Distance runners who live at high altitudes with low oxygen levels are known to improve their performance during races in areas that are at sea level. Can heart failure patients, who suffer from fatigue, improve their exercise performance by staying in a tent-like, high-altitude simulator?
That is the question being studied among 15 heart failure patients at Montefiore Medical Center. "The goal of the FDA-approved study is to see if high altitude simulation is safe and feasible for heart failure patients. And, more specifically, will low-oxygen exposure improve their skeletal muscle function, cardiac function and exercise capacity," said Simon Maybaum, MD, medical director of the Montefiore-Einstein Center for Advanced Cardiac Therapy.
"It seems counterintuitive to put heart failure patients in a low-oxygen tent to improve their performance," said Dr. Maybaum. "But, we know that athletes, as they acclimate to an oxygen-low environment, benefit physiologically. In just a few weeks, they show improvement in the oxygen carrying capacity of their blood, in tissue oxygenation and in physical performance. We want to see if similar physiological changes would be beneficial to heart failure patients," he said.
The Montefiore study will enroll stable, chronic heart-failure patients whose ability to exercise is limited despite maximal conventional therapies. They will sit in tents during 10 high-altitude sessions over 22 days, with each session lasting three to four hours. The oxygen inside the tent will be adjusted slowly to mimic the amount of oxygen at 1,500 meters and gradually increased to 2,700 meters (1.7 miles high), slightly above the pressurization of an airplane cabin. Then they will be tested to see how acclimatization to low oxygen in the tent has affected their exercise performance.
Dr. Maybaum, who is a marathoner, has previously studied how his chronic heart failure patients can benefit from other performance enhancing techniques used by athletes, including the muscle bulking drug clenbuterol. He found that clenbuterol increased their skeletal muscle mass and strength, but not their endurance. Among other things, he wants to determine if exposure to the high-altitude simulator will improve patients' endurance.
Montefiore Medical Center encompasses 125 years of outstanding patient care, innovative medical "firsts," pioneering clinical research, dedicated community service and ground-breaking social activism. A full-service, integrated delivery system caring for patients in the New York metropolitan region and beyond, Montefiore is a 1,491-bed medical center that includes: four hospitals -- the Henry and Lucy Moses Division, the Jack D. Weiler Division, the North Division and The Children's Hospital at Montefiore; a large home healthcare agency; the largest school health program in the U.S.; a 25-site medical group practice integrated throughout the Bronx and Westchester; and, a care management organization providing services to 179,000 health plan members.
In 2008, The Children's Hospital at Montefiore was ranked as one of "America's Best Children's Hospitals" in US News & World Report's prestigious annual listing and also received honors in the magazine's 2009 edition. The Leapfrog Group lists Montefiore among the top one percent of all U.S. hospitals based on its strategic investments in sophisticated and integrated healthcare technology.
Montefiore is committed to meeting the healthcare needs of the future through medical education and manages one of the largest residency programs in the country. Montefiore is The University Hospital and Academic Medical Center for Albert Einstein College of Medicine and has an affiliation with New York Medical College for residency programs at the North Division.
Distinguished centers of excellence at Montefiore include cardiology and cardiac surgery, cancer care, tissue and organ transplantation, children's health, women's health, surgery and the surgical subspecialties. Montefiore is a national leader in the research and treatment of diabetes, headaches, obesity, cough and sleep disorders, geriatrics and geriatric psychiatry, neurology and neurosurgery, adolescent and family medicine, HIV/AIDS and social and environmental medicine, among many other specialties.
Source: Montefiore Medical Center