Evaluation of right ventricle and hypoxic pulmonary hypertension in young highlanders of the Andes

Roberto Baltodano-Arellano, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
Giovanni Meneses-Flores, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
Jimmy Mego-Vásquez, Instituto Nacional de Rehabilitación Dra. Adriana Rebaza Flores, Lima, Peru
Rosmy Gagliffi-Artica, Faculty of Medicine, Universidad Norbert Wiener, Lima, Peru
Lindsay Benites-Yshpilco, Cardiology Service, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru

Background: Hypobaric hypoxia can lead to pulmonary hypertension (PHT), which in turn may result in right ventricular hypertrophy. Validated non-invasive techniques, such as echocardiography, are currently available to detect these alterations. Objective: To determine the echocardiographic and electrocardiographic characteristics of the right ventricle and the echocardiographic probability of pulmonary hypertension in young individuals native to Cerro de Pasco, a high-altitude city (4340 m above sea level) in the Peruvian Andes. Methods: Echocardiographic examinations were performed using a Terason T3000 system, and electrocardiograms were recorded with a Fukuda Cardisuny C-110 electrocardiograph. Hematocrit was determined by microcentrifugation. Twenty-four healthy subjects (13 men and 11 women; mean age 20.9 years) were recruited; however, three were excluded from the echocardiographic analysis due to poor acoustic windows. Results: On echocardiography, all participants showed right ventricular basal diameter and systolic-diastolic function within normal ranges. Only one subject (4.7%) had an intermediate probability of pulmonary hypertension, whereas the remaining participants had a low probability. Approximately 24% met at least one electrocardiographic criterion for right ventricular hypertrophy, and the mean QRS axis was 65.6°. Conclusion: Echocardiographic and electrocardiographic characteristics of the right ventricle in high-altitude residents were similar to those reported in populations living at sea level. 

Keywords: Hypertension pulmonary. Echocardiography. High-altitude. Peru.