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Pulmonary Hypertension in High-Altitude Dwellers: Novel Mechanisms, Unsuspected Predisposing Factors

  • Urs Scherrer
  • Pierre Turini
  • Sébastien Thalmann
  • Damian Hutter
  • Carlos Salinas Salmon
  • Thomas Stuber
  • Sidney Shaw
  • Pierre -Yves Jayet
  • Céline Sartori-Cucchia
  • Mercedes Villena
  • Yves Allemann
  • Claudio Sartori
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 588)

Abstract

Studies of high-altitude populations, and in particular of maladapted subgroups, may provide important insight into underlying mechanisms involved in the pathogenesis of hypoxemia-related disease states in general. Over the past decade, studies involving short-term hypoxic exposure have greatly advanced our knowledge regarding underlying mechanisms and predisposing events of hypoxic pulmonary hypertension. Studies in high altitude pulmonary edema (HAPE)-prone subjects, a condition characterized by exaggerated hypoxic pulmonary hypertension, have provided evidence for the central role of pulmonary vascular endothelial and respiratory epithelial nitric oxide (NO) for pulmonary artery pressure homeostasis. More recently, it has been shown that pathological events during the perinatal period (possibly by impairing pulmonary NO synthesis), predispose to exaggerated hypoxic pulmonary hypertension later in life. In an attempt to translate some of this new knowledge to the understanding of underlying mechanisms and predisposing events of chronic hypoxic pulmonary hypertension, we have recently initiated a series of studies among high-risk subpopulations (experiments of nature) of high-altitude dwellers. These studies have allowed to identify novel risk factors and underlying mechanisms that may predispose to sustained hypoxic pulmonary hypertension. The aim of this article is to briefly review this new data, and demonstrate that insufficient NO synthesis/bioavailability, possibly related in part to augmented oxidative stress, may represent an important underlying mechanism predisposing to pulmonary hypertension in high-altitude dwellers.

Keywords

Nitric Oxide Pulmonary Hypertension Down Syndrome Hypoxic Pulmonary Vasoconstriction Hypoxic Pulmonary Hypertension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Urs Scherrer
    • 1
  • Pierre Turini
    • 1
  • Sébastien Thalmann
    • 1
  • Damian Hutter
    • 2
  • Carlos Salinas Salmon
    • 4
  • Thomas Stuber
    • 2
  • Sidney Shaw
    • 3
  • Pierre -Yves Jayet
    • 1
  • Céline Sartori-Cucchia
    • 1
  • Mercedes Villena
    • 4
  • Yves Allemann
    • 2
  • Claudio Sartori
    • 1
  1. 1.Department of Internal Medicine and the Botnar Center for Clinical ResearchCentre Hospitalier Universitaire VaudoisLausanne
  2. 2.Swiss Cardiovascular CenterUniversity HospitalBerneSwitzerland
  3. 3.Department of Clinical Research (S.S.)University HospitalBerneSwitzerland
  4. 4.Instituto Boliviano de Biologia de AlturaLa PazBolivia

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