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Kjeld T, Krag TO, Brenøe A, Møller AM, Arendrup HC, Højberg J, Fuglø D, Hancke S, Tolbod LP, Gormsen LC, Vissing J, Hansen EG. Hemoglobin concentration and blood shift during dry static apnea in elite breath hold divers. Front Physiol 2024; 15:1305171. [PMID: 38745836 PMCID: PMC11092981 DOI: 10.3389/fphys.2024.1305171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/23/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Elite breath-hold divers (BHD) enduring apneas of more than 5 min are characterized by tolerance to arterial blood oxygen levels of 4.3 kPa and low oxygen-consumption in their hearts and skeletal muscles, similar to adult seals. Adult seals possess an adaptive higher hemoglobin-concentration and Bohr effect than pups, and when sedated, adult seals demonstrate a blood shift from the spleen towards the brain, lungs, and heart during apnea. We hypothesized these observations to be similar in human BHD. Therefore, we measured hemoglobin- and 2,3-biphosphoglycerate-concentrations in BHD (n = 11) and matched controls (n = 11) at rest, while myocardial mass, spleen and lower extremity volumes were assessed at rest and during apnea in BHD. Methods and results After 4 min of apnea, left ventricular myocardial mass (LVMM) determined by 15O-H2O-PET/CT (n = 6) and cardiac MRI (n = 6), was unaltered compared to rest. During maximum apnea (∼6 min), lower extremity volume assessed by DXA-scan revealed a ∼268 mL decrease, and spleen volume, assessed by ultrasonography, decreased ∼102 mL. Compared to age, BMI and VO2max matched controls (n = 11), BHD had similar spleen sizes and 2,3- biphosphoglycerate-concentrations, but higher total hemoglobin-concentrations. Conclusion Our results indicate: 1) Apnea training in BHD may increase hemoglobin concentration as an oxygen conserving adaptation similar to adult diving mammals. 2) The blood shift during dry apnea in BHD is 162% more from the lower extremities than from the spleen. 3) In contrast to the previous theory of the blood shift demonstrated in sedated adult seals, blood shift is not towards the heart during dry apnea in humans.
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Affiliation(s)
- Thomas Kjeld
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas O. Krag
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Brenøe
- Department of Clinical Medicine, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Ann Merete Møller
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens Højberg
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Dan Fuglø
- Department of Nuclear Medicine, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Søren Hancke
- Department of Clinical Medicine, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Lars Poulsen Tolbod
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Christian Gormsen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Egon Godthaab Hansen
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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2
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Drviš I, Vrdoljak D, Dujić G, Dujić Ž, Foretić N. Construction and Validation of Newly Adapted Sport-Specific Anaerobic Diving Tests. Sports (Basel) 2024; 12:110. [PMID: 38668578 PMCID: PMC11053401 DOI: 10.3390/sports12040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
Breath-hold diving is explained as an activity that requires enduring muscle asphyxia and acidosis, high anaerobic capacity, and the tactic of the dive. Therefore, this study aimed to construct and validate tests that will mimic anaerobic processes in the specific media of freedivers. The sample of participants included 34 Croatian freedivers (average age: 26.85 ± 4.0 years, competitive age: 3.82 ± 1.92 years, their body height: 180.14 ± 8.93 cm, and their body mass: 76.82 ± 12.41 kg). The sample of variables consists of anthropometric indices, competitive efficiency (maximal length of a dive (DYN)), and specific anaerobic capacities (100 m and 2 min tests). Newly developed tests included the swimming anaerobic sprint test (SAST) and diving anaerobic sprint test (DAST). DAST and SAST variables included the total time of the test (DAST/SAST) and the fastest interval (DASTmax/SASTmax). The results showed good reliability of the tests with high Cronbach alpha coefficients (DAST: 0.98, DASTmax: 0.97, SAST: 0.99, SASTmax: 0.91). Furthermore, pragmatic validity shows a high correlation among all variables and DAST (DYN: -0.70, 100 m: 0.66, 2 min: -0.68). High relation is also found between 100 m (0.96), 2 min (-0.94), and a moderate result for DYN (-0.43) and the SAST test. A factor analysis extracted one significant factor. The factor analysis involved DAST, SAST, DYN, 100 m, and 2 min tests regarding factor 1. After the examination of all variables, the total time of the DAST test showed the best predictive values for the performance of divers. However, both tests could be used for diagnostics and the evaluation of specific condition abilities in freediving.
