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High altitude pulmonary edema: a pressure-induced leak.
Respir Physiol Neurobiol. 2007 Sep 30; 158(2-3):266-73.RP

Abstract

High altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that can occur in healthy individuals who ascend rapidly to altitudes above 3000-4000m. Excessive pulmonary artery pressure (PAP) is crucial for the development of HAPE, since lowering pulmonary artery pressure by nifedipine or tadalafil (phosphodiesterase-5-inhibitor) will in most cases prevent HAPE. Recent studies using microspheres in swine and magnetic resonance imaging in humans strongly support the concept and primacy of nonuniform hypoxic arteriolar vasoconstriction to explain how hypoxic pulmonary vasoconstriction occurring predominantly at the arteriolar level can cause leakage. Evidence is accumulating that the excessive PAP response in HAPE-susceptible individuals is due to a reduced NO bioavailability. HAPE-susceptible individuals show an endothelial dysfunction in the systemic circulation in hypoxia. Lower levels of exhaled NO in hypoxia before and during HAPE suggest that this abnormality also occurs in the lungs and polymorphisms of the eNOS gene are associated with susceptibility to HAPE in the Indian and Japanese population.

Authors+Show Affiliations

Medical University Clinic, Department of Internal Medicine, Div. of Sports Medicine, Im Neuenheimer Feld 410, D - 69120 Heidelberg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17602898

Citation

Dehnert, Christoph, et al. "High Altitude Pulmonary Edema: a Pressure-induced Leak." Respiratory Physiology & Neurobiology, vol. 158, no. 2-3, 2007, pp. 266-73.
Dehnert C, Berger MM, Mairbäurl H, et al. High altitude pulmonary edema: a pressure-induced leak. Respir Physiol Neurobiol. 2007;158(2-3):266-73.
Dehnert, C., Berger, M. M., Mairbäurl, H., & Bärtsch, P. (2007). High altitude pulmonary edema: a pressure-induced leak. Respiratory Physiology & Neurobiology, 158(2-3), 266-73.
Dehnert C, et al. High Altitude Pulmonary Edema: a Pressure-induced Leak. Respir Physiol Neurobiol. 2007 Sep 30;158(2-3):266-73. PubMed PMID: 17602898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High altitude pulmonary edema: a pressure-induced leak. AU - Dehnert,Christoph, AU - Berger,Marc Moritz, AU - Mairbäurl,Heimo, AU - Bärtsch,Peter, Y1 - 2007/05/18/ PY - 2007/02/15/received PY - 2007/04/30/revised PY - 2007/05/01/accepted PY - 2007/7/3/pubmed PY - 2008/1/4/medline PY - 2007/7/3/entrez SP - 266 EP - 73 JF - Respiratory physiology & neurobiology JO - Respir Physiol Neurobiol VL - 158 IS - 2-3 N2 - High altitude pulmonary edema (HAPE) is a non-cardiogenic pulmonary edema that can occur in healthy individuals who ascend rapidly to altitudes above 3000-4000m. Excessive pulmonary artery pressure (PAP) is crucial for the development of HAPE, since lowering pulmonary artery pressure by nifedipine or tadalafil (phosphodiesterase-5-inhibitor) will in most cases prevent HAPE. Recent studies using microspheres in swine and magnetic resonance imaging in humans strongly support the concept and primacy of nonuniform hypoxic arteriolar vasoconstriction to explain how hypoxic pulmonary vasoconstriction occurring predominantly at the arteriolar level can cause leakage. Evidence is accumulating that the excessive PAP response in HAPE-susceptible individuals is due to a reduced NO bioavailability. HAPE-susceptible individuals show an endothelial dysfunction in the systemic circulation in hypoxia. Lower levels of exhaled NO in hypoxia before and during HAPE suggest that this abnormality also occurs in the lungs and polymorphisms of the eNOS gene are associated with susceptibility to HAPE in the Indian and Japanese population. SN - 1569-9048 UR - https://www.unboundmedicine.com/medline/citation/17602898/High_altitude_pulmonary_edema:_a_pressure_induced_leak_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1569-9048(07)00141-3 DB - PRIME DP - Unbound Medicine ER -