Abstract
Every year more than 100 million people travel through mountains. Many of these travelers are middle aged and even elderly in whom there is minimal cardiovascular research. In this study we evaluated sympathico-vagal tone before and after exposure to middle altitudes. 13 subjects, 7 women and 6 men, ages 45 to 72 were evaluated before and after exposure to middle altitudes. Evaluations consisted of cardiac loading during echocardiography as well as calculating the vegetative tone by using the Kerdo index. Vegetative tone was analyzed using the Fisher’s maximum-likelihood estimation, after which the integral under the line of best fit was obtained with limits defined as the shortest loading test in seconds when compared to baseline. Time to reach 85% maximally predicted cardiac rate increased for almost all subjects after exposure to middle altitudes. For the comparison of the vegetative control the integral of the fitting exponentials over time has been utilized. As demonstrated by an increase in the Kerdo index, 10 out of 13 of the subjects showed decrease followed by increase of the sympathetic responce as they acclimatized. Two of the three who did not demonstrate this shift has significant cardiovascular disorders which was discovered prior to exposure. We have demonstrated decrease followed by increase of the sympathetic response during proper acclimatization. We demonstrated this with the vegetative Kerdo index in 10 healthy subjects. Furthermore the majority of the subjects with underlying cardiac pathology failed to demonstrate this shift.
Similar content being viewed by others
REFERENCES
Rusko, H.K., Tikkanen, H.O., and Peltonen, J.E., Altitude and endurance training, J. Sports Sci., 2004, vol. 22, no. 10, p. 928.
Friedmann-Bette, B., Classical altitude training, Scand. J. Med. Sci. Sports, 2008, vol. 18, suppl. 1, p. 11.
Saunders, P.U., Pyne, D.B., and Gore, C.J., Endurance training at altitude, High Alt. Med. Biol., 2009, vol. 10, no. 2, p. 135.
Constantini, K., Wilhite, D.P., and Chapman, R.F., A clinician guide to altitude training for optimal endurance exercise performance at sea level, High Alt. Med. Biol., 2017, vol. 18, no. 2, p. 93.
Veglio, M., Maule, S., Cametti, G., Cogo, A., et al., The effects of exposure to moderate altitude on cardiovascular autonomic function in normal subjects, Clin. Auton. Res., 1999. vol. 9, no. 3, p. 123.
Riley, C.J. and Gavin, M., Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease, High Alt. Med. Biol., 2017, vol. 18, no. 2, p. 102.
Higgins, J.P., Tuttle, T., and Higgins, J.A., Altitude and the heart: is going high safe for your cardiac patient? Am. Heart J., 2010, vol. 159, no. 1, p. 25.
Minvaleev, R.S., Comparison of the rates in the lipid spectrum of human blood serum at moderate altitude, Hum. Physiol., 2011, vol. 37, no. 3, p. 355.
Wee, J. and Climstein, M., Hypoxic training: clinical benefits on cardiometabolic risk factors, J. Sci. Med. Sport, 2015, vol. 18, no. 1, p. 56.
Gutwenger, I., Hofer, G., Gutwenger, A.K., Sandri, M., et al., Pilot study on the effects of a 2-week hiking vacation at moderate versus low altitude on plasma parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome, BMC Res. Notes, 2015, vol. 28, no. 8, p. 103.
Seccombe, L.M. and Peters, M.J., Physiology in medicine: acute altitude exposure in patients with pulmonary and cardiovascular disease, J. Appl. Physiol., 2014, vol. 116, no. 5, p. 478.
Parati, G., Ochoa, J.E., Torlasco, C., Salvi, P., et al., Aging, high altitude, and blood pressure: a complex relationship, High Alt. Med. Biol., 2015, vol. 16, no. 2, p. 97.
Perini, R., Milesi, S., Biancardi, L., and Veicsteinas, A., Effects of high altitude acclimatization on heart rate variability in resting humans, Eur. J. Appl. Physiol. Occup. Physiol., 1996, vol. 73, no. 6, p. 521.
