UKC

BBC Article here
http://www.bbc.co.uk/news/health-25347564

In reply to Gone:

Interesting but I'm not entirely clear as to what is news here other than using TAPSE at altitude (and using the sats data). Given that the subjects all had to hop on the 'frique to the Aiguille du Midi it's not going to set the world on fire for screening purposes.

I'll have a yarn with one of our echo techs who went to the Pyramid lab - not sure if they checked TAPSE or just stuck to bernouilli.

Thanks for the link - I look forward to reading it in print.

b

I didn't entirely get the premise of the test - are some people generally more prone to AMS, or is it per-trip? And can they only tell once you've gone sea-level to 4000m in a oner? Surely the headache at that point is a bit of a giveaway.

In reply to Gone:


Correct me if I'm wrong, but the study showed that there were physiological differences in those people who were already displaying syptoms. In what way is that a predictive test?


So what next? A test for susceptibility to catching the common cold based on people sneezing & having runny noses?

On a related note: http://www.runnersworld.com/health/how-to-predict-altitude-illness

In reply to Chris Harris:


That's based on the BBC's summary of the research. A more detailed summary is here:

http://www.escardio.org/about/press/press-releases/pr-13/Pages/test-predict...

This was presented as a poster at the European Society of Cardiology, EuroEcho-Imaging meeting 2013.


Abstract: P628
Ultrasound-based biomarkers as predictors of acute mountain sickness

Authors:
R M Bruno1, G Giardini2, B Catizzo2, R Brustia2, S Malacrida3, S Armenia4, E Cauchy5, L Pratali1, 1Institute of Clinical Physiology of CNR - Pisa - Italy, 2Della Valle d'Aosta Regional Hospital - Aosta - Italy, 3University of Padua - Padua - Italy, 4University of Pisa - Pisa - Italy, 5IFREMMONT - Chamonix - France,

Eur Heart J Cardiovasc Imaging Abstracts Supplement ( 2013 ) 14 ( Supplement 2 ), ii117

Purpose: Acute mountain sickness (AMS) is a common disorder typically encountered by mountaineers after rapid ascent to high altitude. We tested the hypothesis that early impairment in cardiovascular adaptation to hypoxia can predict AMS development the day after.

Methods: 34 healthy volunteers (age 38±11years, 13 women) were studied at the sea-level and after passive ascent (cable-car) to 3842 m (Aguille du Midi, France). Blood pressure (BP), O2 saturation (SO2), endothelial function in the brachial artery (flow-mediated dilation, FMD), cardiac ultrasound, Lake-Louise Score (LLS) were performed at after 4 and 24 h of hypobaric hypoxia (HH4 and HH24).

Results: At HH24 13 individuals had AMS, defined as LLS>6. AMS+ had a greater SO2 worsening at HH4 as compared to AMS- (AMS+ 97,3±1 to 79,4±6,1%; AMS- 97,2±1,1 to 83,1±5,7%; p=0.01), with similar heart rate increase and unchanged BP. AMS+ had a blunted increase in tricuspid annular plane systolic excursion (TAPSE ; AMS+ 24,6±4,8 to 24,3±3,8mm; AMS- 25,2±3,4 to 29,2±4,3mm; p=0.03)and ejection fraction, with a similar increase in systolic pulmonary pressure compared to AMS-. At HH4 AMS+ individuals had a greater FMD worsening than AMS-. A TAPSE value <28mm at 4HH can predict AMS at HH24 with a sensitivity of 0.92 and a specificity of 0.63. The presence of SO2<87% and TAPSE<28mm at HH4 can predict who will develop AMS at HH24 with excellent negative predictive value and sensitivity (see figure).

Conclusions: A blunted increase in RV function in response to HH might favor O2 desaturation and predispose to AMS. The combined measurement of SO2 and TAPSE after 4 hour-hypobaric hypoxia is able to identify who will not develop AMS the day after. This finding can help applying preventative strategies only in selected individuals.