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Affiliation(s)
- Ivan Drviš
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Dario Vrdoljak
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
| | - Goran Dujić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia;
| | - Željko Dujić
- Department of Integrative Physiology, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Nikola Foretić
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
- High Performance Sport Center, Croatian Olympic Committee, 10000 Zagreb, Croatia
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3
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Vrdoljak D, Foretić N, Drviš I, Ivančev V, Perić M, Dujić Ž. Do freedivers and spearfishermen differ in local muscle oxygen saturation and anaerobic power? J Sports Med Phys Fitness 2024; 64:21-29. [PMID: 37902796 DOI: 10.23736/s0022-4707.23.15185-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Freediving is defined as an activity where athletes repetitively dive and are exposed to long efforts with limited oxygen consumption. Therefore, anaerobic features are expected to be an important facet of diving performance. This study aimed to investigate differences in anaerobic capacity and local muscle oxygenation in spearfisherman and freedivers. METHODS The sample of participants included 17 male athletes (nine freedivers, and eight spearfishermen), with an average age of 37.0±8.8 years, training experience of 10.6±9.5 years, body mass of 82.5±9.5 kg and height of 184.2±5.7 cm. Anthropometric characteristics included: body mass, body height, seated height, and body fat percentage. Wingate anaerobic test was conducted, during which local muscle oxygenation was measured with a NIRS device (Moxy monitor). Wingate power outputs were measured (peak power [W/kg] and average power [W/kg]), together with muscle oxygenation variables (baseline oxygen saturation [%], desaturation slope [%/s], minimum oxygen saturation [%], half time recovery [s], and maximum oxygen saturation [%]). RESULTS The differences were not obtained between freedivers and spearfisherman in power outputs (peak power (9.24±2.08 spearfisherman; 10.68±1.04 freedivers; P=0.14); average power (6.85±0.95 spearfisherman; 7.44±0.60 freedivers; P=0.15) and muscle oxygenation parameters. However, analysis of effect size showed a moderate effect in training experience (0.71), PP (0.89), AP (0.75), Desat slope mVLR (0.66), half time recovery mVLR (0.90). CONCLUSIONS The non-existence of differences between freedivers and spearfishermen indicates similar training adaptations to the anaerobic demands. However, the results show relatively low anaerobic capacities of our divers that could serve as an incentive for the further development of these mechanisms.
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Affiliation(s)
- Dario Vrdoljak
- Faculty of Kinesiology, University of Split, Split, Croatia -
| | - Nikola Foretić
- Faculty of Kinesiology, University of Split, Split, Croatia
- High Performance Sport Center, Croatian Olympic Committee, Zagreb, Croatia
| | - Ivan Drviš
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | | | - Mia Perić
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Željko Dujić
- School of Medicine, University of Split, Split, Croatia
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4
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Lundberg JO, Schiffer T, Weitzberg E, Larsen FJ. The Tortoise and the Hare. Trends Endocrinol Metab 2023; 34:317-318. [PMID: 37062666 DOI: 10.1016/j.tem.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023]
Abstract
Distance running requires a high absolute oxygen consumption, while for a breath-hold diver the opposite is preferable. We compared physiological exercise parameters and mitochondrial function in a competitive triathlete with those seen in an accomplished breath-hold diver and notice some remarkable differences, possibly explaining why both have become successful.
