiac morphology and function, which is little known in healthy children at high altitude. We compared the cardiopulmonary measurements between the healthy children at 16 m and those at 3700 m in China and between the Hans and the Tibetans at 3700 m. METHODS: Echocardiography was assessed in 477 children (15 day-14 years) including 220 at 16 m and 257 at 3700 m. The dimensions and wall thickness of the left- and right-sided heart, systolic and diastolic functions including cardiac output index (CI) were measured using standard methods. Mean pulmonary arterial pressure (mPAP) was estimated by the Doppler waveforms in the main pulmonary artery. RESULTS: Compared to the 16 m-group, 3700 m-group had higher mPAP, increasing dilatation of the right heart, and slower decrease in right ventricular hypertrophy in 14 years (p < 0.05). The left heart morphology was not different (p > 0.20). Systolic and diastolic functions of both ventricles were significantly reduced, but CI was higher (p < 0.0001). There was no difference in any measurement between the Hans and the Tibetans (p > 0.05). CONCLUSIONS: Children living at high altitude in China have significantly higher mPAP, dilated right heart and slower regression of right ventricular hypertrophy in the first 14 years of life. Systolic and diastolic functions of both ventricles were reduced with a paradoxically higher CI. There was no significant difference in these features between the Hans and the Tibetans. These values provide references for the care of healthy children and the sick ones with cardiopulmonary diseases at high altitude.