Bernardi, L., Passino, C., Spadacini, G., Calciati, A., et al., Cardiovascular autonomic modulation and activity of carotid baroreceptors at altitude, Clin. Sci. (London), 1998, vol. 95, no. 5, p. 565.
Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, Circulation, 1996, vol. 93, no. 5, p. 1043.
Casadei, B., Cochrane, S., Johnston, J., Conway, J., et al., Pitfalls in the interpretation of spectral analysis of the heart rate variability during exercise in humans, Acta Physiol. Scand., 1995, vol. 153, no. 2, p. 125.
Nussinovitch, U., Elishkevitz, K.P., Katz, K., Nussinovitch, M., et al., Reliability of ultra-short ECG indices for heart rate variability, Ann. Noninvasive Electrocardiol., 2011, vol. 16, no. 2, p. 117.
Nakamura, F.Y., Flatt, A.A., Pereira, L.A., Ramirez-Campillo, R., et al., Ultra short term heart rate variability is sensitive to training effects in team sports players, J. Sports Sci. Med., 2015, vol. 14, no. 3, p. 602.
Jaradeh, S.S. and Prieto, T.E., Evaluation of the autonomic nervous system, Phys. Med. Rehabil. Clin. N. Am., 2003, vol. 14, no. 2, p. 287.
Low, P.A., Laboratory evaluation of autonomic function, Suppl. Clin. Neurophysiol., 2004, vol. 57, p. 358.
Novak, P., Quantitative autonomic testing, J. Vis. Exp., 2011, vol. 53, p. 2502.
Saito, M. and Mano, T., Exercise mode affects muscle sympathetic nerve responsiveness, Jpn. J. Physiol., 1991, vol. 41, no. 1, p. 143.
Ichinose, M., Saito, M., Fujii, N., Ogawa, T., et al., Modulation of the control of muscle sympathetic nerve activity during incremental leg cycling, J. Physiol., 2008, vol. 586, no. 11, p. 2753.
Tavrovskaya, T.V., Veloergometriya. Prakticheskoe posobie dlya vrachei (Bicycle Ergometry: Practical Manual for Physicians), St. Petersburg: Altai. Gos. Med. Univ., 2007, p. 20.
Kérdö, I., Ein aus Daten der Blutzirkulation kalkulierter Index zur Beurteilung der vegetativen Tonuslage, Acta Neurovegetative (Wien), 1966, vol. 29, no. 2, p. 250.
Namozova, S.Sh., Khubbiev, Sh.Z., Minvaleev, R.S., and Shadrin, L.V., Monitoring of functional state of national teams' members in university sport pedagogical management system: selection of relevant criteria, Teor. Prakt. Fiz. Kul’t., 2016, no. 4, p. 20.
Wolfel, E.E., Selland, M.A., Mazzeo, R.S., and Reeves, J.T., Systemic hypertension at 4,300 m is related to sympathoadrenal activity, J. Appl. Physiol., 1994, vol. 76, no. 4, p. 1643.
Mingji, C., Onakpoya, I.J., Perera, R., Ward, A.M., et al., Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review, Heart, 2015, vol. 101, no. 13, p. 1054.
Cunningham, W.L., Becker, E.J., and Kreuzer, F., Catecholamines in plasma and urine at high altitude, J. Appl. Physiol., 1965, vol. 20, no. 4, p. 607.
Mazzeo, R.S., Bender, P.R., Brooks, G.A., Butterfield, G.E., et al., Arterial catecholamine responses during exercise with acute and chronic high-altitude exposure, Am. J. Physiol., 1991, vol. 261, no. 4, pt. 1, E419.
Mazzeo, R.S., Wolfel, E.E., Butterfield, G.E., and Reeves, J.T., Sympathetic response during 21 days at high altitude (4,300 m) as determined by urinary and arterial catecholamines, Metabolism, 1994, vol. 43, no. 10, p. 1226.
Antezana, A.M., Kacimi, R., Le Trong, J.L., Marchal, M., et al., Adrenergic status of humans during prolonged exposure to the altitude of 6,542 m, J. Appl. Physiol., 1994, vol. 76, no. 3, p. 1055.
