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Novel Insights into Cardiovascular Regulation in Patients with Chronic Mountain Sickness

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Book cover Hypoxia

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 903))

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 in general. Chronic mountain sickness (CMS) is a major public health problem in mountainous regions of the world affecting many millions of high-altitude dwellers. It is characterized by exaggerated chronic hypoxemia, erythrocytosis, and mild pulmonary hypertension. In later stages these patients often present with right heart failure and are predisposed to systemic cardiovascular disease, but the underlying mechanisms are poorly understood. Here, we present recent new data providing insight into underlying mechanisms that may cause these complications.

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References

  1. West JB, Schoene RB, Milledge JS. High altitude medicine and physiology. 4th ed. London, UK: Hodder Arnold; 2007.

    Google Scholar 

  2. Penaloza D, Arias-Stella J. The heart and pulmonary circulation at high altitudes: healthy highlanders and chronic mountain sickness. Circulation. 2007;115:1132–46.

    Article  PubMed  Google Scholar 

  3. Duplain H, Vollenweider L, Delabays A, Nicod P, Bartsch P, Scherrer U. Augmented sympathetic activation during short-term hypoxia and high-altitude exposure in subjects susceptible to high-altitude pulmonary edema. Circulation. 1999;99:1713–8.

    Article  CAS  PubMed  Google Scholar 

  4. Hainsworth R, Drinkhill MJ. Cardiovascular adjustments for life at high altitude. Respir Physiol Neurobiol. 2007;158:204–11.

    Article  PubMed  Google Scholar 

  5. Hansen J, Sander M. Sympathetic neural overactivity in healthy humans after prolonged exposure to hypobaric hypoxia. J Physiol. 2003;546:921–9.

    Article  CAS  PubMed  Google Scholar 

  6. Huez S, Faoro V, Guenard H, Martinot JB, Naeije R. Echocardiographic and tissue doppler imaging of cardiac adaptation to high altitude in native highlanders versus acclimatized lowlanders. Am J Cardiol. 2009;103:1605–9.

    Article  PubMed  Google Scholar 

  7. Klausen K. Cardiac output in man in rest and work during and after acclimatization to 3,800 m. J Appl Physiol. 1966;21:609–16.

    CAS  PubMed  Google Scholar 

  8. Vogel JA, Harris CW. Cardiopulmonary responses of resting man during early exposure to high altitude. J Appl Physiol. 1967;22:1124–8.

    CAS  PubMed  Google Scholar 

  9. Tune JD. Control of coronary blood flow during hypoxemia. Adv Exp Med Biol. 2007;618:25–39.

    Article  PubMed  Google Scholar 

  10. Bartsch P, Gibbs JS. Effect of altitude on the heart and the lungs. Circulation. 2007;116:2191–202.

    Article  PubMed  Google Scholar 

  11. Mazzeo RS, Reeves JT. Adrenergic contribution during acclimatization to high altitude: perspectives from pikes peak. Exerc Sport Sci Rev. 2003;31:13–8.

    Article  PubMed  Google Scholar 

  12. Rimoldi SF, Sartori C, Seiler C, Delacretaz E, Mattle HP, Scherrer U, Allemann Y. High-altitude exposure in patients with cardiovascular disease: risk assessment and practical recommendations. Prog Cardiovasc Dis. 2010;52:512–24.

    Article  PubMed  Google Scholar 

  13. Scherrer U, Rexhaj E, Jayet PY, Allemann Y, Sartori C. New insights in the pathogenesis of high-altitude pulmonary edema. Prog Cardiovasc Dis. 2010;52:485–92.

    Article  PubMed  Google Scholar 

  14. Sartori C, Rimoldi SF, Scherrer U. Lung fluid movements in hypoxia. Prog Cardiovasc Dis. 2010;52:493–9.

    Article  CAS  PubMed  Google Scholar 

  15. Emery CJ, Teng GQ, Liu X, Barer GR. Vasoreactions to acute hypoxia, whole lungs and isolated vessels compared: modulation by no. Respir Physiol Neurobiol. 2003;134:115–29.

    Article  CAS  PubMed  Google Scholar 

  16. Sartori C, Allemann Y, Trueb L, Delabays A, Nicod P, Scherrer U. Augmented vasoreactivity in adult life associated with perinatal vascular insult. Lancet. 1999;353:2205–7.

    Article  CAS  PubMed  Google Scholar 

  17. Sebkhi A, Strange JW, Phillips SC, Wharton J, Wilkins MR. Phosphodiesterase type 5 as a target for the treatment of hypoxia-induced pulmonary hypertension. Circulation. 2003;107:3230–5.

