PT  - JOURNAL ARTICLE
AU  - Simon Raphael Schneider
AU  - Laura C Mayer
AU  - Mona Lichtblau
AU  - Charlotte Berlier
AU  - Esther I Schwarz
AU  - Stéphanie Saxer
AU  - Lu Tan
AU  - Konrad E Bloch
AU  - Silvia Ulrich
TI  - Effects of a daytrip to high altitude (2500m) in pulmonary hypertension
AID  - 10.1183/13993003.congress-2021.PA3605
DP  - 2021 Sep 05
TA  - European Respiratory Journal
PG  - PA3605
VI  - 58
IP  - suppl 65
4099  - http://erj.ersjournals.com/content/58/suppl_65/PA3605.short
4100  - http://erj.ersjournals.com/content/58/suppl_65/PA3605.full
SO  - Eur Respir J2021 Sep 05; 58
AB  - Aims and objectives: To investigate exercise performance and hypoxia-related health effects in patients with pulmonary hypertension (PH) during a high-altitude sojourn.Methods: In a randomized crossover trial in patients with pulmonary arterial or chronic thromboembolic PH (PAH/CTEPH) who were stable on therapy with resting PaO2 ≥7.3kPa, we compared symptom-limited constant work-rate exercise test (CWRET) cycling time during a daytrip to 2500m vs. 470m. Further outcomes were symptoms, oxygenation and echocardiography. For safety, patients with sustained hypoxemia at altitude (SpO2<80% for >30 or <75% for >15min) received oxygen therapy.Results: 28 PAH/CTEPH (15/13)-patients, 13 females, mean±SD age 63±15y were included. After >3h at 2500m vs. 470m, CWRET-time was reduced to 17±11 vs. 24±9min (mean-difference (95%CI) -6(-10 to -3) corresponding to -27.6% (-41.1 to -14.1) p<0.001 but similar Borg-dyspnea scale. At altitude, PaO2 was significantly lower (7.3±0.8 vs. 10.4±1.5kPa; -3.2(-3.6 to -2.8)), whereas heart rate and tricuspid regurgitation pressure gradient (TRPG) were higher (86±18 vs. 71±16 bpm; 15(7 to 23) and 56±25 vs. 40±15 mmHg; (17(9 to 24)) and remained so until end-exercise, all p<0.001. The TRPG/cardiac output slope during exercise was similar at both altitudes. Overall, 3/28 (11%) patients received oxygen at 2500m due to hypoxemia.Conclusion: This randomized cross-over study showed that the majority of PH-patients tolerate a daytrip to 2500m well. At high vs. low altitude, the mean exercise time was reduced, albeit with a high inter-individual variability, and pulmonary artery pressure at rest and during exercise increased, but pressure-flow slope and dyspnea sensation were unchanged.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3605.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).