Objective High-altitude pulmonary edema(HAPE)is a kind of noncardiogenic edema and it develops in healthy individuals.The incidence is high in young males and recurrent cases are occasionally noted.In Japan,most patie...Objective High-altitude pulmonary edema(HAPE)is a kind of noncardiogenic edema and it develops in healthy individuals.The incidence is high in young males and recurrent cases are occasionally noted.In Japan,most patients are climbers.It frequently occurs in the central mountainous region centering the Northern Alps,and a few cases occur yearly.It is cured by prompt transfer to lowland,but it progresses to a severe state and may result in death when rescue is delayed.Our department has performed right heart catheterization and bronchoalveolar lavage in the acute phase of HAPE since 1980s,analyzed the pathophysiology,and elucidated the developmental mechanism.It was clarified that the essence of HAPE is"mixed pulmonary edema"in which pulmonary hypertension-induced elevation of intravascular pressure and inflammation-induced promotion of vascular permeability coexist.We have also performed molecular-genetic investisation paying attention to constitutional predisposition because persons with a past medical history of HAPE develop specific cardiorespiratory reactions to a low oxygen load,and i-dentified several disease-susceptible genes including the endothelial nitric oxide synthase gene(eNOS)associated with pulmonary hypertension.展开更多
文摘Objective High-altitude pulmonary edema(HAPE)is a kind of noncardiogenic edema and it develops in healthy individuals.The incidence is high in young males and recurrent cases are occasionally noted.In Japan,most patients are climbers.It frequently occurs in the central mountainous region centering the Northern Alps,and a few cases occur yearly.It is cured by prompt transfer to lowland,but it progresses to a severe state and may result in death when rescue is delayed.Our department has performed right heart catheterization and bronchoalveolar lavage in the acute phase of HAPE since 1980s,analyzed the pathophysiology,and elucidated the developmental mechanism.It was clarified that the essence of HAPE is"mixed pulmonary edema"in which pulmonary hypertension-induced elevation of intravascular pressure and inflammation-induced promotion of vascular permeability coexist.We have also performed molecular-genetic investisation paying attention to constitutional predisposition because persons with a past medical history of HAPE develop specific cardiorespiratory reactions to a low oxygen load,and i-dentified several disease-susceptible genes including the endothelial nitric oxide synthase gene(eNOS)associated with pulmonary hypertension.
