Pulmonary vascular disease & thromboembolism
Beta-adrenergic blockade increases pulmonary vascular resistance and causes exaggerated hypoxic pulmonary vasoconstriction at high altitude: a physiological study
Authors' conclusion
Our data show that beta-adrenergic blockade increases, and muscarinic blockade decreases PVR, whereas both increase pulmonary artery elastance.
Study context
- Population
- Seven healthy male lowlanders
- Participants
- 7 healthy male lowlanders
- Comparison
- PROP vs PROP + glycopyrrolate (GLYC) vs no medication, at sea level (SL) and high altitude (HA)
- Outcome
- Ppa and PVR, invasively measured
- Follow-up
- At SL (488 m) and after a 3-week sojourn at 3454 m (HA)
Methodological detailsinvasive haemodynamic measurement, sea level and high altitude, Bilateral thigh-cuff release manoeuvres to derive pulmonary pressure-flow relationships and pulmonary vessel distensibility
- Invasive haemodynamic measurement
- Sea level and high altitude
- Bilateral thigh-cuff release manoeuvres to derive pulmonary pressure-flow relationships and pulmonary vessel distensibility
Main finding
As reported in the abstract
SL (488 m)
Increase in Ppa
21%
P = 0.01
PROP
Increase in pulmonary vascular resistance (PVR)
57%
P < 0.0001
PROP
No medication
14 ± 1
mean ± SEM · SE 1 · mmHg
PROP
17 ± 1
mean ± SEM · SE 1 · mmHg
Further findings
| Outcome | No medication | PROP | PROP + GLYC | Increase in PVR | P value |
|---|---|---|---|---|---|
| PVR response to PROP at HA · HA (3454 m)PROP vs No medication · amplified at HA | 76% | P < 0.0001 | |||
| Pulmonary vessel distensibility | mean ± SEM 2.9 ± 0.5 (SE 0.5) % mmHg-1 | mean ± SEM 1.2 ± 0.2 (SE 0.2) % mmHg-1 | mean ± SEM 0.9 ± 0.2 (SE 0.2) % mmHg-1 |
- Pulmonary vessel distensibility — Decrease from 2.9 ± 0.5 to 1.7 ± 0.2 at HA
- P < 0.0001
- Pulmonary vessel distensibility — Further decrease to 0.9 ± 0.2 % mmHg-1 with PROP + GLYC
- P = 0.01
- PVR response to PROP at HA: P[interaction] = 0.05
- Pulmonary vessel distensibility: No medication mean ± SEM 1.7 ± 0.2 (SE 0.2) % mmHg-1 · at HA 1.7 ± 0.2
Ppa and PVR with PROP + GLYC · both altitudes
- PROP + GLYC abolished the effect of PROP on Ppa and PVR at both altitudes
Original publication
Beta-adrenergic blockade increases pulmonary vascular resistance and causes exaggerated hypoxic pulmonary vasoconstriction at high altitude: a physiological study. Eur Heart J Cardiovasc Pharmacother. Published 12 January 2024. doi:10.
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