{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:21:43Z","timestamp":1790767303128,"version":"4.1.0"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Actelion SA","award":["unrestricted research grant"],"award-info":[{"award-number":["unrestricted research grant"]}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2021,6,21]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Question addressed by the study<\/jats:title><jats:p>To investigate exercise performance and hypoxia-related health effects in patients with pulmonary hypertension (PH) during a high-altitude sojourn.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>In a randomised crossover trial in stable (same therapy for &gt;4\u2005weeks) patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) with resting arterial oxygen tension (<jats:italic>P<\/jats:italic><jats:sub>aO<jats:sub>2<\/jats:sub><\/jats:sub>) \u22657.3\u2005kPa, we compared symptom-limited constant work-rate exercise test (CWRET) cycling time during a day-trip to 2500\u2005m<jats:italic>versus<\/jats:italic>470\u2005m. Further outcomes were symptoms, oxygenation and echocardiography. For safety, patients with sustained hypoxaemia at altitude (peripheral oxygen saturation &lt;80% for &gt;30\u2005min or &lt;75% for &gt;15\u2005min) received oxygen therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>28 PAH\/CTEPH patients (n=15\/n=13); 13 females; mean\u00b1<jats:sc>sd<\/jats:sc>age 63\u00b115\u2005years were included. After &gt;3\u2005h at 2500\u2005m<jats:italic>versus<\/jats:italic>470\u2005m, CWRET-time was reduced to 17\u00b111<jats:italic>versus<\/jats:italic>24\u00b19\u2005min (mean difference \u22126, 95% CI \u221210 to \u22123), corresponding to \u221227.6% (\u221241.1 to \u221214.1; p&lt;0.001), but similar Borg dyspnoea scale. At altitude,<jats:italic>P<\/jats:italic><jats:sub>aO<jats:sub>2<\/jats:sub><\/jats:sub>was significantly lower (7.3\u00b10.8<jats:italic>versus<\/jats:italic>10.4\u00b11.5\u2005kPa; mean difference \u22123.2 kPa, 95% CI \u22123.6 to \u22122.8 kPa), whereas heart rate and tricuspid regurgitation pressure gradient (TRPG) were higher (86\u00b118<jats:italic>versus<\/jats:italic>71\u00b116\u2005beats\u00b7min<jats:sup>\u22121<\/jats:sup>, mean difference 15 beats\u00b7min<jats:sup>\u22121<\/jats:sup>, 95% CI 7 to 23\u2005beats\u00b7min<jats:sup>\u22121<\/jats:sup>) and 56\u00b125<jats:italic>versus<\/jats:italic>40\u00b115\u2005mmHg (mean difference 17 mmHg, 95% CI 9 to 24 mmHg), respectively, and remained so until end-exercise (all p&lt;0.001). The TRPG\/cardiac output slope during exercise was similar at both altitudes. Overall, three (11%) out of 28 patients received oxygen at 2500\u2005m due to hypoxaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This randomised crossover study showed that the majority of PH patients tolerate a day-trip to 2500\u2005m well. At high<jats:italic>versus<\/jats:italic>low altitude, the mean exercise time was reduced, albeit with a high interindividual variability, and pulmonary artery pressure at rest and during exercise increased, but pressure\u2013flow slope and dyspnoea were unchanged.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00314-2021","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T09:07:03Z","timestamp":1633943223000},"page":"00314-2021","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Effect of a day-trip to altitude (2500\u2005m) on exercise performance in pulmonary hypertension: randomised crossover trial"],"prefix":"10.1183","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3635-0515","authenticated-orcid":false,"given":"Simon R.","family":"Schneider","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-1758","authenticated-orcid":false,"given":"Mona","family":"Lichtblau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Berlier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther I.","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-6277","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Saxer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8518-5029","authenticated-orcid":false,"given":"Michael","family":"Furian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad E.","family":"Bloch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-5022","authenticated-orcid":false,"given":"Silvia","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2024101711160118000_7.4.00314-2021.1","unstructured":"Permanent Secretariat of the Alpine Convention . 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