Int J Sports Med 2015; 36(08): 609-614
DOI: 10.1055/s-0034-1398623
Physiology & Biochemistry
© Georg Thieme Verlag KG Stuttgart · New York

Acute Mountain Sickness, Hypoxia, Hypobaria and Exercise Duration each Affect Heart Rate

D. M. DiPasquale
1   Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
2   Psychiatry, Charlestown, Massachusetts General Hospital, Charlestown, Massachusetts, United States
4   Harvard Medical School, Boston, Massachusetts, United States
,
G. E. Strangman
2   Psychiatry, Charlestown, Massachusetts General Hospital, Charlestown, Massachusetts, United States
4   Harvard Medical School, Boston, Massachusetts, United States
,
N. S. Harris
3   Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States
4   Harvard Medical School, Boston, Massachusetts, United States
,
S. R. Muza
5   Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
› Author Affiliations
Further Information

Publication History



accepted after revision 28 December 2014

Publication Date:
02 April 2015 (online)

Abstract

In this study, we quantified the changes in post-exercise resting heart rate (HRrst) associated with acute mountain sickness (AMS), and compared the effects of hypobaric hypoxia (HH) and normobaric hypoxia (NH) on HRrst. We also examined the modulating roles of exercise duration and exposure time on HRrst. Each subject participated in 2 of 6 conditions: normobaric normoxia (NN), NH, or HH (4 400 m altitude equivalent) combined with either 10 or 60 min of moderate cycling at the beginning of an 8-h exposure. AMS was associated with a 2 bpm higher HRrst than when not sick, after taking into account the ambient environment, exercise duration, and SpO2. In addition, HRrst was elevated in both NH and HH compared to NN with HRrst being 50% higher in HH than in NH. Participating in long duration exercise led to elevated resting HRs (0.8–1.4 bpm higher) compared with short exercise, while short exercise caused a progressive increase in HRrst over the exposure period in both NH and HH (0.77–1.2 bpm/h of exposure). This data suggests that AMS, NH, HH, exercise duration, time of exposure, and SpO2 have independent effects on HRrst. It further suggests that hypobaria exerts its own effect on HRrst in hypoxia. Thus NH and HH may not be interchangeable environments.