    Article  CAS  PubMed  Google Scholar 

  18. Settergren G, Angdin M, Astudillo R, Gelinder S, Liska J, Lundberg JO, Weitzberg E. Decreased pulmonary vascular resistance during nasal breathing: modulation by endogenous nitric oxide from the paranasal sinuses. Acta Physiol Scand. 1998;163:235–9.

    Article  CAS  PubMed  Google Scholar 

  19. Duplain H, Sartori C, Lepori M, Egli M, Allemann Y, Nicod P, Scherrer U. Exhaled nitric oxide in high-altitude pulmonary edema: role in the regulation of pulmonary vascular tone and evidence for a role against inflammation. Am J Respir Crit Care Med. 2000;162:221–4.

    Article  CAS  PubMed  Google Scholar 

  20. Busch T, Bartsch P, Pappert D, Grunig E, Hildebrandt W, Elser H, Falke KJ, Swenson ER. Hypoxia decreases exhaled nitric oxide in mountaineers susceptible to high-altitude pulmonary edema. Am J Respir Crit Care Med. 2001;163:368–73.

    Article  CAS  PubMed  Google Scholar 

  21. Sartori C, Vollenweider L, Loffler BM, Delabays A, Nicod P, Bartsch P, Scherrer U. Exaggerated endothelin release in high-altitude pulmonary edema. Circulation. 1999;99:2665–8.

    Article  CAS  PubMed  Google Scholar 

  22. Lepori M, Sartori C, Trueb L, Owlya R, Nicod P, Scherrer U. Haemodynamic and sympathetic effects of inhibition of nitric oxide synthase by systemic infusion of n(g)-monomethyl-l-arginine into humans are dose dependent. J Hypertens. 1998;16:519–23.

    Article  CAS  PubMed  Google Scholar 

  23. Maggiorini M. Cardio-pulmonary interactions at high altitude. Pulmonary hypertension as a common denominator. Adv Exp Med Biol. 2003;543:177–89.

    Article  PubMed  Google Scholar 

  24. Groves BM, Droma T, Sutton JR, McCullough RG, McCullough RE, Zhuang J, Rapmund G, Sun S, Janes C, Moore LG. Minimal hypoxic pulmonary hypertension in normal tibetans at 3,658 m. J Appl Physiol. 1993;74:312–8.

    CAS  PubMed  Google Scholar 

  25. Beall CM, Decker MJ, Brittenham GM, Kushner I, Gebremedhin A, Strohl KP. An ethiopian pattern of human adaptation to high-altitude hypoxia. Proc Natl Acad Sci U S A. 2002;99:17215–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Moudgil R, Michelakis ED, Archer SL. Hypoxic pulmonary vasoconstriction. J Appl Physiol. 2005;98:390–403.

    Article  CAS  PubMed  Google Scholar 

  27. Sartori C, Allemann Y, Scherrer U. Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema. Respir Physiol Neurobiol. 2007;159:338–49.

    Article  CAS  PubMed  Google Scholar 

  28. Beall CM, Laskowski D, Strohl KP, Soria R, Villena M, Vargas E, Alarcon AM, Gonzales C, Erzurum SC. Pulmonary nitric oxide in mountain dwellers. Nature. 2001;414:411–2.

    Article  CAS  PubMed  Google Scholar 

  29. Hoit BD, Dalton ND, Erzurum SC, Laskowski D, Strohl KP, Beall CM. Nitric oxide and cardiopulmonary hemodynamics in tibetan highlanders. J Appl Physiol. 2005;99:1796–801.

    Article  CAS  PubMed  Google Scholar 

  30. Schwab M, Jayet PY, Stuber T, Salinas CE, Bloch J, Spielvogel H, Villena M, Allemann Y, Sartori C, Scherrer U. Pulmonary-artery pressure and exhaled nitric oxide in bolivian and caucasian high altitude dwellers. High Alt Med Biol. 2008;9:295–9.

    Article  CAS  PubMed  Google Scholar 

  31. Cook S, Vollenweider P, Menard B, Egli M, Nicod P, Scherrer U. Increased eno and pulmonary inos expression in enos null mice. Eur Respir J. 2003;21:770–3.

    Article  CAS  PubMed  Google Scholar 

  32. Sartori C, Lepori M, Busch T, Duplain H, Hildebrandt W, Bartsch P, Nicod P, Falke KJ, Scherrer U. Exhaled nitric oxide does not provide a marker of vascular endothelial function in healthy humans. Am J Respir Crit Care Med. 1999;160:879–82.

