Institute of Molecular Biology and Medicine, Bishkek, Kyrgyzstan
Abstract: The aim of this study was to investigate the adaptive and non-adaptive structural changes of the pulmonary vessels during the development of high-altitude pulmonary hypertension (HAPH) and their characteristics in patients with COPD at high altitude. Histological, morphometrical and electron microscopy methods were applied. In native highlanders, due to long (chronic) adaptation, regional morphofunctional changes of the pulmonary vessels develop, which are caused by strengthening of the upper and medial zones of the lungs, increase in the capacity of the capillary channel and the extent of working zones of the air haematic barrier. The following characteristics are revealed in patients with chronic obstructive pulmonary diseases (COPD) at high altitude: remodeling of pulmonary arteries and arterioles, substantial expressed arterializations of the finest arterioles by diameter from 30 to 40 microns, with simultaneous increase in their quantity, reduction of terminal arteries and arteriole lumens as a result of endothelial and smooth muscle cell proliferation towards a vessel lumen from the internal elastic membranes, formation of multichannel arteries due to endothelial and smooth muscle cell proliferation with simultaneous growth of collagen and elastic fiber and development of the angiomatosis foci, which represent closely located vessels with different diameters. During rapid ascent to high altitude, more than 3000m above sea level, pulmonary edema develops in people who are not adapted to high altitude.
Keywords: altitude; pulmonary circulation. Introduction
It is known that high altitude results in a hypoxic form of pulmonary arterial hypertension. Despite numerous investigations devoted to vascular remodelling of pulmonary arterioles during HAPH, [10,1,18,7,8,9,15,5,6]
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