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Affiliation(s)
- Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Solna, Sweden.
| | - Tomas Schiffer
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Solna, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Solna, Sweden
| | - Filip J Larsen
- The Swedish School of Sport and Health Sciences, 114 33 Stockholm, Sweden
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5
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Kelly T, Brown C, Bryant-Ekstrand M, Lord R, Dawkins T, Drane A, Futral JE, Barak O, Dragun T, Stembridge M, Spajić B, Drviš I, Duke JW, Ainslie PN, Foster GE, Dujic Z, Lovering AT. Blunted hypoxic pulmonary vasoconstriction in apnoea divers. Exp Physiol 2022; 107:1225-1240. [PMID: 35993480 DOI: 10.1113/ep090326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is new and noteworthy? What is the central question of this study? Does the hyperbaric, hypercapnic, acidotic, hypoxic stress of apnoea diving lead to greater pulmonary vasoreactivity and increased right-heart work in apnoea divers? What is the main finding and its importance? Compared to sex- and age-matched controls, Divers had a significantly lower change in total pulmonary resistance in response to short duration isocapnic hypoxia. With oral sildenafil (50 mg), there were no differences in total pulmonary resistance between groups, suggesting Divers can maintain normal pulmonary artery tone in hypoxic conditions. Blunted hypoxic pulmonary vasoconstriction may be beneficial during apnoea diving. ABSTRACT Competitive apnoea divers repetitively dive to depths beyond 50 m. During the final portions of ascent, Divers experience significant hypoxaemia. Additionally, hyperbaria during diving increases thoracic blood volume while simultaneously reducing lung volume, increasing pulmonary artery pressure. We hypothesized that Divers would have exaggerated hypoxic pulmonary vasoconstriction leading to increased right-heart work due to their repetitive hypoxaemia and hyperbaria, and that the administration of sildenafil would have a greater effect in reducing pulmonary resistance in Divers. We recruited 16 Divers and 16 age and sex matched non-diving controls (Controls). Using a double-blinded, placebo-controlled, cross-over design, participants were evaluated for normal cardiac and lung function, then their cardiopulmonary responses to 20-30 minutes of isocapnic hypoxia (end-tidal PO2 = 50 mm Hg) were measured one hour following ingestion of 50 mg sildenafil or placebo. Cardiac structure and cardiopulmonary function were similar at baseline. With placebo, Divers had a significantly smaller increase in total pulmonary resistance than controls after 20-30 minutes isocapnic hypoxia (Δ -3.85 ± 72.85 vs 73.74 ± 91.06 dynes/sec/cm-5 , p = .0222). With sildenafil, Divers and Controls had similarly blunted increases in total pulmonary resistance after 20-30 minutes of hypoxia. Divers also had a significantly lower systemic vascular resistance following sildenafil in normoxia. These data indicate that repetitive apnoea diving leads to a blunted hypoxic pulmonary vasoconstriction. We suggest this is a beneficial adaption allowing for increased cardiac output with reduced right heart work and thus reducing cardiac oxygen utilization under hypoxemic conditions. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tyler Kelly
- Department of Human Physiology, University of Oregon, Eugene, Oregon, USA
| | - Courtney Brown
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | | | - Rachel Lord
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Tony Dawkins
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Aimee Drane
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Joel E Futral
- Department of Human Physiology, University of Oregon, Eugene, Oregon, USA
| | - Otto Barak
- Department of Physiology, University of Novi Sad, Novi Sad, Serbia
| | - Tanja Dragun
- Department of Integrative Physiology, University of Split School of Medicine, Split, Croatia
| | - Michael Stembridge
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Boris Spajić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Ivan Drviš
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Philip N Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Glen E Foster
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Zeljko Dujic
- Department of Integrative Physiology, University of Split School of Medicine, Split, Croatia
| | - Andrew T Lovering
- Department of Human Physiology, University of Oregon, Eugene, Oregon, USA
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6
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Arce-Álvarez A, Salazar-Ardiles C, Cornejo C, Paez V, Vásquez-Muñoz M, Stillner-Vilches K, Jara CR, Ramirez-Campillo R, Izquierdo M, Andrade DC. Chemoreflex Control as the Cornerstone in Immersion Water Sports: Possible Role on Breath-Hold. Front Physiol 2022; 13:894921. [PMID: 35733994 PMCID: PMC9207453 DOI: 10.3389/fphys.2022.894921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
Immersion water sports involve long-term apneas; therefore, athletes must physiologically adapt to maintain muscle oxygenation, despite not performing pulmonary ventilation. Breath-holding (i.e., apnea) is common in water sports, and it involves a decrease and increases PaO2 and PaCO2, respectively, as the primary signals that trigger the end of apnea. The principal physiological O2 sensors are the carotid bodies, which are able to detect arterial gases and metabolic alterations before reaching the brain, which aids in adjusting the cardiorespiratory system. Moreover, the principal H+/CO2 sensor is the retrotrapezoid nucleus, which is located at the brainstem level; this mechanism contributes to detecting respiratory and metabolic acidosis. Although these sensors have been characterized in pathophysiological states, current evidence shows a possible role for these mechanisms as physiological sensors during voluntary apnea. Divers and swimmer athletes have been found to displayed longer apnea times than land sports athletes, as well as decreased peripheral O2 and central CO2 chemoreflex control. However, although chemosensitivity at rest could be decreased, we recently found marked sympathoexcitation during maximum voluntary apnea in young swimmers, which could activate the spleen (which is a reservoir organ for oxygenated blood). Therefore, it is possible that the chemoreflex, autonomic function, and storage/delivery oxygen organ(s) are linked to apnea in immersion water sports. In this review, we summarized the available evidence related to chemoreflex control in immersion water sports. Subsequently, we propose a possible physiological mechanistic model that could contribute to providing new avenues for understanding the respiratory physiology of water sports.
