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Electrocardiographic changes during sustained normobaric hypoxia in patients after myocardial infarction

Kramer, T. and Hoenemann, J.N. and Weis, H. and Hoffmann, F. and Rosenkranz, S. and Baldus, S. and Hellmich, M. and Levine, B.D. and Jordan, J. and Tank, J. and Limper, U. (2023) Electrocardiographic changes during sustained normobaric hypoxia in patients after myocardial infarction. Scientific Reports, 13 (1), p. 17452. Nature Publishing Group. doi: 10.1038/s41598-023-43707-5. ISSN 2045-2322.

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Official URL: https://doi.org/10.1038/s41598-023-43707-5


The safety of prolonged high-altitude stays and exercise for physically fit post-myocardial infarction (MI) patients is unclear. Myocardial tissue hypoxia and pulmonary hypertension can affect cardiac function and electrophysiology, possibly contributing to arrhythmias. We included four non-professional male athletes, clinically stable after left ventricular MI (three with ST-segment elevation MI and one with non-ST-segment elevation MI) treated with drug-eluting stents for single-vessel coronary artery disease. Oxygen levels were reduced to a minimum of 11.8%, then restored to 20.9%. We conducted electrocardiography (ECG), ergometry, and echocardiography assessments in normoxic and hypoxic conditions. With an average age of 57.8 ± 3.3 years and MI history 37 to 104 months prior, participants experienced a significant increase in QTc intervals during hypoxia using Bazett's (from 402 ± 13 to 417 ± 25 ms), Fridericia's (from 409 ± 12 to 419 ± 19 ms), and Holzmann's formulas (from 103 ± 4 to 107 ± 6%) compared to normoxia. This effect partially reversed during recovery. Echocardiographic signs of pulmonary hypertension during normobaric hypoxia correlated significantly with altered QTc intervals (p < 0.001). Despite good health and complete revascularization following MI, susceptibility to hypoxia-induced QTc prolongation and ventricular ectopic beats persists, especially during physical activity. MI survivors planning high-altitude activities should consult cardiovascular specialists with high-altitude medicine expertise.

Item URL in elib:https://elib.dlr.de/199591/
Document Type:Article
Title:Electrocardiographic changes during sustained normobaric hypoxia in patients after myocardial infarction
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
Kramer, T.Klinik für Kardiologie, Angiologie, Pneumologie und Internistische Intensivmedizin, Herzzentrum der Universität zu Köln, KölnUNSPECIFIEDUNSPECIFIED
Hoenemann, J.N.Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Germany and German Aerospace Center, Institute of Aerospace Medicine, Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Weis, H.Nuklearmedizin, Universitätsklinikum Köln, KölnUNSPECIFIEDUNSPECIFIED
Hoffmann, F.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.;Department of Cardiology, Pneumology, and Angiology, Heart Center of the University of Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Baldus, S.Department of Internal Medicine III (F.H., H.R., S.B.), University of Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Levine, B.D.Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USAUNSPECIFIEDUNSPECIFIED
Jordan, J.UNSPECIFIEDhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Tank, J.UNSPECIFIEDhttps://orcid.org/0000-0002-5672-1187UNSPECIFIED
Limper, U.German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germanyhttps://orcid.org/0000-0001-9927-4180UNSPECIFIED
Date:14 October 2023
Journal or Publication Title:Scientific Reports
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In ISI Web of Science:Yes
Page Range:p. 17452
Publisher:Nature Publishing Group
Keywords:myocardial infarction; Electrocardiographic changes; hypoxia
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:23 Nov 2023 14:13
Last Modified:30 Jan 2024 10:06

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