ERJ open research · 2026
The effect of high altitude on exercise capacity and cardiorespiratory function in patients with pulmonary vascular disease after an overnight stay at 2500 m: a randomised crossover study.
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Mayer Laura, Schneider Simon R, Röösli Aline, Müller Julian, Bauer Meret, Carta Arcangelo, Furian Michael, Bloch Konrad E, Schwarz Esther I, Lichtblau Mona, Ulrich Silvia
Аннотация
AIM: We investigated the effect of an overnight stay at high altitude (HA; 2500 m) on constant work rate exercise test (CWRET) time and cardiorespiratory function in patients with pulmonary vascular disease (PVD) and the impact of supplemental oxygen therapy (SOT) in case of severe altitude-induced hypoxaemia.
METHODS: In a randomised crossover trial, stable patients diagnosed with pulmonary arterial or distal chronic thromboembolic pulmonary hypertension (PVD, PAH/CTEPH) performed a symptom-limited cycling CWRET at 470 m and after an overnight stay at 2500 m. For safety, patients with an oxygen saturation measured by pulse oximetry (S pO2 ) <80% for >30 min received SOT during the subsequent HA stay. The primary outcome was CWRET time; secondary outcomes were changes in ergospirometric parameters.
RESULTS: Of 27 PVD patients (44% female; mean age 62±14 years, 20 PAH, seven distal CTEPH), 10 (37%) required SOT. Overall at HA versus 470 m, CWRET time decreased to 292±181 s versus 454±411 s (mean difference -162 s, 95% CI -290 to -34 s; p=0.026), driven by patients without need for SOT (261±187 s versus 519±497 s; p=0.017), who revealed lower resting arterial oxygen tension (P aO2 ) (7.4±0.7 kPa versus 10.6±1.4 kPa, p<0.001) and ventilatory efficiency, but exercise-induced S pO2 desaturation was not significantly different (-0.9%, 95% CI -3.9 to 2). In 10 out of 27 patients needing SOT, SOT restored CWRET time to 470 m values (344±170 s versus 345±167 s; p=0.990), corrected altitude-induced hypoxaemia and attenuated hyperventilation.
CONCLUSION: The majority of PVD patients tolerated an overnight stay at 2500 m well. In those without need for SOT at HA, CWRET time was reduced with increased hypoxaemia and hyperventilation. In PVD patients who received SOT due to severe nocturnal hypoxaemia, SOT restored CWRET time to 470 m levels and dampened the exercise-induced hypoxaemia.
METHODS: In a randomised crossover trial, stable patients diagnosed with pulmonary arterial or distal chronic thromboembolic pulmonary hypertension (PVD, PAH/CTEPH) performed a symptom-limited cycling CWRET at 470 m and after an overnight stay at 2500 m. For safety, patients with an oxygen saturation measured by pulse oximetry (S pO2 ) <80% for >30 min received SOT during the subsequent HA stay. The primary outcome was CWRET time; secondary outcomes were changes in ergospirometric parameters.
RESULTS: Of 27 PVD patients (44% female; mean age 62±14 years, 20 PAH, seven distal CTEPH), 10 (37%) required SOT. Overall at HA versus 470 m, CWRET time decreased to 292±181 s versus 454±411 s (mean difference -162 s, 95% CI -290 to -34 s; p=0.026), driven by patients without need for SOT (261±187 s versus 519±497 s; p=0.017), who revealed lower resting arterial oxygen tension (P aO2 ) (7.4±0.7 kPa versus 10.6±1.4 kPa, p<0.001) and ventilatory efficiency, but exercise-induced S pO2 desaturation was not significantly different (-0.9%, 95% CI -3.9 to 2). In 10 out of 27 patients needing SOT, SOT restored CWRET time to 470 m values (344±170 s versus 345±167 s; p=0.990), corrected altitude-induced hypoxaemia and attenuated hyperventilation.
CONCLUSION: The majority of PVD patients tolerated an overnight stay at 2500 m well. In those without need for SOT at HA, CWRET time was reduced with increased hypoxaemia and hyperventilation. In PVD patients who received SOT due to severe nocturnal hypoxaemia, SOT restored CWRET time to 470 m levels and dampened the exercise-induced hypoxaemia.