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Affiliation(s)
- Alexis Arce-Álvarez
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
- Escuela de Kinesiología, Facultad de Salud, Universidad Católica Silva Henríquez, Santiago, Chile
- Navarrabiomed, Hospital Universitario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Camila Salazar-Ardiles
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Carlos Cornejo
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Valeria Paez
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Manuel Vásquez-Muñoz
- Navarrabiomed, Hospital Universitario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- Clínica Santa María, Santiago, Chile
| | | | - Catherine R. Jara
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - David C. Andrade
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de La Salud, Universidad de Antofagasta, Antofagasta, Chile
- *Correspondence: David C. Andrade, ,
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7
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Kjeld T, Isbrand AB, Linnet K, Zerahn B, Højberg J, Hansen EG, Gormsen LC, Bejder J, Krag T, Vissing J, Bøtker HE, Arendrup HC. Extreme Hypoxia Causing Brady-Arrythmias During Apnea in Elite Breath-Hold Divers. Front Physiol 2021; 12:712573. [PMID: 34925050 PMCID: PMC8678416 DOI: 10.3389/fphys.2021.712573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The cardiac electrical conduction system is very sensitive to hypoglycemia and hypoxia, and the consequence may be brady-arrythmias. Weddell seals endure brady-arrythmias during their dives when desaturating to 3.2 kPa and elite breath-hold-divers (BHD), who share metabolic and cardiovascular adaptions including bradycardia with diving mammals, endure similar desaturation during maximum apnea. We hypothesized that hypoxia causes brady-arrythmias during maximum apnea in elite BHD. Hence, this study aimed to define the arterial blood glucose (Glu), peripheral saturation (SAT), heart rhythm (HR), and mean arterial blood pressure (MAP) of elite BHD during maximum apneas. Methods: HR was monitored with Direct-Current-Pads/ECG-lead-II and MAP and Glu from a radial arterial-catheter in nine BHD performing an immersed and head-down maximal static pool apnea after three warm-up apneas. SAT was monitored with a sensor on the neck of the subjects. On a separate day, a 12-lead-ECG-monitored maximum static apnea was repeated dry (n = 6). Results: During pool apnea of maximum duration (385 ± 70 s), SAT decreased from 99.6 ± 0.5 to 58.5 ± 5.5% (∼PaO2 4.8 ± 1.5 kPa, P < 0.001), while Glu increased from 5.8 ± 0.2 to 6.2 ± 0.2 mmol/l (P = 0.009). MAP increased from 103 ± 4 to 155 ± 6 mm Hg (P < 0.005). HR decreased to 46 ± 10 from 86 ± 14 beats/minute (P < 0.001). HR and MAP were unchanged after 3–4 min of apnea. During dry apnea (378 ± 31 s), HR decreased from 55 ± 4 to 40 ± 3 beats/minute (P = 0.031). Atrioventricular dissociation and junctional rhythm were observed both during pool and dry apneas. Conclusion: Our findings contrast with previous studies concluding that Glu decreases during apnea diving. We conclude during maximum apnea in elite BHD that (1) the diving reflex is maximized after 3–4 min, (2) increasing Glu may indicate lactate metabolism in accordance with our previous results, and (3) extreme hypoxia rather than hypoglycemia causes brady-arrythmias in elite BHD similar to diving mammals.
