Acute Exposure to High Altitude on Pulmonary Artery Pressure and Right Heart Function (Echo)

Overview

Randomized crossover Trial in patients with Pulmonary Hypertension (PAH, CTEPH) to assess the acute response to High Altitude ("Säntis"; 2500m above sea level) on pulmonary artery pressure and right heart function (echo)

Full Title of Study: “Acute Exposure to Hypoxia in Precapillary Pulmonary Hypertension: Physiological and Clinical Effects at Rest and During Exercise”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 1, 2019

Detailed Description

Low altitude baseline measurements will be performed in Zurich (460m asl) including Echocardiography, Right heart catheterization, six-minute walk test (6MWT), pulmonary function test, clinical assessment and blood gas Analysis. Randomly assigned to the order of testing, the participants will be tested in Low Altitude (Zurich, 470m) and at High Altitude (2500m). Several times within the exposure, the pulmonary artery pressure (PAP) and the right heart function will be assessed by echo.

Interventions

  • Other: Assessment at Low Altitude (470m above sea level)
    • Assessment at Low Altitude (in Zurich; 470m above sea level) in order to compare this data with High altitude exposure
  • Other: Exposure to High Altitude (2500m above sea level)
    • Exposure to High Altitude (“Säntis”; 2500m above sea level) for approximately 5 hours

Arms, Groups and Cohorts

  • Experimental: Order A
    • The participants will be tested in Zurich (Low altitude: 470m above sea level) and consecutively at High Altitude(“Säntis”; 2500m above sea Level)
  • Experimental: Order B
    • The participants will be tested at High Altitude (“Säntis”; 2500m above sea level) and consecutively in Zurich (Low altitude; 470m above sea level).

Clinical Trial Outcome Measures

Primary Measures

  • Echocardiographic assessment at High Altitude (2500m above sea level)
    • Time Frame: 1 day at altitude
    • Pulmonary artery pressure will be measured by echo (TTE).

Secondary Measures

  • Echocardiographic right heart assessment at High Altitude (2500m above sea level)
    • Time Frame: 1 day at altitude
    • The right heart function (fac, D-Shaping, etc.) will be assessed by Echocardiography (TTE)

Participating in This Clinical Trial

Inclusion Criteria

  • Informed consent – PH diagnosed according to internation Guidelines: mean pulmonary artery pressure (mPAP) ≥ 25 mmHg along with a pulmonary artery wedge pressure (PAWP) ≤15 mmHg during right heart catheterization at the time of Initial diagnosis – PH class 1 (PAH) or 4 (CTEPH) – Stable condition, on the same medication for > 4 weeks – Patient live permanently at an altitude < 1000m asl. Exclusion Criteria:

  • Resting partial Oxygen pressure (PaO2) ≤7.3 kPA corresponding to the requirement of long-term oxygen therapy > 16hour daily (nocturnal oxygen therapy alone is allowed) – Severe daytime hypercapnia (pCO2 > 6.5 kilopascal (kPa)) – Susceptibility to high altitude related diseases (AMS, high-altitude pulmonary edema (HAPE), etc.) based on previous experienced discomfort at altitudes. – Exposure to an altitude >1500m for ≥3 nights during the last 4 weeks before the study participation – Residence > 1000m above sea level – Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic problems with Walking disability – Women who are pregnant or breast feeding

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Zurich
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Silvia Ulrich, Prof., Principal Investigator, University of Zurich

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