    Article  CAS  PubMed  Google Scholar 

  33. Ahsan A, Charu R, Pasha MA, Norboo T, Afrin F, Baig MA. Enos allelic variants at the same locus associate with hape and adaptation. Thorax. 2004;59:1000–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Droma Y, Hanaoka M, Ota M, Katsuyama Y, Koizumi T, Fujimoto K, Kobayashi T, Kubo K. Positive association of the endothelial nitric oxide synthase gene polymorphisms with high-altitude pulmonary edema. Circulation. 2002;106:826–30.

    Article  CAS  PubMed  Google Scholar 

  35. Erzurum SC, Ghosh S, Janocha AJ, Xu W, Bauer S, Bryan NS, Tejero J, Hemann C, Hille R, Stuehr DJ, Feelisch M, Beall CM. Higher blood flow and circulating no products offset high-altitude hypoxia among tibetans. Proc Natl Acad Sci U S A. 2007;104:17593–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Barker DJ. The fetal and infant origins of disease. Eur J Clin Invest. 1995;25:457–63.

    Article  CAS  PubMed  Google Scholar 

  37. Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, Schisterman EF, Thadhani R, Sachs BP, Epstein FH, Sibai BM, Sukhatme VP, Karumanchi SA. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–83.

    Article  CAS  PubMed  Google Scholar 

  38. Scherrer U, Vollenweider L, Delabays A, Savcic M, Eichenberger U, Kleger GR, Fikrle A, Ballmer PE, Nicod P, Bartsch P. Inhaled nitric oxide for high-altitude pulmonary edema. N Engl J Med. 1996;334:624–9.

    Article  CAS  PubMed  Google Scholar 

  39. Franco MC, Akamine EH, Reboucas N, Carvalho MH, Tostes RC, Nigro D, Fortes ZB. Long-term effects of intrauterine malnutrition on vascular function in female offspring: implications of oxidative stress. Life Sci. 2007;80:709–15.

    Article  CAS  PubMed  Google Scholar 

  40. Jayet PY, Rimoldi SF, Stuber T, Salmon CS, Hutter D, Rexhaj E, Thalmann S, Schwab M, Turini P, Sartori-Cucchia C, Nicod P, Villena M, Allemann Y, Scherrer U, Sartori C. Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia. Circulation. 2010;122:488–94.

    Article  PubMed  Google Scholar 

  41. Rexhaj E, Bloch J, Jayet PY, Rimoldi SF, Dessen P, Mathieu C, Tolsa JF, Nicod P, Scherrer U, Sartori C. Fetal programming of pulmonary vascular dysfunction in mice: role of epigenetic mechanisms. Am J Physiol Heart Circ Physiol. 2011;301:H247–52.

    Article  CAS  PubMed  Google Scholar 

  42. Maignan M, Rivera-Ch M, Privat C, Leon-Velarde F, Richalet JP, Pham I. Pulmonary pressure and cardiac function in chronic mountain sickness patients. Chest. 2009;135(2):499–504.

    Article  PubMed  Google Scholar 

  43. Penaloza D, Sime F. Chronic cor pulmonale due to loss of altitude acclimatization (chronic mountain sickness). Am J Med. 1971;50:728–43.

    Article  CAS  PubMed  Google Scholar 

  44. Leon-Velarde F, Maggiorini M, Reeves JT, Aldashev A, Asmus I, Bernardi L, Ge RL, Hackett P, Kobayashi T, Moore LG, Penaloza D, Richalet JP, Roach R, Wu T, Vargas E, Zubieta-Castillo G, Zubieta-Calleja G. Consensus statement on chronic and subacute high altitude diseases. High Alt Med Biol. 2005;6:147–57.

    Article  PubMed  Google Scholar 

  45. Himelman RB, Stulbarg M, Kircher B, Lee E, Kee L, Dean NC, Golden J, Wolfe CL, Schiller NB. Noninvasive evaluation of pulmonary artery pressure during exercise by saline-enhanced Doppler echocardiography in chronic pulmonary disease. Circulation. 1989;79:863–71.

    Article  CAS  PubMed  Google Scholar 

  46. Leavitt JI, Coats MH, Falk RH. Effects of exercise on transmitral gradient and pulmonary artery pressure in patients with mitral stenosis or a prosthetic mitral valve: a Doppler echocardiographic study. J Am Coll Cardiol. 1991;17:1520–6.