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Affiliation(s)
- Thomas Kjeld
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anders Brenøe Isbrand
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Linnet
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jens Højberg
- Department of Cardiothoracic Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Egon Godthaab Hansen
- Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lars Christian Gormsen
- Department of Clinical Physiology and Nuclear Medicine, Skejby Hospital, Aarhus University, Aarhus, Denmark
| | - Jacob Bejder
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Thomas Krag
- Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - John Vissing
- Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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8
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Evaluation of Physiological Stress Experienced by Divers Maintaining an Upright Position on the Water Surface Depending on the Buoyancy Control Device. POLISH HYPERBARIC RESEARCH 2021. [DOI: 10.2478/phr-2021-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
The knowledge of physiological reactions enabling a diver increasing the functional reserve in a life-threatening situation is not yet complete. It is suggested that the ability to adapt to prolonged stress experienced by divers maintaining an upright position on the water surface is associated with the diver’s individual characteristics and the type of the buoyancy control device. The purpose of this study was to perform a preliminary evaluation of physiological variables in divers wearing two different types of buoyancy control device and floating upright at the surface to determine the level of safety offered by each of them. The physiological variables were measured while participants wearing a classical dive vest and a wing dive vest. The oxygen uptake and heart rate measured after 30 minutes of experiment were significantly greater in participants using wing dive vest than classical dive vest. The results confirm the possibility of using physiological indicators to compare the fatigue and rescue function in divers depending on the buoyancy control device type.
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9
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Valdivia-Valdivia JM, Räisänen-Sokolowski A, Lindholm P. Prolonged syncope with multifactorial pulmonary oedema related to dry apnoea training: Safety concerns in unsupervised dry static apnoea. Diving Hyperb Med 2021; 51:210-215. [PMID: 34157738 DOI: 10.28920/dhm51.2.210-215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/07/2021] [Indexed: 11/05/2022]
Abstract
Many competitive breath-hold divers use dry apnoea routines to improve their tolerance to hypoxia and hypercapnia, varying the amount of prior hyperventilation and lung volume. When hyperventilating and exhaling to residual volume prior to starting a breath-hold, hypoxia is reached quickly and without too much discomfort from respiratory drive. Cerebral hypoxia with loss of consciousness (LOC) can easily result. Here, we report on a case where an unsupervised diver used a nose clip that is thought to have interfered with his resumption of breathing after LOC. Consequently, he suffered an extended period of severe hypoxia, with poor ventilation and recovery. He also held his breath on empty lungs; thus, trying to inhale created an intrathoracic sub-atmospheric pressure. Upon imaging at the hospital, severe intralobular pulmonary oedema was noted, with similarities to images presented in divers suffering from pulmonary barotrauma of descent (squeeze, immersion pulmonary oedema). Describing the physiological phenomena observed in this case highlights the risks associated with unsupervised exhalatory breath-holding after hyperventilation as a training practice in competitive freediving.
