Science Project Deutsche Version

Scientific Project in High Altitude Medicine

Prof. Dr. med. Dr. rer. nat. Friedrich Grimminger

Dr. med. Ardeschir Ghofrani

Dr. med. Eike Mrosek

Dr. med. Frank Reichenberger

Dr. med. Markus Kohstall

Dr. med. Peter Becker

Timon Seeger

A medical team from the University of Giessen will accompany the 50th Anniversary Expedition to the Mount Everest. Under the direction of Professor Friedrich Grimminger, a specialist for pulmonary and critical care medicine, Dr. Ardeschir Ghofrani, Dr. Eike Mrosek, Dr. Frank Reichenberger and Dr. Markus Kohstall from the Department of Internal Medicine (University Hospital Giessen, Germany) and Dr. Peter Becker (Bad Tölz, Germany) will investigate on changes of cardiac performance and lung function at extreme altitudes. Mountaineers, high-altitude rescue teams as well as inhabitants of these regions suffer from malfunctions of both organ systems, which can only in part be compensated by acclimatisation.

The hypoxic conditions at these altitudes lead to dramatic constrictive reactions of pulmonary vessels, which can lead to fatal complications in subjects that are not adapted to hypoxia. Acclimatisation is defined as the adaptation of the right ventricular myocardium with an increase in contractility. Still, a prolonged stay under hypoxic conditions can result in progressive thickening of the pulmonary vessels (Figure 1) resulting in increased right ventricular overload. Staying at altitudes above 5500 m can not be survived in the long run. In the so called “death zone” above 7000 m survival without technical support is unlikely for more than hours (up to some days). In the view of the physicians from Giessen, the changes observed under conditions of chronic hypoxia in mountaineers and inhabitants of high altitudes are representative for numerous chronic cardiac- and lung diseases (e.g. chronic obstructive lung disease, lung fibrosis, pulmonary hypertension, congenital heart disease, chronic left heart failure, acute and chronic lung embolism). In these diseases chronic remodelling processes of the lung and the right ventricle occur that resemble these changes. As a result, patients suffer from persistent limitation of their exercise tolerance, their quality of life and their life expectancy. The aim of the current study is to develop a specific therapy for pulmonary hypertension for both collectives, mountaineers in an emergency situation, and patients with chronic diseases of the cardio-pulmonary system, respectively.

The specialist from Giessen are seeking for an optimal drug that can overcome the excessive lung vascular reaction and simultaneously improve oxygenation by specific dilatation of the pulmonary vessels.

The main objective is to evaluate the effectiveness of suitable interventions in a group of highly trained athletes under the extreme conditions of a Mount Everest expedition. These subjects are voluntarily exposed to an acute pulmonary hypertensive reaction caused by hypoxia. In just few weeks reactions of the vasculature are induced which develop over years and decades in patients with chronic lung diseases. Fortunately, the organ alterations of the mountaineers are reversible due to the temporary exposition, while the disease processes seen in patients – due to the lack of a specific therapy – are irreversible at present. The scientific part of the expedition therefore will provide knowledge that is of importance not only for high-altitude medicine but may be of importance for general medicine.

Figure 1. Click opens image in a new window Figure 1. Click opens image in a new window
Figure 1: Cross sections of a healthy lung (a) and one lung which was exposed to long-term hypoxia (b) are presented. Arrows indicate small pulmonary arterial resistance vessels. The fragile structure of a normal vessel (a) is opposed to a markedly hypertrophied vessel under conditions of chronic hypoxia (b).

Figure 2. Click opens image in a new window
Figure 2: Schematic cross sections through pulmonary resistance vessels. Acute hypoxia induces active vasoconstriction (cross sections in the left and middle part of the figure) which is reversible under normoxic conditions. Chronic hypoxia - additionally to vasoconstriction - induces vascular wall thickening, which then results in chronic pulmonary hypertension (cross section in the right part of the figure).


March 16, 2003: A first step is taken on the way to Mount Everest: The health checks of the team members in Giessen, almost at sea level, are finished.
More information (in German)

March 24, 2003: The research project reaches the final phase of preparations. The instruments are on the way to the mountain.
More information (in German)

April 15, 2003: The expedition reached Namche Bazar
More information

May 05, 2003: Main part of medical study completed
More information (in German)

Updated 15 April 2003 by webmaster@everest-2003.com