PT  - JOURNAL ARTICLE
AU  - J-P Schmid
AU  - M Noveanu
AU  - R Gaillet
AU  - G Hellige
AU  - A Wahl
AU  - H Saner
TI  - Safety and exercise tolerance of acute high altitude exposure (3454 m) among patients with coronary artery disease
AID  - 10.1136/hrt.2005.072520
DP  - 2006 Jul 01
TA  - Heart
PG  - 921--925
VI  - 92
IP  - 7
4099  - http://heart.bmj.com/content/92/7/921.short
4100  - http://heart.bmj.com/content/92/7/921.full
SO  - Heart2006 Jul 01; 92
AB  - Objectives: To assess the safety and cardiopulmonary adaptation to high altitude exposure among patients with coronary artery disease. Methods: 22 patients (20 men and 2 women), mean age 57 (SD 7) years, underwent a maximal, symptom limited exercise stress test in Bern, Switzerland (540 m) and after a rapid ascent to the Jungfraujoch (3454 m). The study population comprised 15 patients after ST elevation myocardial infarction and 7 after a non-ST elevation myocardial infarction 12 (SD 4) months after the acute event. All patients were revascularised either by percutaneous coronary angioplasty (n  =  15) or by coronary artery bypass surgery (n  =  7). Ejection fraction was 60 (SD 8)%. β blocking agents were withheld for five days before exercise testing. Results: At 3454 m, peak oxygen uptake decreased by 19% (p < 0.001), maximum work capacity by 15% (p < 0.001) and exercise time by 16% (p < 0.001); heart rate, ventilation and lactate were significantly higher at every level of exercise, except at maximum exertion. No ECG signs of myocardial ischaemia or significant arrhythmias were noted. Conclusions: Although oxygen demand and lactate concentrations are higher during exercise at high altitude, a rapid ascent and submaximal exercise can be considered safe at an altitude of 3454 m for low risk patients six months after revascularisation for an acute coronary event and a normal exercise stress test at low altitude.