Women and Children Hospital, Xining, Research Center for High Altitude Medicine, Qinghai
Medical College, Xining, China
2
.
In China, high altitude heart disease (HAHD) as a form of chronic mountain sickness is a
common illness in children at high altitude. The aim of the present study was to investigate the
characteristics of HAHD. The clinical data of 55 patients with HAHD hospitalized in Qinghai
Provincial Women and Children Hospital from May 2001 to Sept. 2003, aged 3-27 months, were
reported and compared with 40 normal age-matched children who lived at 3700m. The nationality
of patients was consisted of 31 Han (56.4%), 15 native Tibetan (27.3%), 8 Hui (14.1%) and 1
Mongolian (1.8%). All of the patients came from 2440m - 4700m. The age ranged from 1 to 26
months with a mean of 7.1 months. Symptoms frequently reported by patients were recurrent
cough (63.6%), dyspnea (92.7%), cyanosis (90%) and edema (60%). Of these patients, 63.4% had
a loud second pulmonic heart sound. 55 cases had clinical evidence of right heart failure. The
hemoglobin of patients vs. healthy controls differed: 10.46 ±2.20, 16.22 ± 3.5 g/dl, respectively,
and p<0.001. On chest X-ray, the mean cardiothoracic ratio (C/T) in patients was 68% compared
to 53% in controls. ECG revealed right axis deviation in 55 patients and 24 controls. 55 patients
and 0 controls showed evidence of right ventricular hypertrophy. Doppler-echocardiography, CT
and MRI demonstrated right ventricular hypertrophy and right ventricular dilation in all patients.
The mean pulmonary artery pressure was 71.82±17.18 mmHg in patients and 30.48±12.94 mmHg
in controls_p_0.001_. No significant differences in signs and symptoms were observed
between the native Tibetan and the Han. In conclusion, the marked pulmonary hypertension, right
ventricular hypertrophy, right heart dilation and right heart failure without polycythemia are main
characteristics of HAHD in childhood. The HAHD occur in the both Han Chinese and Tibetan
natives at high altitude.
197.
COMPARATIVE STUDY OF PULMONARY ARTERIAL PRESSURE IN HEALTHY
CHILDREN AT DIFFERENT ALTITUDE BY DOPPLER ECHOCARDIOGRAPHY. Ma Ru-
Yan
1
, Qi Hai-Ying
1
, Peng Ying
1
, Sun Kun
2
, Ge Ri-Li
3
. Dept.of Cardiology, Qinghai Provincial
Women and Children Hospital;Xining, Dept. of Cardiology;Shanghai Children Medical
Center,Shanghai
2
, Research Center for High Altitude Medicine, Qinghai Medical College,
Xining, China
3
.
The aim of this study was to obtain pulmonary arterial pressures (PAP) in healthy children
who live at different altitudes. We compared PAP in two groups of children: those living at high
altitude vs. those living at sea level and Han children vs. Tibetan children at high altitude. All
children were divided into seven age groups. The right ventricular systolic time intervals _RSTI)
and arterial oxygen saturation (SaO2) of 1061 cases of healthy children aged 0-14yr (residing at
16m,2260m and 3700m) were examined using Doppler echocardiography and pulse oximeter.
RSTI included the previous ejection period (PEP), ascending time (AT), ejection time (ET),
PEP/AT and AT/ET. The mean pulmonary arterial pressure (mPAP) was estimated by Doppler
echocardiography. The AT and AT/ET of the groups at 2260m and 3700m were shorter than
those of the groups at 16m in each age group (p_ 0.05_0.001). The PEP and PEP/AT at 3700m
were longer than those at 2260m and 16m for all age groups. The mPAP in all groups at 3700m
was higher than the mPAP of the groups at 2260m and 16m (p_ 0.01_0.001). The mPAP in
newborns and older infants was greater than that of juveniles at 3700m (p_0.01). There was no
obvious difference in mPAP between the 2260m and 16m groups (p_0.05). No significant
differences in SaO2, STI and mPAP were observed between the native Tibetan children and the
Han Chinese at 3700m (p_0.05). In conclusion, the PAP in healthy children at 3700m was
significantly increased compared to those at lower altitude, and this value decreased with time.
Whereas a hypoxic environment did play a major role in increasing PAP in children at high
altitude, the racial differences between the Han and Tibetan children did not contribute.
198.
RIGHT VENTRICULAR DIASTOLIC FUNCTION IN HIGHLANDERS WITH HIGH
ALTITUDE COR PULMONALE. Ibragim Sabirov
1
, Akylbek Sydykov
1
, Ibragim Sabirov
1
,