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Affiliation(s)
- Juan M Valdivia-Valdivia
- Neurosurgery Department, St. Joseph's Hospital, Tampa FL, USA.,International Association for Development of Apnea (AIDA International) - Medical and Science Committee, Zurich, Switzerland.,Corresponding author: Professor Peter Lindholm, Department of Emergency Medicine, University of California San Diego, San Diego CA, USA,
| | - Anne Räisänen-Sokolowski
- Pathology, Helsinki University and Helsinki University Hospital, Helsinki, Finland.,The Centre for Military Medicine, The Finnish Defense Forces, Helsinki, Finland
| | - Peter Lindholm
- Department of Emergency Medicine, University of California San Diego, San Diego CA, USA
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10
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Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: a state-of-the-art review. Eur J Appl Physiol 2021; 121:1543-1566. [PMID: 33791844 PMCID: PMC8144079 DOI: 10.1007/s00421-021-04664-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Breath-hold diving is an activity that humans have engaged in since antiquity to forage for resources, provide sustenance and to support military campaigns. In modern times, breath-hold diving continues to gain popularity and recognition as both a competitive and recreational sport. The continued progression of world records is somewhat remarkable, particularly given the extreme hypoxaemic and hypercapnic conditions, and hydrostatic pressures these athletes endure. However, there is abundant literature to suggest a large inter-individual variation in the apnoeic capabilities that is thus far not fully understood. In this review, we explore developments in apnoea physiology and delineate the traits and mechanisms that potentially underpin this variation. In addition, we sought to highlight the physiological (mal)adaptations associated with consistent breath-hold training. Breath-hold divers (BHDs) are evidenced to exhibit a more pronounced diving-response than non-divers, while elite BHDs (EBHDs) also display beneficial adaptations in both blood and skeletal muscle. Importantly, these physiological characteristics are documented to be primarily influenced by training-induced stimuli. BHDs are exposed to unique physiological and environmental stressors, and as such possess an ability to withstand acute cerebrovascular and neuronal strains. Whether these characteristics are also a result of training-induced adaptations or genetic predisposition is less certain. Although the long-term effects of regular breath-hold diving activity are yet to be holistically established, preliminary evidence has posed considerations for cognitive, neurological, renal and bone health in BHDs. These areas should be explored further in longitudinal studies to more confidently ascertain the long-term health implications of extreme breath-holding activity.
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Cardiac hypoxic resistance and decreasing lactate during maximum apnea in elite breath hold divers. Sci Rep 2021; 11:2545. [PMID: 33510292 PMCID: PMC7844051 DOI: 10.1038/s41598-021-81797-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/06/2021] [Indexed: 01/30/2023] Open
Abstract
Breath-hold divers (BHD) enduring apnea for more than 4 min are characterized by resistance to release of reactive oxygen species, reduced sensitivity to hypoxia, and low mitochondrial oxygen consumption in their skeletal muscles similar to northern elephant seals. The muscles and myocardium of harbor seals also exhibit metabolic adaptations including increased cardiac lactate-dehydrogenase-activity, exceeding their hypoxic limit. We hypothesized that the myocardium of BHD possesses similar adaptive mechanisms. During maximum apnea 15O-H2O-PET/CT (n = 6) revealed no myocardial perfusion deficits but increased myocardial blood flow (MBF). Cardiac MRI determined blood oxygen level dependence oxygenation (n = 8) after 4 min of apnea was unaltered compared to rest, whereas cine-MRI demonstrated increased left ventricular wall thickness (LVWT). Arterial blood gases were collected after warm-up and maximum apnea in a pool. At the end of the maximum pool apnea (5 min), arterial saturation decreased to 52%, and lactate decreased 20%. Our findings contrast with previous MR studies of BHD, that reported elevated cardiac troponins and decreased myocardial perfusion after 4 min of apnea. In conclusion, we demonstrated for the first time with 15O-H2O-PET/CT and MRI in elite BHD during maximum apnea, that MBF and LVWT increases while lactate decreases, indicating anaerobic/fat-based cardiac-metabolism similar to diving mammals.
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Pintus R, Bongiovanni T, Corbu S, Francavilla VC, DessÌ A, Noto A, Corsello G, Finco G, Fanos V, Cesare Marincola F. Sportomics in professional soccer players: metabolomics results during preseason. J Sports Med Phys Fitness 2020; 61:324-330. [PMID: 32936572 DOI: 10.23736/s0022-4707.20.11200-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sportomics is the application of metabolomics to study the metabolism shifts of individuals that practice sports or do physical exercise. This aim was reached by the analysis of low molecular weight metabolites (<1.5 kDa) present in biological fluids such as blood, saliva or urine. METHODS In this study, authors performed a 1H-NMR analysis of urine from 21 professional soccer players collected at 3 different time points during the preseason preparation period before the beginning of Serie A Championship (first division) in Italy. RESULTS Urine profile changed during the observational period. In particular, significant variations were observed for trimethylamine-N-oxide, dimethylamine, hippuric acid, hypoxanthine, guanidoacetic acid, 3-hydroxybutyric acid, citric acid and creatine. These modifications could be related to the diet, training and microbiota. For instance, trimethylamine-N-oxide and hippuric acid are both of dietary origins but are also related to the microbiota, while 3-hydroxy-butyric acid is associated with the type of physical exercise. CONCLUSIONS This is the first sportomics study ever performed on professional soccer players, according to authors' knowledge. In the future, sportomics could be applied in a tailored way to choose the best diet and training program in the single individual to obtain the best possible performances and to prevent injuries of athletes.
