Hallazgos electrocardiográficos en un grupo de adultos jóvenes físicamente activos que residen a 2,600 metros sobre el nivel del mar: un estudio exploratorio (Electrocardiographic findings in a group of physically active young adults who reside at 2,600 meters above the sea level: an exploratory study)

Autores/as

  • Jaime Tomás Rojas-Valencia Universidad de Ciencias Aplicadas y Ambientales https://orcid.org/0000-0002-2710-6476
  • Elkin Higuera-Dagovett Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C - Colombia https://orcid.org/0000-0002-2730-5731
  • Rodolfo Vega Llamas Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C - Colombia. Universidad Simón Bolívar, Barranquilla – Colombia
  • Laura del Pilar Prieto Mondragón Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C - Colombia https://orcid.org/0000-0002-9140-3598
  • Jorge Enrique Buitrago Espitia Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C - Colombia. Universidad Industrial de Santander, Bucaramanga - Colombia.
  • Jeansy Alonso Rodríguez Buitrago Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C - Colombia

DOI:

https://doi.org/10.47197/retos.v59.103145

Palabras clave:

Electrocardiograma, gran altura, actividad física, ejercicio

Resumen

Propósito: Las adaptaciones fisiológicas a la actividad física regular y a la hipoxia hipobárica asociada con la residencia en la gran altura están relacionadas con una serie de adaptaciones cardiovasculares que pueden generar modificaciones electrocardiográficas. El objetivo de este estudio fue describir los principales hallazgos y determinar los valores medios de los parámetros electrocardiográficos en un grupo de adultos jóvenes físicamente activos que residen en la gran altura. Métodos: 49 sujetos (11 mujeres) jóvenes físicamente activos pertenecientes a un programa de ciencias del deporte participaron en el estudio. Cada participante fue sometido a una entrevista médica, un examen físico y un electrocardiograma en reposo. Dos médicos analizaron los electrocardiogramas buscando criterios de alteraciones anatómicas o fisiológicas, también se realizó un análisis descriptivo de la duración de las ondas e intervalos y la amplitud las ondas P y T. Resultados: Los valores medios de los parámetros electrocardiográficos se encontraron dentro de los parámetros esperados. Los principales hallazgos incluyen bradicardia sinusal y cambios asociados con el lado derecho del corazón: bloque incompleto rama derecha, desviación a la derecha del eje del QRS e hipertrofia ventricular derecha. Conclusiones: Los hallazgos de este estudio están relacionados con otros estudios que describen cambios en el lado derecho del corazón en habitantes de la altura y bradicardia sinusal en sujetos físicamente activos y, en algunos casos, en residentes de la gran altura. Cada residente joven de la altura que realice actividad física debería ser sometido a un electrocardiograma en reposo, teniendo en cuenta que hay una alta probabilidad de encontrar cambios en el electrocardiograma en pacientes asintomáticos, que podrían requerir una exploración más profunda.

Palabras claves: Electrocardiograma, gran altura, hipoxia, ejercicio

Abstract. Purpose: The physiological adaptations to regular physical activity and hypobaric hypoxia associated with high-altitude residence are related to a series of cardiovascular adaptations that can generate electrocardiographic modifications. This study aimed to describe the principal findings and determine the mean values of the electrocardiographic parameters in a group of physically active young adults who reside at a high altitude. Methods: 49 young, physically active subjects (11 women) in a Sports Sciences program participated in the study. Each participant was subjected to a medical interview, a physical examination, and a resting electrocardiogram. Two physicians analyzed the electrocardiogram, searching for criteria of anatomical or physiological abnormalities; a descriptive analysis of the duration of waves and intervals and the amplitude of the T and P waves was also carried out. Results: The mean values of the electrocardiographic parameters were between the expected values. The principal findings involve sinus bradycardia and changes associated with the right side of the heart: incomplete right bundle branch block, right QRS axis deviation, and right ventricular hypertrophy. Conclusions: The findings of this study are related to other studies that describe changes in the right side of the heart in inhabitants of high altitude and sinus bradycardia in physically active subjects and, in some cases, in high-altitude residents. Every young dweller of the altitude who engages in physical activity should be submitted to a resting ECG, considering there is a high probability of finding asymptomatic changes in the ECG that could require further exploration.

Keywords: Electrocardiogram, high altitude, hypoxia, exercise

Citas

Akcay, M. (2018). The effect of moderate altitude on Tp-e interval, Tp-e/QT, QT, cQT and P-wave dispersion. Jour-nal of Electrocardiology, 51(6), 929–933. https://doi.org/10.1016/j.jelectrocard.2018.07.016

Aldashev, A. A., Kojonazarov, B. K., Amatov, T. A., Sooronbaev, T. M., Mirrakhimov, M. M., Morrell, N. W., Wharton, J., & Wilkins, M. R. (2005). Phosphodiesterase type 5 and high altitude pulmonary hypertension. Thorax, 60(8), 683–687. https://doi.org/10.1136/thx.2005.041954