Rostrup, M., Catecholamines, hypoxia and high altitude, Acta Physiol. Scand., 1998, vol. 162, no. 3, p. 389.
Mazzeo, R.S. and Reeves, J.T., Adrenergic contribution during acclimatization to high altitude: perspectives from Pikes Peak, Exercise Sport Sci. Rev., 2003, vol. 31, no. 1, p. 13.
Messerli-Burgy, N., Meyer, K., Steptoe, A., and Laederach-Hofmann, K., Autonomic and cardiovascular effects of acute high altitude exposure after myocardial infarction and in normal volunteers, Circ. J., 2009, vol. 73, no. 8, p. 1485.
Hansen, J. and Sander, M., Sympathetic neural over activity in healthy humans after prolonged exposure to hypobaric hypoxia, J. Physiol., 2003, vol. 546, no. 3, p. 921.
Sevre, K., Bendz, B., Hankø, E., Hauge, A., et al., Reduced autonomic activity during stepwise exposure to high altitude, Acta Physiol. Scand., 2001, vol. 173, no. 4, p. 409.
Åstrand, P.O. and Åstrand, I., Heart rate during muscular work in man exposed to prolonged hypoxia, J. Appl. Physiol., 1958, vol. 13, no. 1, p. 75.
Hartley, L.H., Vogel, J.A., and Cruz, J.C., Reduction of maximal exercise heart rate at altitude and its reversal with atropine, J. Appl. Physiol., 1974, vol. 36, no. 3, p. 362.
Boushel, R., Calbet, J.A., Rådegran, G., Sonder-gaard, H., et al., Parasympathetic neural activity accounts for the lowering of exercise heart rate at high altitude, Circulation, 2001, vol. 104, p. 785.
Hughson, R.L., Yamamoto, Y., McCullough, R.E., Sutton, J.R., et al., Sympathetic and parasympathetic indicators of heart rate control at altitude studied by spectral analysis, J. Appl. Physiol., 1994, vol. 77, no. 6, p. 2537.
Bhaumik, G., Dass, D., Bhattacharyya, D., et al., Heart rate variability changes during first week of acclimatization to 3500 m altitude in Indian military personnel, Indian J. Physiol. Pharmacol., 2013, vol. 57, no. 1, p. 16.
Levine, B.D., Zuckerman, J.H., and de Filippi, C.R., Effect of high-altitude exposure in the elderly: the Tenth Mountain Division study, Circulation, 1997, vol. 96, no. 4, p. 1224.
Sander, M., Does the sympathetic nervous system adapt to chronic altitude exposure? Adv. Exp. Med. Biol., 2016, vol. 903, p. 375.
Siebenmann, C., Rasmussen, P., Hug, M., Keiser, S., et al., Parasympathetic withdrawal increases heart rate after 2 weeks at 3454 m altitude, J. Physiol., 2017, vol. 595, no. 5, p. 1619.
Kanai, M., Nishihara, F., Shiga, T., Shimada, H., et al., Alterations in autonomic nervous control of heart rate among tourists at 2700 and 3700 m above sea level, Wilderness Environ. Med., 2001, vol. 12, no. 1, p. 8.
de Vries, S.T., Komdeur, P., Aalbersberg, S., et al., Effects of altitude on exercise level and heart rate in patients with coronary artery disease and healthy controls, Neth. Heart. J., 2010, vol. 18, no. 3, p. 118.
ACKNOWLEDGMENTS
We thank Arkhipova I.V., the CEO of the Faraon studio of historical films and the organizer of international research expeditions to the Himalayas, carried out through the project ‘‘V poiskakh utrachennykh znanii’’ (In Search for Lost Knowledge).
Author information
Authors and Affiliations
Corresponding author
Additional information
1The article was translated by the authors.
Rights and permissions
About this article
Cite this article
Minvaleev, R.S., Sarana, A.M., Scherbak, S.G. et al. Autonomic Control of Muscular Activity Before and After Exposure to Altitudes of 2000–3700 m. Hum Physiol 44, 556–564 (2018). https://doi.org/10.1134/S0362119718030106
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1134/S0362119718030106