Display options
Cite
Aryal N, Weatherall M, Bhatta YK, et al. Electrocardiography in people living at high altitude of Nepal. Heart Asia. 2017;9(1):48-53doi: 10.1136/heartasia-2016-010838.
Aryal, N., Weatherall, M., Bhatta, Y. K., & Mann, S. (2017). Electrocardiography in people living at high altitude of Nepal. Heart Asia, 9(1), 48-53. https://doi.org/10.1136/heartasia-2016-010838
Aryal, Nirmal, et al. "Electrocardiography in people living at high altitude of Nepal." Heart Asia vol. 9,1 (2017): 48-53. doi: https://doi.org/10.1136/heartasia-2016-010838
Aryal N, Weatherall M, Bhatta YK, Mann S. Electrocardiography in people living at high altitude of Nepal. Heart Asia. 2017 Feb 03;9(1):48-53. doi: 10.1136/heartasia-2016-010838. eCollection 2017. PMID: 28243317; PMCID: PMC5294039.
Copy Download .nbib Format: NLM
Share it on

Heart Asia. 2017 Feb 03;9(1):48-53. doi: 10.1136/heartasia-2016-010838. eCollection 2017.

Electrocardiography in people living at high altitude of Nepal.

Heart Asia

Nirmal Aryal, Mark Weatherall, Yadav Kumar Deo Bhatta, Stewart Mann

Affiliations

  1. Department of Medicine , University of Otago , Wellington , New Zealand.
  2. Norvic International Hospital , Kathmandu , Nepal.

PMID: 28243317 PMCID: PMC5294039 DOI: 10.1136/heartasia-2016-010838

Abstract

OBJECTIVE: The main objective of this study was to estimate the prevalence of coronary heart disease (CHD) of high-altitude populations in Nepal determined by an ECG recordings and a medical history.

METHODS: We carried out a cross-sectional survey of cardiovascular disease and risk factors among people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. 12-lead ECGs were recorded on 485 participants. ECG recordings were categorised as definitely abnormal, borderline or normal.

RESULTS: No participant had Q waves to suggest past Q-wave infarction. Overall, 5.6% (95% CI 3.7 to 8.0) of participants gave a self-report of CHD. The prevalence of abnormal (or borderline abnormal) ECG was 19.6% (95% CI 16.1 to 23.4). The main abnormalities were: right axis deviation in 5.4% (95% CI 3.5 to 7.7) and left ventricular hypertrophy by voltage criteria in 3.5% (95% CI 2.0 to 5.5). ECG abnormalities were mainly on the left side of the heart for Mustang participants (Tibetan origin) and on the right side for Humla participants (Indo-Aryans). There was a moderate association between the probability of abnormal (or borderline abnormal) ECG and altitude when adjusted for potential confounding variables in a multivariate logistic model; with an OR for association per 1000 m elevation of altitude of 2.83 (95% CI 1.07 to 7.45), p=0.03.

CONCLUSIONS: Electrocardiographic evidence suggests that although high-altitude populations do not have a high prevalence of CHD, abnormal ECG findings increase by altitude and risk pattern varies by ethnicity.

Keywords: CORONARY ARTERY DISEASE

Conflict of interest statement

Competing interests: None declared.

References

  1. Ann Intern Med. 1960 Aug;53:247-58 - PubMed
  2. Eur J Prev Cardiol. 2016 Mar;23 (5):530-43 - PubMed
  3. Circulation. 2012 Oct 16;126(16):2020-35 - PubMed
  4. Zhonghua Liu Xing Bing Xue Za Zhi. 1993 Feb;14(1):10-3 - PubMed
  5. Science. 2010 Jul 2;329(5987):75-8 - PubMed
  6. Bol Oficina Sanit Panam. 1967 Jun;62(6):496-502 - PubMed
  7. Am Heart J. 1968 Jun;75(6):752-8 - PubMed
  8. Exp Physiol. 2006 Sep;91(5):803-6 - PubMed
  9. Proc Natl Acad Sci U S A. 2007 May 15;104 Suppl 1:8655-60 - PubMed
  10. Nephrol Dial Transplant. 2012 Dec;27 Suppl 4:iv11-6 - PubMed
  11. Indian Heart J. 2009 Jul-Aug;61(4):341-7 - PubMed
  12. Am J Cardiol. 1965 Oct;16(4):494-9 - PubMed
  13. Am J Phys Anthropol. 1998;Suppl 27:25-64 - PubMed
  14. Respir Physiol Neurobiol. 2007 Sep 30;158(2-3):224-36 - PubMed
  15. High Alt Med Biol. 2010 Spring;11(1):51-60 - PubMed
  16. Int J Biometeorol. 1981 Sep;25(3):205-17 - PubMed
  17. J Electrocardiol. 1998 Jul;31(3):237-43 - PubMed
  18. High Alt Med Biol. 2011 Spring;12 (1):45-55 - PubMed
  19. Circulation. 1959 May;19(5):719-28 - PubMed
  20. J Assoc Physicians India. 1995 Jan;43(1):15-6 - PubMed
  21. Am Heart J. 1949 Feb;37(2):161-86 - PubMed
  22. JAMA. 1985 Jun 7;253(21):3124-8 - PubMed
  23. MedGenMed. 2006 Nov 07;8(4):28 - PubMed
  24. Aging Dis. 2013 Dec 05;5(4):274-80 - PubMed
  25. Lancet. 2016 Jan 16;387(10015):251-72 - PubMed
  26. J Hypertens. 2007 Aug;25(8):1578-82 - PubMed
  27. J Appl Physiol (1985). 1993 Jan;74(1):312-8 - PubMed

Publication Types