    Article  CAS  PubMed  Google Scholar 

  47. Mininni S, Diricatti G, Vono MC, Giglioli C, Margheri M, Olivo G, Gensini G, Galanti G. Noninvasive evaluation of right ventricle systolic pressure during dynamic exercise by saline-enhanced Doppler echocardiography in progressive systemic sclerosis. Angiology. 1996;47:467–74.

    Article  CAS  PubMed  Google Scholar 

  48. Dehnert C, Grunig E, Mereles D, von Lennep N, Bartsch P. Identification of individuals susceptible to high-altitude pulmonary oedema at low altitude. Eur Respir J. 2005;25:545–51.

    Article  CAS  PubMed  Google Scholar 

  49. Stuber T, Sartori C, Schwab M, Jayet PY, Rimoldi SF, Garcin S, Thalmann S, Spielvogel H, Salmon CS, Villena M, Scherrer U, Allemann Y. Exaggerated pulmonary hypertension during mild exercise in chronic mountain sickness. Chest. 2010;137:388–92.

    Article  PubMed  Google Scholar 

  50. Leon-Velarde F, Richalet JP. Respiratory control in residents at high altitude: physiology and pathophysiology. High Alt Med Biol. 2006;7:125–37.

    Article  PubMed  Google Scholar 

  51. Cremona G, Asnaghi R, Baderna P, Brunetto A, Brutsaert T, Cavallaro C, Clark TM, Cogo A, Donis R, Lanfranchi P, Luks A, Novello N, Panzetta S, Perini L, Putnam M, Spagnolatti L, Wagner H, Wagner PD. Pulmonary extravascular fluid accumulation in recreational climbers: a prospective study. Lancet. 2002;359:303–9.

    Article  PubMed  Google Scholar 

  52. Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, Picano E. “Ultrasound comet-tail images”: a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest. 2005;127:1690–5.

    Article  PubMed  Google Scholar 

  53. Pratali L, Rimoldi SF, Rexhaj E, Hutter D, Faita F, Salinas Salmon C, et al. Exercise induces rapid intertitial lung water accumulation in patients with chronic mountain sickness. Chest. 2012;141:953–8. doi: 10.1378/chest.11-0084.

    Google Scholar 

  54. Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E. Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol. 2004;93:1265–70.

    Article  PubMed  Google Scholar 

  55. Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G. Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiogr. 2006;19:356–63.

    Article  PubMed  Google Scholar 

  56. Barr RG, Mesia-Vela S, Austin JH, Basner RC, Keller BM, Reeves AP, Shimbo D, Stevenson L. Impaired flow-mediated dilation is associated with low pulmonary function and emphysema in ex-smokers: the Emphysema and Cancer Action Project (EMCAP) Study. Am J Respir Crit Care Med. 2007;176:1200–7.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Huiart L, Ernst P, Suissa S. Cardiovascular morbidity and mortality in COPD. Chest. 2005;128:2640–6.

    Article  PubMed  Google Scholar 

  58. Sidney S, Sorel M, Quesenberry Jr CP, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser permanente medical care program. Chest. 2005;128:2068–75.

    Article  PubMed  Google Scholar 

  59. Deanfield J, Donald A, Ferri C, Giannattasio C, Halcox J, Halligan S, Lerman A, Mancia G, Oliver JJ, Pessina AC, Rizzoni D, Rossi GP, Salvetti A, Schiffrin EL, Taddei S, Webb DJ. Endothelial function and dysfunction. Part I: methodological issues for assessment in the different vascular beds: a statement by the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. J Hypertens. 2005;23:7–17.

    Article  CAS  PubMed  Google Scholar 

  60. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation. 2007;115:1285–95.

    PubMed  Google Scholar 

  61. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994;24:1468–74.

    Article  CAS  PubMed  Google Scholar 

  62. Halcox JP, Donald AE, Ellins E, Witte DR, Shipley MJ, Brunner EJ, Marmot MG, Deanfield JE. Endothelial function predicts progression of carotid intima-media thickness. Circulation. 2009;119:1005–12.

    Article  PubMed  Google Scholar 

  63. Yeboah J, Crouse JR, Hsu FC, Burke GL, Herrington DM. Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the Cardiovascular Health Study. Circulation. 2007;115:2390–7.

    Article  PubMed  Google Scholar 

  64. Yeboah J, Folsom AR, Burke GL, Johnson C, Polak JF, Post W, Lima JA, Crouse JR, Herrington DM. Predictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: the multi-ethnic study of atherosclerosis. Circulation. 2009;120:502–9.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–27.

