Microcirculatory and Rheological Adaptive Mechanisms at High Altitude in European Lowlander Hikers and Nepalese Highlanders

Author:

Salvi Paolo1,Grillo Andrea2ORCID,Brunacci Fausto3,Severi Francesca3,Montaguti Luca3,Gautier Sylvie4,Salvi Lucia5,Pretolani Enzo3,Parati Gianfranco16ORCID,Benetos Athanase47

Affiliation:

1. Department of Cardiology, IRCCS, Istituto Auxologico Italiano, 20149 Milan, Italy

2. Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy

3. Department of Emergency, Internal Medicine and Cardiology, Internal Medicine, ‘M. Bufalini’ Hospital, 47521 Cesena, Italy

4. CHRU-Nancy, Pôle “Maladies du Vieillissement, Gérontologie et Soins Palliatifs”, Université de Lorraine, 54800 Nancy, France

5. Medicina II Cardiovascolare, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy

6. Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy

7. DCAC u1116, INSERM, Université de Lorraine, 54000 Nancy, France

Abstract

Background: Physical activity at high-altitudes is increasingly widespread, both for tourist trekking and for the growing tendency to carry out sports and training activities at high-altitudes. Acute exposure to this hypobaric–hypoxic condition induces several complex adaptive mechanisms involving the cardiovascular, respiratory and endocrine systems. A lack of these adaptive mechanisms in microcirculation may cause the onset of symptoms of acute mountain sickness, a frequent disturbance after acute exposure at high altitudes. The aim of our study was to evaluate the microcirculatory adaptive mechanisms at different altitudes, from 1350 to 5050 m a.s.l., during a scientific expedition in the Himalayas. Methods: The main haematological parameters, blood viscosity and erythrocyte deformability were assessed at different altitudes on eight European lowlanders and on a group of eleven Nepalese highlanders. The microcirculation network was evaluated in vivo by conjunctival and periungual biomicroscopy. Results: Europeans showed a progressive and significant reduction of blood filterability and an increase of whole blood viscosity which correlate with the increase of altitude (p < 0.02). In the Nepalese highlanders, haemorheological changes were already present at their residence altitude, 3400 m a.s.l. (p < 0.001 vs. Europeans). With the increase in altitude, a massive interstitial oedema appeared in all participants, associated with erythrocyte aggregation phenomena and slowing of the flow rate in the microcirculation. Conclusions: High altitude causes important and significant microcirculatory adaptations. These changes in microcirculation induced by hypobaric–hypoxic conditions should be considered when planning training and physical activity at altitude.

Funder

ICOT Impianti srl, Forlí, Italy, with the collaboration of Zeneca Italia s.p.a.

Laboratoires Knoll France

Publisher

MDPI AG

Subject

General Medicine

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