PHYSIOLOGICAL ADAPTATION OF CARDIAC FUNCTION UNDER HYPOXIC CONDITIONS
Abstract
Cardiac adaptation to hypoxic conditions is considered one of the important yet not fully explored aspects of cardiovascular physiology. Although previous studies have described certain individual cardiac responses to oxygen deficiency, an integrated concept encompassing the interaction between the two ventricles, changes in loading conditions, and the maintenance of functional stability under hypoxia has not been sufficiently developed. The aim of this study is to investigate the physiological mechanisms ensuring cardiac adaptation to hypoxia based on a comprehensive functional approach.
References
[1] M. Williams, B. D. Levine, and M. Stembridge, “Mechanisms of cardiac adaptation to acute and chronic hypoxia,” Journal of Physiology, vol. 600, no. 18, pp. 4089–4104, 2022.
[2] S. Yang et al., “Hypoxia regulates the proliferation and apoptosis of coronary artery smooth muscle cells through HIF-1α mediated autophagy in yak,” Biomolecules, vol. 15, no. 2, Art. no. 256, 2025.
[3] L. Lei et al., “Cardioprotective effects of high-altitude adaptation in cardiac surgical patients: A retrospective cohort study,” Frontiers in Cardiovascular Medicine, vol. 11, Art. no. 1347552, 2024.
[4] M. Jiang, X. Fan, Y. Wang, and X. Sun, “Effects of hypoxia in cardiac metabolic remodeling and heart failure,” Experimental Cell Research, 2023.
[5] J. Ma et al., “Clinical changes of cardiac function from high altitude exposure,” Scientific Reports, 2025, in press.
[6] G. Dantu, “Cardiovascular implications of intermittent hypoxia: A comprehensive narrative review,” Cureus, 2025.
[7] N. V. Naryzhnaya, “The effect of adaptation to hypoxia on cardiac tolerance,” Journal of Basic Research (JBR), vol. 36, 2023.
[8] “Impact of hypoxia on resting and exertional right ventricular function,” ClinicalTrials.gov Identifier: NCT05272514, ongoing clinical study, 2024.
[9] “Right ventricular strain impairment due to hypoxia in patients with COPD,” Open Heart, vol. 12, Art. no. e002837, 2024.
[10] J. D. Marley and S. J. Smith, “Right ventricular response to acute hypoxia exposure: A systematic review,” Respiratory Physiology & Neurobiology, 2021.
[11] A. Smith et al., “Hypoxia-induced cardiopulmonary remodeling and recovery in chronic hypoxia,” bioRxiv, preprint, 2025.
[12] S. A. Lee and T. C. Kim, “Sex-specific cardiac remodeling in response to chronic hypoxia at high altitude,” Open Journal of Medical Imaging, vol. 15, no. 2, pp. 79–88, 2025.
[13] R. P. Kapoor and M. T. Carter, “Pulmonary vascular adaptations to hypoxia and implications for right ventricular function,” Pulmonary Circulation, 2023.
[14] K. J. Anderson et al., “Metabolic flexibility of the hypoxic heart: Relevance for heart failure and ischemic preconditioning,” Cardiovascular Research, 2024.
[15] D. L. Hernandez et al., “HIF-1α signaling in cardiomyocyte survival and cardiac remodeling under hypoxia,” American Journal of Physiology – Heart and Circulatory Physiology, 2022.
[16] T. P. Nguyen and J. M. Lopez, “Sympathetic regulation and cardiac adaptation in high-altitude hypoxia,” High Altitude Medicine & Biology, 2023.
[17] R. O’Connor, L. S. Peterson, and J. D. Rowe, “Ventricular–arterial coupling during hypoxia: Insights from speckle-tracking echocardiography,” Journal of the American Society of Echocardiography, 2024.
[18] F. Q. Choi and H. S. Reddy, “Hypoxia, inflammation, and cardiac function: Integrative molecular pathways,” Experimental & Molecular Medicine, 2025.
[19] M. J. Bates and A. N. Fletcher, “Cellular redox and metabolic signaling in hypoxic hearts,” Journal of Molecular and Cellular Cardiology, 2023.
[20] L. A. Torres et al., “High-altitude training and cardiac performance: Physiological adaptations and clinical relevance,” Sports Medicine, 2024.