Aryal, N., Weatherall, M., & Bhatta, Y. (2017). Electrocardiography in people living at high altitude of Nepal. Heart Asia, 9, 48–53. https://doi.org/10.1136/heartasia-2016

Bjørnstad, H., Storstein, L., Dyre Meen, H., & Hals, O. (1993). Electrocardiographic Findings According to the Level of Fitness and Sport Activity. Cardiology, 83(4), 268–279. https://doi.org/10.1159/000175980

Burtscher, M., Gatterer, H., Burtscher, J., & Mairbäurl, H. (2018). Extreme terrestrial environments: Life in thermal stress and hypoxia. A narrative review. Frontiers in Physiology, 9(MAY). https://doi.org/10.3389/fphys.2018.00572

Corrado, D., Pelliccia, A., Bjørnstad, H. H., Vanhees, L., Biffi, A., Borjesson, M., Panhuyzen-Goedkoop, N., Deligiannis, A., Solberg, E., Dugmore, D., Mellwig, K. P., Assanelli, D., Delise, P., van-Buuren, F., Anastasakis, A., Heidbuchel, H., Hoffmann, E., Fagard, R., Priori, S. G., … Thiene, G. (2005). Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common Euro-pean protocol. European Heart Journal, 26(5), 516–524. https://doi.org/10.1093/eurheartj/ehi108

Dhar, P., Sharma, V. K., Das, S. K., Barhwal, K., Hota, S. K., & Singh, S. B. (2018). Differential responses of auto-nomic function in sea level residents, acclimatized lowlanders at >3500 m and Himalayan high altitude natives at >3500 m: A cross-sectional study. Respiratory Physiology and Neurobiology, 254, 40–48. https://doi.org/10.1016/j.resp.2018.04.002

D’souza, A., Bucchi, A., Johnsen, A. B., Logantha, S. J. R. J., Monfredi, O., Yanni, J., Prehar, S., Hart, G., Cart-wright, E., Wisloff, U., Dobryznski, H., Difrancesco, D., Morris, G. M., & Boyett, M. R. (2014). Exercise training reduces resting heart rate via downregulation of the funny channel HCN4. Nature Communications, 5. https://doi.org/10.1038/ncomms4775

Goldberger, A. L., Goldberger, Z. D., & Shvilkin, A. (2018). Goldberger’s Clinical Electrocardiography A Simplified Ap-proach (Ninth Edition). Elsevier.

Guntekin, U., Gunes, Y., Tuncer, M., Gumrukcuoglu, A., & Kaya, Y. (2008). The Effect of Altitude on P-Wave and QT Duration and Dispersion. Pacing and Clinical Electrophysiology, 31(7), 889–892.

Halperin, B. D., Sun, S., Zhuang, J., Droma, T., & Moore, L. G. (1998). ECG Observations in Tibetan and Han Resi-dents of Lhasa. Journal of Electrocardiology, 31(3), 237–243.

Horii, M., Takasaki, I., Ohtsuka, K., Tsukiyama, H., Takahashi, A., Hatori, Y., & Hakuta., T. (1987). Changes of heart rate and QT interval at high altitude in alpinists: Analysis by holter ambulatory electrocardiogram. Clinical Cardiolo-gy, 10(4), 238–242. https://doi.org/10.1002/clc.4960100406

Huicho, L., & Niermeyer, S. (2007). Cross-sectional study of electrocardiographic pattern in healthy children resident at high altitude. American Journal of Physical Anthropology, 133(2), 879–886. https://doi.org/10.1002/ajpa.20563

Jensen-Urstad, K., Bouvier, F., Saltin, B., & Jensen-Urstad, M. (1998). High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise. Heart, 79, 161–164.

Kim, J. H., Noseworthy, P. A., McCarty, D., Yared, K., Weiner, R., Wang, F., Wood, M. J., Hutter, A. M., Picard, M. H., & Baggish, A. L. (2011). Significance of electrocardiographic right bundle branch block in trained athletes. American Journal of Cardiology, 107(7), 1083–1089. https://doi.org/10.1016/j.amjcard.2010.11.037

Kligfield, P., Gettes, L. S., Bailey, J. J., Childers, R., Deal, B. J., Hancock, E. W., Van Herpen, G., Kors, J. A., Macfarlane, P., Mirvis, D. M., Pahlm, O., Rautaharju, P., & Wagner, G. S. (2007). Recommendations for the standardization and interpretation of the electrocardiogram: Part I: The electrocardiogram and its technology: A sci-entific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. In Circula-tion (Vol. 115, Issue 10, pp. 1306–1324). https://doi.org/10.1161/CIRCULATIONAHA.106.180200

Lundby, C., Calbet, J., van Hall, G., Saltin, B., & Sander, M. (2018). Sustained sympathetic activity in altitude acclima-tizing lowlanders and high-altitude natives. Scandinavian Journal of Medicine and Science in Sports, 28(3), 854–861. https://doi.org/10.1111/sms.12976

Monge C, C., & León-Velarde S, F. (2003). El Reto Fisiológico de Vivir en los Andes. In C. Monge C & F. León-Velarde S (Eds.), El Reto Fisiológico de Vivir en los Andes (Primera, p. 52). Universidad Peruana Cayetano Heredia - Fondo Editorial.

