Autonomic cardiovascular function in high-altitude Andean natives with chronic mountain sickness

Autonomic cardiovascular function in high-altitude Andean natives with chronic mountain sickness. C. KEYL, 1 A. SCHNEIDER, 1 A. GAMBOA, 2 L. SPICUZZA, 3 N. CASIRAGHI, 4 ́ N-VELARDE, 2 AND L. BERNARDI 4, A. MORI, 5 R. TAPIA RAMIREZ, 2 F. LEO 1 Department of Anesthesiology, University Medical Center, 93042 Regensburg, Germany; 2 Department of Physiological Sciences, Universidad Cayetano Heredia, Lima 700, Peru; 3 Institute of Respiratory Diseases, University of Catania, 95124 Catania, Italy; 4 Department of Internal Medicine and Institute of Hematology, and 5 Department of Pathology, University of Pavia and Istituto di Ricovero e Cura a Carattere Scientifico San Matteo, 27100 Pavia, Italy We evaluated autonomic cardiovascular regulation in subjects with polycythemia and chronic mountain sickness (CMS) and tested the hypothesis that an increase in arterial oxygen saturation has a beneficial effect on arterial baroreflex sensitivity in these subjects. Ten Andean natives with a Hct >65% and 10 natives with a Hct <60%, all living permanently at an altitude of 4,300 m, were included in the study. Cardiovascular autonomic regulation was evaluated by spectral analysis of hemodynamic parameters, while subjects breathed spontaneously or frequency controlled at 0.1 and 0.25 Hz, respectively. The recordings were repeated after a 1-h administration of supplemental oxygen and after frequency-controlled breathing at 6 breaths/min for 1 h, respectively. Subjects with Hct >65% showed an increased incidence of CMS compared with subjects with Hct <60%. Spontaneous baroreflex sensitivity was significantly lower in subjects with high Hct compared with the control group. The effects of supplemental oxygen or modification of the breathing pattern on autonomic function were as follows: 1) heart rate decreased significantly after both maneuvers in both groups, and 2) spontaneous baroreflex sensitivity increased significantly in subjects with high Hct and did not differ from subjects with low Hct. Temporary slow-frequency breathing may provide a beneficial effect on the autonomic cardiovascular function in high-altitude natives with CMS.