Citations

Introduction Optivol (Medtronic Inc.) thoracic impedance (ZT) provides preemptive disease status information in heart failure (HF). It remains unclear how pulmonary‐capillary blood volume (Vc), lung volume (Lvol), and interstitial fluid influence ZT. Hypothesis Positional change and exercise result in increased Vc and/or lung interstitial fluid and ZT tracks fluctuation in these variables. Methods 12 HF patients (age 63±8yr, LVEF 41±14%) were recruited. Measures were taken at rest, exercise, recovery. This included: spirometry, ZT, diffusing capacity of the lungs for CO and NO (DLCO, DLNO), alveolar‐capillary conductance (Dm, interstitial fluid index), and Vc. Inspiratory capacity was obtained to provide consistent lung volumes for assessing ZT. Results Positional change (upright‐supine) resulted in an increased ZT (5±4%, p<0.01), while the change in Lvol (RV‐TLC) resulted in a 7±2 ohm swing in ZT (0.2±0.1ohm change/100ml change in Lvol). After 30min supine, Vc increased 28±39% (p<0.05) while Dm/Vc and Lvol decreased (29±11% and 17±3%, p<0.05). During exercise compared to baseline, Vc increased 56±44% (p<0.01), DmCO/Vc decreased 25±7% (p<0.05), and ZT did not change. During recovery measures normalized except DmCO/Vc. Conclusion Positional changes and fluctuations in Lvol influence ZT yet measures of lung fluid minimally impact this measure despite significant fluctuations.

BACKGROUND High altitude (HA) exposure influences appetite, protein synthesis and breakdown, and aerobic capacity. Thus, HA exposure typically causes weight (wt) loss, while the impact on aerobic capacity upon return to sea level is more variable. OBJECTIVE To examine the influence of hypobaric hypoxia on body composition and exercise capacity in elite HA climbers (n=4, 2 female) acclimating at ≥5,150 m over 2 mo. relative to trekkers (n=8, 0 female) acclimating at 5,150 m over 2 wks (Mt. Everest, Nepal). Each elite climber successfully summited Mt. Everest. METHODS Body composition (DEXA, skin folds, wt) and exercise capacity (treadmill) were assessed before and within 2 wks post HA. RESULTS HA exposure increased Hct and Hb, with peak values of 52±5% and 18±2 g/dl, and 50±3% and 17±1 g/dl for the climbers and trekkers, respectively. HA decreased lean and fat tissue in both the climbers (lean −4.4±2.3%, fat −8.2±4.0%) and trekkers (lean −1.8±1.6%, fat −5.8±6.1%) (all P ≤0.06). No change was observed in skin folds for either group. Wt decreased in the climbers (−5±2%, P <0.03) and trekkers (−3±1%, P <0.01). There was no change in VO 2max pre‐to post‐HA in either group (climbers 3.26 ± 0.37 vs. 3.27 ± 0.61 L/min; trekkers 3.60 ± 0.54 vs. 3.66 ± 0.43 L/min). CONCLUSION HA results in both lean and fat tissue loss in well acclimatized climbers and trekkers with little subsequent impact on aerobic capacity. Mayo Clinic & TNF.