To investigate the value of transthoracic echocardiography (TTE) in the assessment of high altitude heart disease (HAHD) in patients from different altitude areas of Tibet.

Forty-nine Tibetan HAHD patients diagnosed at the Department of Cardiology, People's Hospital of Tibet Autonomous Region between December 2015 and April 2017 were included in this study. All patients were examined by TTE. Right ventricular diameter and right ventricular anterior wall thickness were recorded, and pulmonary arterial systolic pressure was estimated. According to their living altitude, the patients were divided into three groups (3000~<4000 m: 26 cases, 4000~<5000 m: 21 cases, ≥5000 m: 2 cases). The clinical data and echocardiographic data of different altitude groups were compared, and the correlation between echocardiographic data and clinical variables was analyzed.

Because there were only two patients in the ≥5000 m group, they were not analyzed. There was no significant difference in gender, course of disease, or RV between the 3000~<4000 m group and 4000~<5000 m group (P>0.05), but there was a statistically significant difference in age of onset and PASP between the two groups (t=2.07, 2.39; P<0.05). There was no correlation between echocardiographic parameters and age, gender, course of disease, or Hb. There was no significant correlation between RV and altitude (r=0.24, P=0.09), although there was a significant correlation between PASP and altitude (r=0.47, P=0.00).

The living altitude, as an environmental factor, is an independent influencing factor for the severity of pulmonary hypertension in HAHD patients.