Walking on Mount Meiggs, near to 5085 m
Ticlio
hypobaric chamber that simulates different altitudes
HEIGHT AND HEIGHT NATURAL SIMULATED IN CORONARY HEART REHABILITATION
USE OF NATURAL AND SIMULATED ALTITUDE IN CORONARY HEART REHABILITATION
HIGH ALTITUDE PHYSIOLOGY . CARDIAC AND RESPIRATORY ASPECTS A CIBA FOUNDATION SYMPOSIUM IN HONOUR OF PROFESOR ALBERTO HURTADO, LONDON 1971
Ticlio
hypobaric chamber that simulates different altitudes HEIGHT AND HEIGHT NATURAL SIMULATED IN CORONARY HEART REHABILITATION
Our teacher Emilio Marticorena in 1994, first reported that the natural hypoxia in the Andes could be used as a effective procedure for coronary cardiac rehabilitation, this procedure was complemented later when he retired Chulec Hospital to work in the Air Force Hospital in Lima using simulated hypoxia using hypobaric chambers.
This procedure was mainly based on anatomical studies (Arias Stella), physiological (Moret) and biochemical (Harris) in the heart of man height.
Three related studies published by the CIBA Foundation in London in 1971 in a tribute to Professor Simposiun Alberto Hurtado, are discussed in this regard by Dr. Marticorena in an article in Acta Andina 2001; 9 (1-2): 63 to published below.
Dr. Achilles Monroy
This procedure was mainly based on anatomical studies (Arias Stella), physiological (Moret) and biochemical (Harris) in the heart of man height.
Three related studies published by the CIBA Foundation in London in 1971 in a tribute to Professor Simposiun Alberto Hurtado, are discussed in this regard by Dr. Marticorena in an article in Acta Andina 2001; 9 (1-2): 63 to published below.
Dr. Achilles Monroy
USE OF NATURAL AND SIMULATED ALTITUDE IN CORONARY HEART REHABILITATION
Dr. Emilio A. Marticorena
Professor Emeritus of Medicine, UNMSM
In 1971, three of the participants in the Ciba Symposyum Physiology Height in 1971 - in London - England, in honor of Professor Alberto Hurtado, respectively presented their observations:
1) The extensive coronary vasculature in individuals of height (A) for specimens of sea level (SL) (1) .
2) Reduced coronary flow more efficiently in the native myocardial Height (2) .
3) Increased myocardial enzyme activity of succinic dehydrogenase in animals under Height (3) .
These three separate research approaches, aimed at exploring the myocardium of Height and Sea Level, have contributed to the development of procedures currently use natural hypoxia (Peruvian Andes) and simulated altitude (hypobaric chamber) for the purpose - specific-Coronary Cardiac Rehabilitation (RCC) .
In this sense, Peru, in the world that moves first to the height (5000 m) in coronary patients with and without myocardial infarction Cardiac Rehabilitation for Coronary (4-5) .
* See article in this blog: "CLIMBING MEDICAL "
Returning to the form of simulated altitude (hypobaric chamber), is reported by Peru in 1994 (4-5) . That same year, mentions the first Soviet experience (6) .
currently in Peru deepen the mechanisms that attempt to explain how he would act rehabilitating myocardial hypoxia, whereas it is probably the level of molecular biology where such arrangements would take place (7-8) .
Finally, it is a privilege for the commentator of these lines of research have dealt with tightly on the significance which means the contribution of researchers: Arias Stella, Moret and Harris in the current management of RCC with hypoxia, Peru and outside.
Professor Emeritus of Medicine, UNMSM
In 1971, three of the participants in the Ciba Symposyum Physiology Height in 1971 - in London - England, in honor of Professor Alberto Hurtado, respectively presented their observations:
1) The extensive coronary vasculature in individuals of height (A) for specimens of sea level (SL) (1) .
2) Reduced coronary flow more efficiently in the native myocardial Height (2) .
3) Increased myocardial enzyme activity of succinic dehydrogenase in animals under Height (3) .
These three separate research approaches, aimed at exploring the myocardium of Height and Sea Level, have contributed to the development of procedures currently use natural hypoxia (Peruvian Andes) and simulated altitude (hypobaric chamber) for the purpose - specific-Coronary Cardiac Rehabilitation (RCC) .