 
  • References

  • 1 Bartsch P, Swenson ER. Clinical practice: Acute high-altitude illnesses. N Engl J Med 2013; 368: 2294-2302
  • 2 Benoit H, Busso T, Castells J, Geyssant A, Denis C. Decrease in peak heart rate with acute hypoxia in relation to sea level VO(2max). Eur J Appl Physiol 2003; 90: 514-519
  • 3 Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 1974; 37: 247-248
  • 4 Donnelly J, Cowan DC, Yeoman DJ, Lucas SJ, Herbison GP, Thomas KN, Ainslie PN, Taylor DR. Exhaled nitric oxide and pulmonary artery pressures during graded ascent to high altitude. Respir Physiol Neurobiol 2011; 177: 213-217
  • 5 Fadel PJ, Raven PB. Human investigations into the arterial and cardiopulmonary baroreflexes during exercise. Exp Physiol 2012; 97: 39-50
  • 6 Faiss R, Pialoux V, Sartori C, Faes C, Deriaz O, Millet GP. Ventilation, oxidative stress, and nitric oxide in hypobaric versus normobaric hypoxia. Med Sci Sports Exerc 2013; 45: 253-260
  • 7 Fulco CS, Beidleman BA, Muza SR. Effectiveness of preacclimatization strategies for high-altitude exposure. Exerc Sport Sci Rev 2013; 41: 55-63
  • 8 Girard O, Koehle MS, MacInnis MJ, Guenette JA, Verges S, Rupp T, Jubeau M, Perrey S, Millet GY, Chapman RF, Levine BD, Conkin J, Wessel 3rd JH, Nespoulet H, Wuyam B, Tamisier R, Levy P, Casey DP, Taylor BJ, Snyder EM, Johnson BD, Laymon AS, Stickford JL, Weavil JC, Loeppky JA, Pun M, Schommer K, Bartsch P, Vagula MC, Nelatury CF. Comments on Point:Counterpoint: Hypobaric hypoxia induces/does not induce different responses from normobaric hypoxia. J Appl Physiol 2012; 112: 1788-1794
  • 9 Harriss DJ, Atkinson G. Ethical standards in sports and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
  • 10 Hemmingsson T, Linnarsson D. Lower exhaled nitric oxide in hypobaric than in normobaric acute hypoxia. Respir Physiol Neurobiol 2009; 169: 74-77
  • 11 Hoefer M, Sybrecht GW, Bauer D. Hypoxic ventilatory response and associated heart rate change predict the severity of acute mountain sickness. In: Roach RC, Wagner PD, Hackett PH. (eds.) Hypoxia: into the next millennium. New York: Kluwer Academic/Plenum Publishers; 1999: 391
  • 12 Karinen HM, Peltonen JE, Kahonen M, Tikkanen HO. Prediction of acute mountain sickness by monitoring arterial oxygen saturation during ascent. High Alt Med Biol 2010; 11: 325-332
  • 13 Koehle MS, Guenette JA, Warburton DE. Oximetry, heart rate variability, and the diagnosis of mild-to-moderate acute mountain sickness. Eur J Emerg Med 2010; 17: 119-122
  • 14 Loeppky JA, Icenogle M, Scotto P, Robergs R, Hinghofer-Szalkay H, Roach RC. Ventilation during simulated altitude, normobaric hypoxia and normoxic hypobaria. Respir Physiol 1997; 107: 231-239
  • 15 Loeppky JA, Icenogle MV, Charlton GA, Conn CA, Maes D, Riboni K, Gates L, Melo MF, Roach RC. Hypoxemia and acute mountain sickness: which comes first?. High Alt Med Biol 2008; 9: 271-279
  • 16 Loeppky JA, Icenogle MV, Maes D, Riboni K, Scotto P, Roach RC. Body temperature, autonomic responses, and acute mountain sickness. High Alt Med Biol 2003; 4: 367-373
  • 17 Macinnis MJ, Carter EA, Koehle MS, Rupert JL. Exhaled nitric oxide is associated with acute mountain sickness susceptibility during exposure to normobaric hypoxia. Respir Physiol Neurobiol 2012; 180: 40-44
  • 18 Maggiorini M, Bartsch P, Oelz O. Association between raised body temperature and acute mountain sickness: cross sectional study. BMJ 1997; 315: 403-404
  • 19 Mellor AJ, Woods DR, O'Hara J, Howley M, Watchorn J, Boos C. Rating of perceived exertion and acute mountain sickness during a high-altitude trek. Aviat Space Environ Med 2014; 85: 1214-1216
  • 20 Millet GP, Faiss R, Pialoux V. Last word on Point: Counterpoint: Hypobaric hypoxia induces different responses from normobaric hypoxia. J Appl Physiol 2012; 112: 1795
  • 21 Millet GP, Faiss R, Pialoux V. Point: Hypobaric hypoxia induces different physiological responses from normobaric hypoxia. J Appl Physiol 2012; 112: 1783-1784
  • 22 Millet GP, Faiss R, Pialoux V. Evidence for differences between hypobaric and normobaric hypoxia is conclusive. Exerc Sport Sci Rev 2013; 41: 133
  • 23 Miyagawa K, Kamijo Y, Ikegawa S, Goto M, Nose H. Reduced hyperthermia-induced cutaneous vasodilation and enhanced exercise-induced plasma water loss at simulated high altitude (3 200 m) in humans. J Appl Physiol 2011; 110: 157-165
  • 24 Moore JP, Hainsworth R, Drinkhill MJ. Phasic negative intrathoracic pressures enhance the vascular responses to stimulation of pulmonary arterial baroreceptors in closed-chest anaesthetized dogs. J Physiol 2004; 555: 815-824
  • 25 Moore JP, Hainsworth R, Drinkhill MJ. Reflexes from pulmonary arterial baroreceptors in dogs: interaction with carotid sinus baroreceptors. J Physiol 2011; 589: 4041-4052
  • 26 Mounier R, Brugniaux JV. Counterpoint: Hypobaric hypoxia does not induce different responses from normobaric hypoxia. J Appl Physiol 2012; 112: 1784-1786
  • 27 Muza SR, Rock PB, Zupan MF, Miller JC, Thomas WR, Cymerman A. Residence at moderate altitude improves ventilatory response to high altitude. Aviat Space Environ Med 2004; 75: 1042-1048
  • 28 Prabhakaran P, Tripathi KK. Autonomic modulations during 5 h at 4 574 m (15 000 ft) breathing 40% oxygen. Aviat Space Environ Med 2011; 82: 863-870
  • 29 Richard NA, Sahota IS, Widmer N, Ferguson S, Sheel AW, Koehle MS. Acute mountain sickness, chemosensitivity, and cardiorespiratory responses in humans exposed to hypobaric and normobaric hypoxia. J Appl Physiol 2014; 116: 945-952
  • 30 Richardson A, Twomey R, Watt P, Maxwell N. Physiological responses to graded acute normobaric hypoxia using an intermittent walking protocol. Wilderness Environ Med 2008; 19: 252-260
  • 31 Roach RC, Loeppky JA, Icenogle MV. Acute mountain sickness: increased severity during simulated altitude compared with normobaric hypoxia. J Appl Physiol 1996; 81: 1908-1910
  • 32 Rockley TJ, Hawke WM. The middle ear as a baroreceptor. Acta Otolaryngol 1992; 112: 816-823
  • 33 Sampson JB, Cymerman A, Burse RL, Maher JT, Rock PB. Procedures for the measurement of acute mountain sickness. Aviat Space Environ Med 1983; 54: 1063-1073
  • 34 Savourey G, Launay JC, Besnard Y, Guinet-Lebreton A, Alonso A, Sauvet F, Bourrilhon C. Normo or hypobaric hypoxic tests: propositions for the determination of the individual susceptibility to altitude illnesses. Eur J Appl Physiol 2007; 100: 193-205
  • 35 Savourey G, Launay JC, Besnard Y, Guinet A, Travers S. Normo- and hypobaric hypoxia: are there any physiological differences?. Eur J Appl Physiol 2003; 89: 122-126
  • 36 Self DA, Mandella JG, Prinzo OV, Forster EM, Shaffstall RM. Physiological equivalence of normobaric and hypobaric exposures of humans to 25 000 feet (7 620 m). Aviat Space Environ Med 2011; 82: 97-103
  • 37 Swenson ER, Bartsch P. High-altitude pulmonary edema. Com Physiol 2012; 2: 2753-2773
  • 38 Tsubone H. Nasal ‚pressure‘ receptors. Nihon juigaku zasshi. Jpn J Vet Sci 1990; 52: 225-232
  • 39 Tucker A, Reeves JT, Robertshaw D, Grover RF. Cardiopulmonary response to acute altitude exposure: water loading and denitrogenation. Respir Physiol 1983; 54: 363-380
  • 40 Wille M, Mairer K, Gatterer H, Philippe M, Faulhaber M, Burtscher M. Changes in cardiac autonomic activity during a passive 8 h acute exposure to 5 500 m normobaric hypoxia are not related to the development of acute mountain sickness. Int J Sports Med 2012; 33: 186-191