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The Cardiovascular System at High Altitude

Mirsaid M. Mirrakhimov, Robert M. Winslow

10.1002/cphy.cp040253

Source: Supplement 14: Handbook of Physiology, Environmental Physiology

Originally published: 1996

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Normal Cardiac Output
1.1 Stroke Volume
1.2 Heart Rate
2 Cardiac Output at High Altitude
2.1 Heart Rate at High Altitude
2.2 Effect of Polycythemia on Cardiac Output
2.3 Sojourners Exposed to Altitude
3 Pulmonary Circulation at Altitude
3.1 Role of Hematocrit in Pulmonary Hypertension
3.2 Role of Hypoxia in Pulmonary Hypertension
3.3 Adrenergic Control of Pulmonary Vasculature
3.4 Pulmonary Artery Morphology
3.5 Connective Tissue Growth: Hypertrophy
3.6 Mechanism of Pulmonary Vasoconstriction
4 Effects of Hypoxia on the Heart
4.1 Morphology
4.2 Metabolic Effects
4.3 Microcirculation
5 Coronary Circulation
6 Systemic Circulation
6.1 Effects of Altitude
6.2 Atrial Natriuretic Factor
6.3 Venous Tone
6.4 Summary of Effects on the Circulatory System
7 Applied Aspects
Figure 1. Figure 1.

Density of β‐adrenoreceptors on peripheral blood lymphocytes of humans who demonstrate normal (N) and increased (H) pulmonary artery pressure rise in response to hypoxia. In normoxic conditions density is higher in normals compared to hyperresponders. When breathing a hypoxic gas mixture (FIO2 = 0.10) only hyperresponders increased density.
Figure 2. Figure 2.

Morphology of pulmonary arterioles (diameter 45 μm). (A) Pulmonary arteriole in a low‐altitude (760 m) native. The wall is composed of elastic fibers. (B) Pulmonary arteriole of a native high‐lander (3,600 m). Muscular layer is enlarged and situated between internal and external elastic membranes.
Figure 3. Figure 3.

Scanning electron microscopy (X 360) of inner surface of a large pulmonary artery branch (diameter 10,000 μm). (A) Endothelial cells of yaks are enlarged with cytoplasmic microprocesses with a cellular structure on the surface. (B) Endothelial cells of calves are smaller, and cytoplasmic microprocesses are absent. Blood cells are seen on the endothelial surface.


Figure 1.

Density of β‐adrenoreceptors on peripheral blood lymphocytes of humans who demonstrate normal (N) and increased (H) pulmonary artery pressure rise in response to hypoxia. In normoxic conditions density is higher in normals compared to hyperresponders. When breathing a hypoxic gas mixture (FIO2 = 0.10) only hyperresponders increased density.



Figure 2.

Morphology of pulmonary arterioles (diameter 45 μm). (A) Pulmonary arteriole in a low‐altitude (760 m) native. The wall is composed of elastic fibers. (B) Pulmonary arteriole of a native high‐lander (3,600 m). Muscular layer is enlarged and situated between internal and external elastic membranes.



Figure 3.

Scanning electron microscopy (X 360) of inner surface of a large pulmonary artery branch (diameter 10,000 μm). (A) Endothelial cells of yaks are enlarged with cytoplasmic microprocesses with a cellular structure on the surface. (B) Endothelial cells of calves are smaller, and cytoplasmic microprocesses are absent. Blood cells are seen on the endothelial surface.

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Article Title: The Cardiovascular System at High Altitude
 

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Mirsaid M. Mirrakhimov, Robert M. Winslow. The Cardiovascular System at High Altitude. Compr Physiol 2011, Supplement 14: Handbook of Physiology, Environmental Physiology: 1241-1257. First published in print 1996. doi: 10.1002/cphy.cp040253