Browsing by Autor "Emrush Rexhaj"

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Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents
(Elsevier BV, 2015) Stefano F. Rimoldi; Emrush Rexhaj; Hervé Duplain; Sébastien Urben; Joël Billieux; Yves Allemann; Catherine Romero; Alejandro Ayaviri; Carlos E. Salinas; Mercedes Villena
EPR spectroscopic evidence of iron-catalysed free radical formation in chronic mountain sickness: Dietary causes and vascular consequences
(Elsevier BV, 2022) Damian M. Bailey; Marcel Culcasi; Teresa Filipponi; Julien V. Brugniaux; Benjamin S. Stacey; Christopher J. Marley; Rodrigo Soria; Stefano F. Rimoldi; David Černý; Emrush Rexhaj
Chronic mountain sickness (CMS) is a high-altitude (HA) maladaptation syndrome characterised by elevated systemic oxidative-nitrosative stress (OXNOS) due to a free radical-mediated reduction in vascular nitric oxide (NO) bioavailability. To better define underlying mechanisms and vascular consequences, this study compared healthy male lowlanders (80 m, n = 10) against age/sex-matched highlanders born and bred in La Paz, Bolivia (3600 m) with (CMS+, n = 10) and without (CMS-, n = 10) CMS. Cephalic venous blood was assayed using electron paramagnetic resonance spectroscopy and reductive ozone-based chemiluminescence. Nutritional intake was assessed via dietary recall. Systemic vascular function and structure were assessed via flow-mediated dilatation, aortic pulse wave velocity and carotid intima-media thickness using duplex ultrasound and applanation tonometry. Basal systemic OXNOS was permanently elevated in highlanders (P = <0.001 vs. lowlanders) and further exaggerated in CMS+, reflected by increased hydroxyl radical spin adduct formation (P = <0.001 vs. CMS-) subsequent to liberation of free 'catalytic' iron consistent with a Fenton and/or nucleophilic addition mechanism(s). This was accompanied by elevated global protein carbonylation (P = 0.046 vs. CMS-) and corresponding reduction in plasma nitrite (P = <0.001 vs. lowlanders). Dietary intake of vitamins C and E, carotene, magnesium and retinol were lower in highlanders and especially deficient in CMS + due to reduced consumption of fruit and vegetables (P = <0.001 to 0.028 vs. lowlanders/CMS-). Systemic vascular function and structure were also impaired in highlanders (P = <0.001 to 0.040 vs. lowlanders) with more marked dysfunction observed in CMS+ (P = 0.035 to 0.043 vs. CMS-) in direct proportion to systemic OXNOS (r = -0.692 to 0.595, P = <0.001 to 0.045). Collectively, these findings suggest that lifelong exposure to iron-catalysed systemic OXNOS, compounded by a dietary deficiency of antioxidant micronutrients, likely contributes to the systemic vascular complications and increased morbidity/mortality in CMS+. TRIAL REGISTRY: ClinicalTrials.gov; No: NCT01182792; URL: www.clinicaltrials.gov.
Exaggerated Pulmonary Hypertension and Right Ventricular Dysfunction in High-Altitude Dwellers With Patent Foramen Ovale
(Elsevier BV, 2014) Roman Brenner; Lorenza Pratali; Stefano F. Rimoldi; Carla Ximena Murillo Jauregui; Rodrigo Soria; Emrush Rexhaj; Carlos Salinas Salmón; Mercedes Villena; Catherine Romero; Cláudio Sartori
Exaggerated systemic oxidative‐inflammatory‐nitrosative stress in chronic mountain sickness is associated with cognitive decline and depression
(Wiley, 2018) Damian M. Bailey; Julien V. Brugniaux; Teresa Filipponi; Christopher J. Marley; Benjamin S. Stacey; Rodrigo Soria; Stefano F. Rimoldi; David Černý; Emrush Rexhaj; Lorenza Pratali
Chronic mountain sickness (CMS) is a maladaptation syndrome encountered at high altitude (HA) characterised by severe hypoxaemia that carries a higher risk of stroke and migraine and is associated with increased morbidity and mortality. The present cross-sectional study examined to what extent exaggerated systemic oxidative-inflammatory-nitrosative stress (OXINOS), defined by an increase in free radical formation and corresponding decrease in vascular nitric oxide (NO) bioavailability, is associated with impaired cerebrovascular function, accelerated cognitive decline and depression in CMS. Venous blood was obtained from healthy male lowlanders (80 m, n = 17), and age- and gender-matched HA dwellers born and bred in La Paz, Bolivia (3600 m) with (CMS+, n = 23) and without (CMS-, n = 14) CMS. We sampled blood for oxidative (electron paramagnetic resonance spectroscopy, HPLC), nitrosative (ozone-based chemiluminescence) and inflammatory (fluorescence) biomarkers. We employed transcranial Doppler ultrasound to measure cerebral blood flow (CBF) and reactivity. We utilised psychometric tests and validated questionnaires to assess cognition and depression. Highlanders exhibited elevated systemic OXINOS (P < 0.05 vs. lowlanders) that was especially exaggerated in the more hypoxaemic CMS+ patients (P < 0.05 vs. CMS-). OXINOS was associated with blunted cerebral perfusion and vasoreactivity to hypercapnia, impaired cognition and, in CMS+, symptoms of depression. Collectively, these findings are the first to suggest that a physiological continuum exists for hypoxaemia-induced OXINOS in HA dwellers that when excessive is associated with accelerated cognitive decline and depression, helping identify those in need of specialist neurological assessment and support.
