(Circulation. 1999;99:2665-2668.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Exaggerated Endothelin Release in High-Altitude Pulmonary Edema
Presented in part at the Annual Congress of the European Respiratory Society, Barcelona, Spain, September 16–20, 1995.
From the Department of Internal Medicine (C.S., P.N., U.S.) and Division of Cardiology (A.D.), Centre Hospitalier Universitaire Vaudois, Lausanne; Institute of Physiology (L.V.), University of Lausanne, Lausanne; Pharma Division Preclinical Research, F. Hoffmann-La Roche Ltd (B.-M.L.), Basel, Switzerland; and Department of Sports Medicine, University of Heidelberg, Heidelberg, Germany (P.B.).
Correspondence to Dr Urs Scherrer, Department of Internal Medicine, BH 10.642, Centre Hospitalier Universitaire Vaudois, CH-1011 Lausanne, Switzerland. E-mail Urs.Scherrer{at}chuv.hospvd.ch
Background—Exaggerated pulmonary hypertension is thought to play an important part in the pathogenesis of high-altitude pulmonary edema (HAPE). Endothelin-1 is a potent pulmonary vasoconstrictor peptide that also augments microvascular permeability.
Methods and Results—We measured endothelin-1 plasma levels and
pulmonary artery pressure in 16 mountaineers prone to HAPE and
in 16 mountaineers resistant to this condition at low (580 m)
and high (4559 m) altitudes. At high altitude, in mountaineers prone to
HAPE, mean (±SE) endothelin-1 plasma levels were 
33% higher than
in HAPE-resistant mountaineers (22.2±1.1 versus 16.8±1.1
pg/mL, P<0.01). There was a direct relationship between
the changes from low to high altitude in endothelin-1 plasma levels and
systolic pulmonary artery pressure
(r=0.82, P<0.01) and between
endothelin-1 plasma levels and pulmonary artery pressure
measured at high altitude (r=0.35,
P=0.05).
Conclusions—These findings suggest that in HAPE-susceptible mountaineers, an augmented release of the potent pulmonary vasoconstrictor peptide endothelin-1 and/or its reduced pulmonary clearance could represent one of the mechanisms contributing to exaggerated pulmonary hypertension at high altitude.
Key Words: endothelin • hypertension, pulmonary • altitude • edema • hypoxia
This article has been cited by other articles:
 |
|
 |
|
  A. P. Gomez, M. J. Moreno, R. M. Baldrich, and A. Hernandez Endothelin-1 Molecular Ribonucleic Acid Expression in Pulmonary Hypertensive and Nonhypertensive Chickens Poult. Sci., July 1, 2008; 87(7): 1395 - 1401. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Bartsch and J. S. R. Gibbs Effect of Altitude on the Heart and the Lungs Circulation, November 6, 2007; 116(19): 2191 - 2202. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Maggiorini High altitude-induced pulmonary oedema Cardiovasc Res, October 1, 2006; 72(1): 41 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Modesti, S. Vanni, M. Morabito, A. Modesti, M. Marchetta, T. Gamberi, F. Sofi, G. Savia, G. Mancia, G. F. Gensini, et al. Role of Endothelin-1 in Exposure to High Altitude: Acute Mountain Sickness and Endothelin-1 (ACME-1) Study Circulation, September 26, 2006; 114(13): 1410 - 1416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. C. Carpenter, S. Schomberg, and K. R. Stenmark Endothelin-mediated increases in lung VEGF content promote vascular leak in young rats exposed to viral infection and hypoxia Am J Physiol Lung Cell Mol Physiol, December 1, 2005; 289(6): L1075 - L1082. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Bartsch, H. Mairbaurl, M. Maggiorini, and E. R. Swenson Physiological aspects of high-altitude pulmonary edema J Appl Physiol, March 1, 2005; 98(3): 1101 - 1110. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Gao and J. U. Raj Role of veins in regulation of pulmonary circulation Am J Physiol Lung Cell Mol Physiol, February 1, 2005; 288(2): L213 - L226. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Carpenter, S. Schomberg, W. Steudel, J. Ozimek, K. Colvin, K. Stenmark, and D. D. Ivy Endothelin B Receptor Deficiency Predisposes to Pulmonary Edema Formation via Increased Lung Vascular Endothelial Cell Growth Factor Expression Circ. Res., September 5, 2003; 93(5): 456 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. W. Raymond Altitude Pulmonary Edema Below 8,000 Feet: What Are We Missing? Chest, January 1, 2003; 123(1): 5 - 7. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Johnson, A. Nohria, L. Garrett, J. C. Fang, J. Igo, M. Katai, P. Ganz, and M. A. Creager Contribution of endothelin to pulmonary vascular tone under normoxic and hypoxic conditions Am J Physiol Heart Circ Physiol, August 1, 2002; 283(2): H568 - H575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Hackett and D. Rennie High-Altitude Pulmonary Edema JAMA, May 1, 2002; 287(17): 2275 - 2278. [Full Text] [PDF]
|
|
|
|
|
|
J. B. Slade Jr, T. Hattori, C. S. Ray, A. A. Bove, and P. Cianci Pulmonary Edema Associated With Scuba Diving : Case Reports and Review Chest, November 1, 2001; 120(5): 1686 - 1694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. F. Luscher and M. Barton Endothelins and Endothelin Receptor Antagonists : Therapeutic Considerations for a Novel Class of Cardiovascular Drugs Circulation, November 7, 2000; 102(19): 2434 - 2440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Carpenter and K. R. Stenmark Endothelin receptor blockade decreases lung water in young rats exposed to viral infection and hypoxia Am J Physiol Lung Cell Mol Physiol, September 1, 2000; 279(3): L547 - L554. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. DUPLAIN, C. SARTORI, M. LEPORI, M. EGLI, Y. ALLEMANN, P. NICOD, and U. SCHERRER 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., July 1, 2000; 162(1): 221 - 224. [Abstract] [Full Text]
|
|