Mechanisms underlying reductions in stroke volume at rest and during exercise at high altitude

European Journal of Sport Science
Mike StembridgeRob Shave

Abstract

High-altitude exposure challenges the cardiovascular system to maintain oxygen delivery to the mitochondria under conditions of hypoxic stress. Following acclimatisation (3-5 days), stroke volume (SV) falls to below sea-level values but heart rate remains elevated, such that cardiac output is maintained compared to sea level. The decrease in SV has been a topic of research for over 40 years, but the underlying mechanisms are incompletely understood. Impaired systolic contractile function secondary to reduced coronary arterial oxygen tension has been investigated as a potential cause for the decrease in SV. However, despite in vitro evidence of impaired cardiac contractile force in severe hypoxia, the majority of studies to date have reported enhanced in vivo ventricular systolic function at rest and during exercise in humans up to and above 5000 m. However, the elevated function observed at rest has recently been suggested to reduce the functional reserve available during exercise. While in vivo systolic function appears enhanced at high altitude, a decrease in left ventricular end-diastolic volume (EDV) and altered filling patterns of both ventricles has been observed. The reduction in ventricular filling will undoubtedly affe...Continue Reading

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Citations

Apr 5, 2016·Travel Medicine and Infectious Disease·Gerard FlahertyNiall Johnston
Mar 16, 2017·High Altitude Medicine & Biology·Callum James Riley, Matthew Gavin
Jan 19, 2020·The International Journal of Cardiovascular Imaging·Jingdu TianLan Huang
May 21, 2020·International Journal of Environmental Research and Public Health·Iker GarcíaGinés Viscor
Feb 7, 2021·The International Journal of Cardiovascular Imaging·Chunyan HeLan Huang
May 1, 2021·Journal of Clinical Medicine·Karolina MikołajczakMałgorzata Poręba
May 11, 2021·Frontiers in Physiology·Sara MagnaniAntonio Crisafulli

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