In this sense, Peru, in the world that moves first to the height (5000 m) in coronary patients with and without myocardial infarction Cardiac Rehabilitation for Coronary (4-5) .
* See article in this blog: "CLIMBING MEDICAL "
Returning to the form of simulated altitude (hypobaric chamber), is reported by Peru in 1994 (4-5) . That same year, mentions the first Soviet experience (6) .
currently in Peru deepen the mechanisms that attempt to explain how he would act rehabilitating myocardial hypoxia, whereas it is probably the level of molecular biology where such arrangements would take place (7-8) .
Finally, it is a privilege for the commentator of these lines of research have dealt with tightly on the significance which means the contribution of researchers: Arias Stella, Moret and Harris in the current management of RCC with hypoxia, Peru and outside.
HIGH ALTITUDE PHYSIOLOGY . CARDIAC AND RESPIRATORY ASPECTS A CIBA FOUNDATION SYMPOSIUM IN HONOUR OF PROFESOR ALBERTO HURTADO, LONDON 1971
Summary
Anatomy of the coronary circulation at high altitude.
ARIAS- STELLA J Y TOPILSKY M. (1)
Using the method of preparing casts of the coronary arterial system through aortic injection of rapidly polymerising acrylic resin at a pressure of 150-200 mmHg, followed by fixation and corrosion, a different pattern has been found in the vascularization of individuals from Cerro de Pasco (4375 msnm) from that seen in subjects from sea level. These results are compared with those recently obtained in our laboratory by Dr. Carmelino in subjects from Puno (3466 - 4287 msnm), using the post mortem stereoangiographic method. Both studies show the number of branches That Leaving the main coronary trunks is great and the peripheral ramifications Are More Numerous at high altitudes. The Physiological and Clinical Significance of These Findings is discussed.
* See this blog article: " THE HEART IS BIGGER, HEAVIER AND HEIGHT vascularized "
Coronary blood flow and myocardial metabolism in man at high altitude
MORET PR (2)
Coronary blood flow and myocardial metabolism Studies in Normal Subjects Were living in Peru and Bolivia at Three Different altitude: Lima (150 m), La Paz (3700 m) and Cerro de Pasco (4375 m). Coronary blood flow is lower at high altitude, as is the oxygen consumption of the myocardium, with the result that myocardial efficiency is greater. The lower coronary flow at high altitude is not compensated for by any increased oxygen transport capacity of the blood. Substrates usually extracted by the heart -glucose, lactate, pyruvate and free fatty acids- are the same at high and low altitude, but at high altitude the heart consumes more carbohydrates, especially lactate, and there are no signs of anaerobic metabolism. The lower coronary blood flow and oxygen consumption and absence of signs of anaerobic metabolism at high altitude suggest an adaptation of cellular metabolism to low oxygen pressure. Six patients with chronic mountain sickness were also studied. Coronary blood flow was higher than in the normal groups, and in some cases the myocardium seems to be slightly underperfused. The percentage oxygen extraction is increased, in contrast to the normal subjects, and the extraction of metabolites also differs.
Some observations on the biochemistry of the myocardium at high altitude
HARRIS P (3)
Measurements of succinic dehydrogenase and lactic dehydrogenase activity have been made on myocardial homogenates from guinea pigs, rabbits and dogs indigenous to high altitude and compared with measurements made on the same species at sea level. A consistent increase in the activity of succinic dehydrogenase was found in the high altitude animals but no significant difference in lactic dehydrogenase.
Analyses of the lipid content of the myocardium have shown that there is a consistent increase in total lipid, total phospholipid, cholesterol and sphingomyelin in the myocardium of the three species of animal at high altitude.
Anatomy of the coronary circulation at high altitude.
ARIAS- STELLA J Y TOPILSKY M. (1)
Using the method of preparing casts of the coronary arterial system through aortic injection of rapidly polymerising acrylic resin at a pressure of 150-200 mmHg, followed by fixation and corrosion, a different pattern has been found in the vascularization of individuals from Cerro de Pasco (4375 msnm) from that seen in subjects from sea level. These results are compared with those recently obtained in our laboratory by Dr. Carmelino in subjects from Puno (3466 - 4287 msnm), using the post mortem stereoangiographic method. Both studies show the number of branches That Leaving the main coronary trunks is great and the peripheral ramifications Are More Numerous at high altitudes. The Physiological and Clinical Significance of These Findings is discussed.
