Altitude-Associated Hemodynamic Alterations: Analysis from the Veterans Affairs Clinical Assessment, Reporting, and Tracking

RATIONALE: Increases in PA pressures and PVR are well-described at altitudes above 2400m. However, the potential hemodynamic implications of changes in altitude at lower elevations (3WU increased with altitude. Patients with EF < 40% at ≥ 1000m elevation were 22% more likely to have a PVR >3 WU than those at < 500m (OR 1.22 95% CI 1.10-1.36; p < 0.001). Pulmonary vascular compliance did not change with altitude, and the pulmonary resistance-compliance relationship was shifted upward and to the right at higher altitude. CONCLUSIONS: Modest increases in altitude (between 0-1640m) are associated with clinically significant alterations in pulmonary artery hemodynamics. Such changes may impact PH diagnosis and classification and eligibility for advanced cardiovascular interventions.