Exercise Induces Rapid Interstitial Lung Water Accumulation in Patients With Chronic Mountain Sickness
(Elsevier BV, 2011) Lorenza Pratali; Stefano F. Rimoldi; Emrush Rexhaj; Damian Hutter; Francesco Faita; Carlos Salinas Salmón; Mercedes Villena; Rosa Sicari; Eugenio Picano; Yves Allemann
Increasing respiratory dead space improves sleep disordered breathing and hypoxemia in patients with chronic mountain sickness
(Wiley, 2011) Emrush Rexhaj; Stefano F. Rimoldi; Pierre‐Yves Jayet; Alban Lovis; Daniela Andries; Carlos Salinas Salmón; Mercedes Villena; Yves Allemann; Raphaël Heinzer; Raphaël Heinzer
Chronic mountain sickness (CMS) is a major public health problem characterized by chronic hypoxemia and erythrocytosis. The underlying mechanism is unknown. Sleep disordered breathing (SDB) is frequent at high altitude. We recently found that increasing the respiratory dead space markedly improves SDB in mountaineers. We speculated that this procedure also has beneficial effects in CMS patients. To test this hypothesis, in 17 male Bolivian high-altitude dwellers (56±9 y) suffering from CMS full night sleep recordings were obtained in random order during one night spent with and one without a 500 ml increase in respiratory dead space through a custom designed full face mask. Recordings were also obtained in 6 control subjects. The major new findings were two-fold; a) CMS patients present markedly more severe SDB and hypoxemia (P<.01) than control subjects; and b) added dead space dramatically improved SDB in CMS patients, as evidenced by a decrease of the apnea/hypopnea (P<.01), hypopnea (P=.01) and oxygen desaturation (P<.01) indexes, and an increase of the nocturnal oxygen saturation (P=.01). The procedure was well tolerated. Here, we show for the first time that increasing respiratory dead space dramatically improves SDB in patients with CMS. We speculate that its long-term use will improve erythrocytosis and pulmonary hypertension and offer an inexpensive treatment for this major public health problem.
Novel Insights into Cardiovascular Regulation in Patients with Chronic Mountain Sickness
(Springer Nature, 2016) Stefano F. Rimoldi; Emrush Rexhaj; Mercedes Villena; Carlos Salinas Salmón; Yves Allemann; Urs Scherrer; Cláudio Sartori
Oxidative-Nitrosative Stress and Systemic Vascular Function in Highlanders With and Without Exaggerated Hypoxemia
(Elsevier BV, 2013) Damian M. Bailey; Stefano F. Rimoldi; Emrush Rexhaj; Lorenza Pratali; Carlos Salinas Salmón; Mercedes Villena; Jane McEneny; Ian Young; Pascal Nicod; Yves Allemann
Response to Letters Regarding Article, “Pulmonary and Systemic Vascular Dysfunction in Young Offspring of Mothers With Preeclampsia”
(Lippincott Williams & Wilkins, 2011) Stefano F. Rimoldi; Pierre‐Yves Jayet; Emrush Rexhaj; Sébastien Thalmann; Marcos Schwab; Pierre Turini; Céline Sartori-Cucchia; Pascal Nicod; Urs Scherrer; Cláudio Sartori
RV Contractility and Exercise-Induced Pulmonary Hypertension in Chronic Mountain Sickness
(Elsevier BV, 2013) Lorenza Pratali; Yves Allemann; Stefano F. Rimoldi; Francesco Faita; Damian Hutter; Emrush Rexhaj; Roman Brenner; Damian M. Bailey; Cláudio Sartori; Carlos Salinas Salmón
Sleep-Disordered Breathing and Vascular Function in Patients With Chronic Mountain Sickness and Healthy High-Altitude Dwellers
(Elsevier BV, 2015) Emrush Rexhaj; Stefano F. Rimoldi; Lorenza Pratali; Roman Brenner; Daniela Andries; Rodrigo Soria; Carlos E. Salinas; Mercedes Villena; Catherine Romero; Yves Allemann
Systemic Vascular Dysfunction in Patients With Chronic Mountain Sickness
(Elsevier BV, 2011) Stefano F. Rimoldi; Emrush Rexhaj; Lorenza Pratali; Damian M. Bailey; Damian Hutter; Francesco Faita; Carlos Salinas Salmón; Mercedes Villena; Pascal Nicod; Yves Allemann