Data di Pubblicazione:
2023
Citazione:
Exercise in hypoxia: a model from laboratory to on field studies / C. Vignati, E. Swenson, P. Agostoni, G. Bilo, G. Parati. - In: EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. - ISSN 2047-4873. - (2023). [Epub ahead of print] [10.1093/eurjpc/zwad185]
Abstract:
Clinical outcome and quality of life of chronic heart failure (HF) patients have greatly
improved over the last two decades. These results and the availability of modern lifts
allow many cardiac patients to spend leisure time at altitude. HF per se doesn’t impede
a safe stay at altitude, but exercise at both simulated and real altitude is associated
with a reduction in performance, which is inversely proportional to HF severity. For
example, in normal subjects, the reduction in functional capacity is ∼2% every 1000 m
altitude increase, whereas it is 4% and 10% in HF patients with normal or slightly
diminished exercise capacity and in HF patients with markedly diminished exercise
capacity. Also the on-field experience with HF patients at altitude confirm safety and
shows overall similar data to that reported at simulated altitude. Even “optimal” HF
treatment in patients spending time at altitude or at hypoxic conditions is likely different
from optimal treatment at sea level, particularly as regards β-blockers selectivity.
Furthermore, high altitude, both simulated or on-field, represents a stimulating model of
hypoxia in HF patients and healthy subjects.
Our data suggest that spending time at altitude (<3500 m) can be safe even for HF
patients, provided that subjects are free of co-morbidities that may directly interfere
with the adaptation to altitude and are stable. However, HF patients experience a
reduction of exercise capacity directly proportional to HF severity and altitude. Finally,
HF patients should be tested for functional capacity and undergo a specific “hypoxictailored treatment” to avoid pharmacological interference with altitude adaptation mechanisms, particularly with regard to the selectivity of beta-blockers.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
High altitude; Exercise; hypoxia; oxygen consumption;
Elenco autori:
C. Vignati, E. Swenson, P. Agostoni, G. Bilo, G. Parati
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