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Global Reach 2018: The adaptive phenotype to life with chronic mountain sickness and polycythaemia

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Author
Hansen, Alexander
Moralez, Gilbert
Amin, Sachin
Simpson, Lydia
Hofstätter, Florian
Anholm, James
Gasho, Chris
Stembridge, Mike
Dawkins, Tony
Tymko, Michael
Ainslie, Philip
Villafuerte, Francisco
Romero, Steven
Hearon, Christopher Jr.
Lawley, Justin
Date
2021-07-10
Acceptance date
2021-06-18
Type
Article
Publisher
Wiley
ISSN
0022-3751
1469-7793 (electronic)
Embargoed until
2022-07-10
Metadata
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Abstract
Excessive haematocrit and blood viscosity can increase blood pressure, cardiac work and reduce aerobic capacity. However, past clinical investigations have demonstrated that certain human high-altitude populations suffering fromexcessive erythrocytosis, Andeans with chronic mountain sickness, appear to have phenotypically adapted to life with polycythaemia, as their exercise capacity is comparable to healthy Andeans and even with sea level inhabitants residing at high altitude. By studying this unique population, which has adapted thru natural selection, this study aimed to describe how humans can adapt to life with polycythaemia. Experimental studies included Andeans with (n=19) and without (n=17) chronic mountain sickness, documenting exercise capacity, and characterizing the transport of oxygen thru blood rheology, including haemoglobin mass, blood and plasma volume & blood viscosity, cardiac output, blood pressure and changes in total and local vascular resistances thru pharmacological dissected of α-adrenergic signalling pathways within non-active and active skeletal muscle. At rest, Andeans with chronic mountain sickness had a substantial plasma volume contraction, which alongside a higher red blood cell volume, caused an increase in blood viscosity yet similar total blood volume. Moreover, both morphological and functional alterations in the periphery normalized vascular shear stress and blood pressure despite high sympathetic nerve activity. During exercise, blood pressure, cardiac work and global oxygen delivery increased similar to healthy Andeans but were sustained by modifications in both non-active and active skeletal muscle vascular function. These findings highlight widespread physiological adaptations that can occur in response to polycythaemia, which allow the maintenance of exercise capacity.
Journal/conference proceeding
Journal of Physiology;
Citation
Hansen, A.B., Moralez, G., Amin, S.B., Simspon, L.L., Hofstaetter, F., Anholm, J.D., Gasho, C., Stembridge, M., Dawkins, T.G., Tymko, M.M. and Ainslie, P.N. (2021) 'Global REACH 2018: the adaptive phenotype to life with chronic mountain sickness and polycythaemia', The Journal of physiology. https://doi.org/10.1113/JP281730
URI
http://hdl.handle.net/10369/11424
DOI
https://doi.org/10.1113/JP281730
Description
Article published in Journal of Physiology available at https://doi.org/10.1113/JP281730
Rights
http://www.rioxx.net/licenses/under-embargo-all-rights-reserved
Sponsorship
HHS | NIH | National Heart, Lung, and Blood Institute (NHBLI): ChristopherM. Hearon, Jr., 1F32-HL1-37285-0
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  • Sport Research Groups [620]

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