High Altitude (HA) Residents With Pulmonary Vascular Diseseases (PVD), Pulmonary Artery Pressure (PAP) Assessed at HA (2840m) vs Sea Level (LA)

Exclusion Criteria

• •Age \<18 years or \>80 years
• •unstable condition
• •Patients who cannot follow the study investigations, patient permanently living \< 2500m.
• •Patients with moderate to severe concomitant lung disease (FEV1\<70% or forced vital capacity \<70%), severe parenchymal lung disease, severe smokers (\>20 cigarettes/day)
• •Severely hypoxemic patients at Quito permanently have persistent oxygen saturation by pulse-oximetry (SpO2) \<80% on ambient air.
• •Patients with chronic mountain sickness (Hemoglobin \> 19 g/dl in women, \>21 g/dl in men)
• •Patient with a non-corrected ventricular septum defect
• •Relevant concomitant other disease of the heart, kidney, liver, blood (anemia hemoglobin\<11 g/dl)