Original Article

Severe acute mountain sickness, brain natriuretic peptide and NT-proBNP in humans

  1. D. R. Woods1,2,3,4,*,
  2. J. Begley5,
  3. M. Stacey3,
  4. C. Smith3,
  5. C. J. Boos3,6,
  6. T. Hooper3,
  7. A. Hawkins5,
  8. P. Hodkinson3,7,
  9. N. Green3,7,
  10. A. Mellor3,8

Article first published online: 25 JAN 2012

DOI: 10.1111/j.1748-1716.2012.02407.x

Issue

Acta Physiologica

Acta Physiologica

Volume 205, Issue 3, pages 349–355, July 2012

Additional Information

How to Cite

Woods, D. R., Begley, J., Stacey, M., Smith, C., Boos, C. J., Hooper, T., Hawkins, A., Hodkinson, P., Green, N. and Mellor, A. (2012), Severe acute mountain sickness, brain natriuretic peptide and NT-proBNP in humans. Acta Physiologica, 205: 349–355. doi: 10.1111/j.1748-1716.2012.02407.x

Author Information

  1. 1

    Northumbria and Newcastle NHS Trusts, Wansbeck General and Royal Victoria Infirmary, Newcastle, UK

  2. 2

    University of Newcastle, Newcastle upon Tyne, UK

  3. 3

    Defence Medical Services, UK

  4. 4

    Ministry of Defence Hospital Unit, Northallerton, UK

  5. 5

    Department of Biochemistry, Poole Hospital NHS Foundation Trust, Poole, UK

  6. 6

    Department of Cardiology, Poole Hospital NHS Foundation trust, Poole, UK

  7. 7

    Centre for Aviation Medicine, RAF Henlow, Henlow, UK

  8. 8

    James Cook University Hospital, Middlesborough, UK

*Correspondence: Dr David Woods, Department of Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.
E-mail: DoctorDRWoods@aol.com

Publication History

  1. Issue published online: 18 MAY 2012
  2. Article first published online: 25 JAN 2012
  3. Accepted manuscript online: 6 JAN 2012 02:00AM EST
  4. Manuscript Accepted: 26 DEC 2011
  5. Manuscript Revised: 22 DEC 2011
  6. Manuscript Revised: 10 OCT 2011
  7. Manuscript Received: 9 SEP 2011

Funded by

  • Medical Command
  • Drummond Foundation

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Keywords:

  • brain natriuretic peptide;
  • acute mountain sickness;
  • hypobaric hypoxia

Abstract

Aim

To examine the response of brain natriuretic peptide (BNP) and NT-proBNP to high altitude (HA) both at rest and following exercise.

Methods

We measured NT-proBNP and BNP and Lake Louise (LL) acute mountain sickness (AMS) scores in 20 subjects at rest in Kathmandu (Kat; 1300 m), following exercise and at rest at 4270 and 5150 m.

Results

BNP and NT-proBNP (pg ml−1, mean ± SEM) rose significantly from Kat (9.2 ± 2 and 36.9 ± 6.6, respectively) to arrival at 4270 m after exercise (16.6 ± 4 and 152 ± 56.1, P = 0.008 and P < 0.001, respectively) and remained elevated the next morning at rest (28.9 ± 9 and 207.4 ± 65.1, P = 0.004 and P < 0.001 respectively). At 5150, immediately following ascent/descent to 5643 m, BNP and NT-proBNP were 32.3 ± 8.8 and 301.1 ± 96.3 (P = 0.003 and P < 0.001 vs. Kat, respectively) and at rest the following morning were 33.3 ± 9.7 and 258.9 ± 89.5 (P = 0.008 and P = 0.001 vs. Kat respectively). NT-proBNP and BNP correlated strongly at 5150 m (ρ 0.905, P < 0.001 and ρ 0.914, P < 0.001 for resting and post-exercise samples respectively). At 5150 m, BNP levels were significantly higher among the four subjects with severe (LL score > 6) AMS (58.4 ± 18.7) compared with those without (BNP 22.7 ± 8.6, P = 0.048). There were significant correlations between change in body water from baseline to 5150 m with both BNP and NT-proBNP (ρ 0.77, P = 0.001, ρ 0.745, P = 0.002 respectively).

Conclusion

In conclusion, these data suggest that BNP and NT-proBNP increase with ascent to HA both after exercise and at rest. We also report the novel finding that BNP is significantly greater in those with severe AMS at 5150 m.

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