Naeije, R. (2010). Physiological adaptation of the cardiovascular system to high altitude. Progress in Cardiovascular Diseas-es, 52(6), 456–466. https://doi.org/10.1016/j.pcad.2010.03.004

Parodi, J. B., Ramchandani, R., Zhou, Z., Chango, D. X., Acunzo, R., Liblik, K., Farina, J. M., Zaidel, E. J., Ruiz-Mori, E., Carreón, J. M. A., Liprandi, A. S., & Baranchuk, A. (2023). A systematic review of electrocardiographic changes in healthy high-altitude populations. Trends in Cardiovascular Medicine, 33(5), 309–315. https://doi.org/10.1016/j.tcm.2022.01.013

Peñaloza, D., Gamboa, R., Marticorena, E., Echevarria, M., Dyer, J., & Gutierrez, E. (1961). The influence of high altitudes on the electrical activity of the heart Electrocardiographic and vectorcardiographic observations in adoles-cence and adulthood. American Heart Journal, 61, 101–115. https://doi.org/10.1016/0002-8703(61)90522

Pinillos-Patiño, Y., Rebolledo-Cobos, R., Herazo-Beltran, Y., Oviedo-Argumedo, E., Guerrero Ospino, M., Valen-cia-Fontalvo, P., & Cortés-Moreno, G. (2022). Estilo de vida en adultos jóvenes universitarios de Barranquilla, Co-lombia. Diferencias según sexo y estatus socioeconómico. Retos, 43, 979–987.

Pollard, A. M. D. (2003). The High Altitude Medicine Handbook (Third edition). Radcliffe Medical Press.

Raynaud, J., Valeix, P., Drouet, L., Escourrou, P., & Durand, J. (1981). Electrocardiographic Observations in High Altitude Residents of Nepal and Bolivia. International. Journal of Biometeorology, 25(3), 205–217. https://doi.org/10.1007/BF02184520

Rochel Vera, C., Albertus Cámara, I., & Martínez González-Moro, I. (2024). An analysis of the factors of heart rate variability affected after a hypoxia tolerance test as a function of gender. Retos, 55, 177–183.

Rotta, A. (1947). Physiologic condition of the heart in the natives of high altitudes. American Heart Journal, 33(5), 669–676. https://doi.org/10.1016/0002-8703(47)90083-5

Rotta, A., & López, A. (1959). Electrocardiographic Patterns in Man at High Altitudes. Circulation, 19(5), 719–728. https://doi.org/10.1161/01.CIR.19.5.719

Sharma, S., Drezner, J. A., Baggish, A., Papadakis, M., Wilson, M. G., Prutkin, J. M., La Gerche, A., Ackerman, M. J., Borjesson, M., Salerno, J. C., Asif, I. M., Owens, D. S., Chung, E. H., Emery, M. S., Froelicher, V. F., Heidbuchel, H., Adamuz, C., Asplund, C. A., Cohen, G., … Corrado, D. (2018). International recommendations for electrocardiographic interpretation in athletes. European Heart Journal, 39(16), 1466–1480. https://doi.org/10.1093/eurheartj/ehw631

Sharma, S., Whyte, G., Elliott, P., Padula, M., Kaushal, R., Mahon, N., & Mckenna, W. J. (1999). Electrocardio-graphic changes in 1000 highly trained junior elite athletes. British Journal of Sports Medicine, 33(5), 319–324. https://doi.org/10.1136/bjsm.33.5.319

The jamovi project. (2022). Jamovi (2.3).

West, J. B. (2012). High-altitude medicine. American Journal of Respiratory and Critical Care Medicine, 186(12), 1229–1237. https://doi.org/10.1164/rccm.201207-1323CI

Whitman, I. R., Patel, V. V., Soliman, E. Z., Bluemke, D. A., Praestgaard, A., Jain, A., Herrington, D., Lima, J. A. C., & Kawut, S. M. (2014). Validity of the surface electrocardiogram criteria for right ventricular hypertrophy: The me-sa-rv study (multi-ethnic study of atherosclerosis-right ventricle). Journal of the American College of Cardiology, 63(7), 672–681. https://doi.org/10.1016/j.jacc.2013.08.1633

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Publicado

2024-10-02

Cómo citar

Rojas-Valencia, J. T., Higuera-Dagovett, E., Vega Llamas, R., Prieto Mondragón, L. del P., Buitrago Espitia, J. E. ., & Rodríguez Buitrago, J. A. (2024). Hallazgos electrocardiográficos en un grupo de adultos jóvenes físicamente activos que residen a 2,600 metros sobre el nivel del mar: un estudio exploratorio (Electrocardiographic findings in a group of physically active young adults who reside at 2,600 meters above the sea level: an exploratory study). Retos, 59, 577–583. https://doi.org/10.47197/retos.v59.103145

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Artículos de carácter científico: investigaciones básicas y/o aplicadas