    Article  PubMed  Google Scholar 

  66. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, Laurent S. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002;39:10–5.

    Article  CAS  PubMed  Google Scholar 

  67. Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. Common carotid intima-media thickness and arterial stiffness: indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial disease). Circulation. 1999;100:951–7.

    Article  CAS  PubMed  Google Scholar 

  68. Salonen R, Nyyssonen K, Porkkala E, Rummukainen J, Belder R, Park JS, Salonen JT, Kuopio Atherosclerosis Prevention Study (KAPS). A population-based primary preventive trial of the effect of LDL lowering on atherosclerotic progression in carotid and femoral arteries. Circulation. 1995;92:1758–64.

    Article  CAS  PubMed  Google Scholar 

  69. Zanchetti A, Bond MG, Hennig M, Neiss A, Mancia G, Dal Palu C, Hansson L, Magnani B, Rahn KH, Reid JL, Rodicio J, Safar M, Eckes L, Rizzini P. Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation. 2002;106:2422–7.

    Article  CAS  PubMed  Google Scholar 

  70. Rimoldi SF, Rexhaj E, Pratali L, Bailey DM, Hutter D, Faita F, Salinas Salmon C, Villena M, Nicod P, Allemann Y, Scherrer U, Sartori C. Systemic vascular dysfunction in patients with chronic mountain sickness. Chest. 2012;141:139–46.

    Google Scholar 

  71. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37:1236–41.

    Article  CAS  PubMed  Google Scholar 

  72. Aparicio Otero O. Texto de medicina de altura. Primera Edicionth ed. La Paz, Bolivia: GMC Artes Graficas; 2008.

    Google Scholar 

  73. Cosby K, Partovi KS, Crawford JH, Patel RP, Reiter CD, Martyr S, Yang BK, Waclawiw MA, Zalos G, Xu X, Huang KT, Shields H, Kim-Shapiro DB, Schechter AN, Cannon 3rd RO, Gladwin MT. Nitrite reduction to nitric oxide by deoxyhemoglobin vasodilates the human circulation. Nat Med. 2003;9:1498–505.

    Article  CAS  PubMed  Google Scholar 

  74. Maher AR, Milsom AB, Gunaruwan P, Abozguia K, Ahmed I, Weaver RA, Thomas P, Ashrafian H, Born GV, James PE, Frenneaux MP. Hypoxic modulation of exogenous nitrite-induced vasodilation in humans. Circulation. 2008;117:670–7.

    Article  CAS  PubMed  Google Scholar 

  75. Bailey DM, Rimoldi SF, Rexhaj E, Pratali L, Salinas Salmon C, Villena M, McEneny J, Young IS, Nicod P, Allemann Y, Scherrer U, Sartori C. Oxidative-Nitrosative stress and systemic vascular function in highlanders with and without exaggerated hypoxemia. Chest 2013;143:444–451.

    Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland

    Stefano F. Rimoldi, Emrush Rexhaj, Yves Allemann & Urs Scherrer

  2. Department of Internal Medicine, Botnar Center for Extreme Medicine, University Hospital, Lausanne, CHUV, Switzerland

    Stefano F. Rimoldi, Emrush Rexhaj, Urs Scherrer & Claudio Sartori

  3. Instituto Boliviano de Biologia de Altura, La Paz, Bolivia

    Mercedes Villena & Carlos Salinas Salmon

  4. Departamento de Biología, Facultad de Ciencias, Universidad de Tarapacá, Arica, Chile

    Urs Scherrer

Authors
  1. Stefano F. Rimoldi
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  2. Emrush Rexhaj
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  3. Mercedes Villena
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  4. Carlos Salinas Salmon
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  5. Yves Allemann
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  6. Urs Scherrer
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  7. Claudio Sartori
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Correspondence to Stefano F. Rimoldi .

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Editors and Affiliations

  1. Altitude Research Center, University of Colorado Anschutz Medical, AURORA, Colorado, USA

    Robert C. Roach

  2. Institute for Altitude Medicine, Telluride, Colorado, USA

    Peter H. Hackett

  3. Division of Physiology 0623A, University of California - San Diego, La Jolla, California, USA

    Peter D. Wagner

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Rimoldi, S.F. et al. (2016). Novel Insights into Cardiovascular Regulation in Patients with Chronic Mountain Sickness. In: Roach, R., Hackett, P., Wagner, P. (eds) Hypoxia. Advances in Experimental Medicine and Biology, vol 903. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7678-9_6

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