Summary
In order to distinguish the effects of beta-receptor stimulation on the ECG from other factors during short-term adjustment to hypoxic aerohypoxia, the ECG of 19 volunteers were compared during moderately acute, stepwise exposure to high altitude (6,000 m) in a low pressure chamber, once with and once without beta-receptor blockade (propranolol), and after isoprenaline inhalation at ground level. The results show that beta-receptor stimulation accounts mainly for most ECG changes during altitude exposure, i.e., for the shortening of R-R interval, the lengthening of Q-T and in particular for the ST-T flattening, the latter therefore being only an indirect sign of hypoxia. After exclusion of the catecholamines, the minor but still significant ECG changes at altitude (shortening of R-R interval, increase of P wave, prolongation of P-Q, deviation of the R vector, T wave flattening in the left precordial leads) may be attributed to other, so far undefined factors, such as cardiac hypoxia, vagal withdrawal, or increase of pulmonary resistance.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Biberman L, Sarma RN, Surawicz B (1971) T-wave abnormalities during hyperventilation and isoproterenol infusion. Am Heart J 81: 166–174
Boutellier U, Koller EA (1981) Propranolol and the respiratory, circulatory, and ECG responses to high altitude. Eur J Appl Physiol 46: 105–119
Bühlmann A (1965) Klinische Funktionsprüfung des Herzens. Schweiz Med Wochenschr 95: 1327–1332
Cunningham WL, Becker EJ, Kreuzer F (1965) Catecholamines in plasma and urine at high altitude. J Appl Physiol 20: 607–610
Furberg C, Tengblad CF (1966) Adrenergic beta-receptor blockade and the effect of hyperventilation on the electrocardiogramm. Scand J Clin Lab Invest 18: 467–472
Hegglin R, Holzmann M (1937) Die klinische Bedeutung der verlÄngerten QT-Distanz (Systolendauer) im Elektrokardiogramm. Z Klin Med 132: 1–32
Holzmann M (1961) Klinische Elektrokardiographie. Stuttgart: Georg Thieme Verlag, Stuttgart New York, pp 91–115
Hopff L, Huber AK, Wyss OAM (1963) Studien zur Vektorkar-diographie. III. Der Nachweis des ProximitÄtseffektes der vorderen Brustwandelektrode beim Menschen. Arch f Kreislaufforsch 40: 236–251
Jorgensen ChR, Wang K, Wang Y, Gobel FL, Nelson RR, Taylor H (1973) Effect of propranolol on myocardial oxygen consumption and its hemodynamic correlates during upright exercise. Circulation 48: 1173–1182
Koller EA, Boutellier U, Ziegler WH (1983) Zum Einflu\ der Katecholamine und von Propranolol auf die akute Höhenanpassung des Menschen. Schweiz Med Wochenschr 113: 1989–1999
Kumada T, Gallager KP, Shirato K, McKown D, Miller M, Kemper WS, White F, Ross J (1980) Reduction of exercise-induced regional myocardial dysfunction by Propranolol. Circ Res 46: 190–200
Laciga P, Koller EA (1976) Respiratory, circulatory, and ECG changes during acute exposure to high altitude. J Appl Physiol 41: 159–167
Laciga P, Koller EA (1978) Respiratory, circulatory and ECG changes at 6,000m and 7,000m. Experientia 34: 900
Lepeschkin E (1957) Das Elektrokardiogramm. Theodor Steinkopff, Dresden-Leipzig, p 304
Peńaloza D, Echevarria M, Marticorena E, Gamboa R (1958) Early electrocardiographic changes produced by ascending to high altitude. Am Heart J 56: 493–500
Puddu PE, Bernard PM, Chaitman BR, Bourassa MG (1982) Q-T interval measurement by a computer assisted program: A potentially useful clinical paramter. J Electrocard 15: 15–22
Reuter H (1981) Beta-adrenoceptor stimulation and membrane calcium permeability. In: Delius W, Gerlach E, Grobecker H, Kubier W (eds) Catecholamines and the heart. Springer, Berlin Heidelberg New York Tokyo, p 170
Saurenmann P, Koller EA (1982) ECG changes due to altitude and to Catecholamines. Experientia 38: 718
Senges J, Henning E, Brachmann J, Pelzer D, Mizutani T, Kübler W (1980) Effects of orciprenaline on the sinoatrial and atrioventricular nodes in presence of hypoxia. J Mol Cell Cardiol 12: 135–147
Swanström S, Bratteby LE (1982) Hypoxanthine as a test of perinatal hypoxia as compared to lactate, base deficit, and pH. Pediatr Res 16: 156–160
Thomsen JH, Wasserburger RH (1967) Effect of hyperventilation on precordial T waves of children and adolescents. Circulation 36: 700–707
Tuchschmid PE, Boutellier U, Koller EA, Duc GV (1981) Comparison of hypoxanthine, lactate, and ECG signs as indicators of hypoxia. Pediatr Res 15: 28–33
Van Liere EJ, Stickney JC (1963) Hypoxia. University of Chicago Press, Chicago-London, p 6
Author information
Authors and Affiliations
Additional information
Dedicated to Prof. O. A. M. Wyss on the occasion of his 80th birthday
The study was supported in part by a grant from the “Stiftung für wissenschaftliche Forschung an der UniversitÄt Zürich”
Rights and permissions
About this article
Cite this article
Saurenmann, P., Koller, E.A. The ECG changes due to altitude and to catecholamines. Europ. J. Appl. Physiol. 53, 35–42 (1984). https://doi.org/10.1007/BF00964687
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00964687