The Impact of Altitude on Exercise Tolerance of Various Patients

Dear Colleagues,

More than 500 million humans live at or above the altitude of 1500 m, and many more people transiently sojourn at such altitudes for recreation, athletic training, or work. A considerable proportion, in particular of elderly people, may suffer from chronic diseases, e.g., cardiovascular, respiratory, and/or metabolic disorders. Barometric and related oxygen partial pressure continuously decrease with increasing altitude (hypobaric hypoxia), thereby negatively affecting aerobic exercise capacity and the associated activities of daily living and quality of life. The negative impact of the low-oxygen environment at altitude largely depends on the type and severity of diseases.

While the general effects of hypobaric hypoxia on aerobic exercise capacity in healthy individuals are well known, information on the differential impact of high altitudes on exercise tolerance in patients suffering from various diseases is rather scarce. Thus, this Special Issue is primarily aimed to uncover disease-dependent pathophysiological mechanisms affecting exercise capacity at high altitudes and provide helpful management strategies.

Gas exchange in the lungs, oxygen delivery to exercising muscles, and the use of oxygen in the mitochondria of these muscles are the main determinants of an individual’s aerobic exercise capacity. Any impairment of these mechanisms and/or their control by the autonomous nervous system, e.g., ventilation/perfusion mismatching, heart failure, myo- and/or mitochondriopathies, and disturbed chemo- and/or/baro-reflexes, will negatively impact on exercise tolerance, which is especially pronounced when ambient oxygen availability is reduced, i.e., at high altitude. The impact of different diseases on an individual’s exercise tolerance when acutely or chronically exposed to high altitudes and, even less, the underlying pathophysiological mechanisms, have not yet been sufficiently investigated. However, such knowledge would be of utmost importance to developing appropriate preventive and therapeutic measures.

Research articles and review articles, as well as short communications, are welcome.

Prof. Dr. Martin Burtscher
Dr. Daniel Neunhaeuserer
Prof. Dr. Silvia Ulrich
Guest Editors

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• high altitude
• hypoxia
• exercise
• exercise limitation
• chronic diseases
• chronic lung disease
• chronic heart disease
• sleep apnea
• arterial hypertension
• pulmonary hypertension