* See this blog article: " THE HEART IS BIGGER, HEAVIER AND HEIGHT vascularized "
Coronary blood flow and myocardial metabolism in man at high altitude
MORET PR (2)
Coronary blood flow and myocardial metabolism Studies in Normal Subjects Were living in Peru and Bolivia at Three Different altitude: Lima (150 m), La Paz (3700 m) and Cerro de Pasco (4375 m). Coronary blood flow is lower at high altitude, as is the oxygen consumption of the myocardium, with the result that myocardial efficiency is greater. The lower coronary flow at high altitude is not compensated for by any increased oxygen transport capacity of the blood. Substrates usually extracted by the heart -glucose, lactate, pyruvate and free fatty acids- are the same at high and low altitude, but at high altitude the heart consumes more carbohydrates, especially lactate, and there are no signs of anaerobic metabolism. The lower coronary blood flow and oxygen consumption and absence of signs of anaerobic metabolism at high altitude suggest an adaptation of cellular metabolism to low oxygen pressure. Six patients with chronic mountain sickness were also studied. Coronary blood flow was higher than in the normal groups, and in some cases the myocardium seems to be slightly underperfused. The percentage oxygen extraction is increased, in contrast to the normal subjects, and the extraction of metabolites also differs.
Some observations on the biochemistry of the myocardium at high altitude
HARRIS P (3)
Measurements of succinic dehydrogenase and lactic dehydrogenase activity have been made on myocardial homogenates from guinea pigs, rabbits and dogs indigenous to high altitude and compared with measurements made on the same species at sea level. A consistent increase in the activity of succinic dehydrogenase was found in the high altitude animals but no significant difference in lactic dehydrogenase.
Analyses of the lipid content of the myocardium have shown that there is a consistent increase in total lipid, total phospholipid, cholesterol and sphingomyelin in the myocardium of the three species of animal at high altitude.
BIBLIOGRAFÍA
1. Arias Stella J y Topilsky M: Anatomy of the coronary circulation at high altitude, High Altitude Physiology: Cardiac and Respiratory Aspects, A Ciba Foundation Symposium, Edit. R. Porter and J. Knight, Churchill Livingstone, London, pp. 149-154, 1971.
2. Moret PR: Coronary blood flow and myocardial metabolism in man at high altitude, High Altitude Physiology Cardiac and Respiratory Aspects, A Ciba Foundation Symposium Edit. R. Porter and J. Knight, Churchill Livingstone, London, pp. 131-144, 1971.
3. Harris P: Some observations on the biochemistry of the myocardium at high altitude, High Altitude Physiology Cardiac and Respiratory Aspects, A Ciba Foundation Symposium, Edit. R. Porter and J. Knight, Churchill Livingstone, London, pp 125-129.1971.
4. Marticorena EA (1984-85) New technique in cardiac rehabilitation and coronary primary prevention: use of high altitude. Areh. Inst Biol. and. 13: 189-206.
5. EA Marticorena, Marticorena JM, Contreras A et. al. (1994) Cardiac Patients bypassed coronary rehabilitation of natural and simulated high altitude techniques. First World Congress of High Altitude Medicine and Physiology, La Paz, Bolivia. Abst. 101.
6. Thinkov AN, Kotz Yl, Alyoshin IA (1994) The first experience of Treatment of Patients with ischemic heart disease using the method of adaptation to intermittent hypoxia in an altitude chamber, Hypoxia Med J 2: p. 73, Abst. 115.
7. Marticorena EA (1998) Molecular basis of hypoxic coronary cardiac rehabilitation and simulated natural height, Rev. Peruvian cardiologist. XXIV: 2:177-186.
8. Col. Marticorena EA (2001) Endothelial relaxing factor (ON) coronary rehabilitation hypobaric chamber, Rev. Peruvian cardiologist. 27: 2:148-9.
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