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Affiliation(s)
- Roberta Pintus
- Neonatal Intensive Care Unit, University Hospital of Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
| | - Tindaro Bongiovanni
- Department of Health, Performance and Recovery, Parma Calcio 1913, Parma, Italy -
| | - Sara Corbu
- Department of Chemical and Geological Sciences, University of Cagliari, Monserrato, Cagliari, Italy
| | - Vincenzo C Francavilla
- School of Engineering, Architecture and Motor Sciences, Kore University of Enna, Enna, Italy
| | - Angelica DessÌ
- Neonatal Intensive Care Unit, University Hospital of Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
| | - Antonio Noto
- Department of Medical Science and Public Health, University of Cagliari, Monserrato, Cagliari, Italy
| | - Giovanni Corsello
- Neonatal Intensive Care Unit, Department of Sciences for Health Promotion and Mother and Child Care, P. Giaccone University Hospital, University of Palermo, Palermo, Italy
| | - Gabriele Finco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University Hospital of Cagliari, University of Cagliari, Monserrato, Cagliari, Italy
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Woorons X, Billaut F, Vandewalle H. Transferable Benefits of Cycle Hypoventilation Training for Run-Based Performance in Team-Sport Athletes. Int J Sports Physiol Perform 2020; 15:1103-1108. [PMID: 32106076 DOI: 10.1123/ijspp.2019-0583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/19/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether high-intensity training with voluntary hypoventilation at low lung volume (VHL) in cycling could improve running performance in team-sport athletes. METHODS Twenty well-fit subjects competing in different team sports completed, over a 3-week period, 6 high-intensity training sessions in cycling (repeated 8-s exercise bouts at 150% of maximal aerobic power) either with VHL or with normal breathing conditions. Before (Pre) and after (Post) training, the subjects performed a repeated-sprint-ability test (RSA) in running (12 × 20-m all-out sprints), a 200-m maximal run, and the Yo-Yo Intermittent Recovery Level 1 test (YYIR1). RESULTS There was no difference between Pre and Post in the mean and best velocities reached in the RSA test, as well as in performance and maximal blood lactate concentration in the 200-m-run trial in both groups. On the other hand, performance was greater in the second part of the RSA test, and the fatigue index of this test was lower (5.18% [1.3%] vs 7.72% [1.6%]; P < .01) after the VHL intervention only. Performance was also greater in the YYIR1 in the VHL group (1468 [313] vs 1111 [248] m; P < .01), whereas no change occurred in the normal-breathing-condition group. CONCLUSION This study showed that performing high-intensity cycle training with VHL could improve RSA and possibly endurance performance in running. On the other hand, this kind of approach does not seem to induce transferable benefits for anaerobic performance.
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Skeletal muscle, haematological and splenic volume characteristics of elite breath-hold divers. Eur J Appl Physiol 2019; 119:2499-2511. [PMID: 31542805 PMCID: PMC6858395 DOI: 10.1007/s00421-019-04230-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/29/2019] [Indexed: 11/25/2022]
Abstract
Purpose The aim of the study was to provide an evaluation of the oxygen transport, exchange and storage capacity of elite breath-hold divers (EBHD) compared with non-divers (ND). Methods Twenty-one healthy males’ (11 EBHD; 10 ND) resting splenic volumes were assessed by ultrasound and venous blood drawn for full blood count analysis. Percutaneous skeletal muscle biopsies were obtained from the m. vastus lateralis to measure capillarisation, and fibre type-specific localisation and distribution of myoglobin and mitochondrial content using quantitative immunofluorescence microscopy. Results Splenic volume was not different between groups. Reticulocytes, red blood cells and haemoglobin concentrations were higher (+ 24%, p < 0.05; + 9%, p < 0.05; + 3%, p < 0.05; respectively) and mean cell volume was lower (− 6.5%, p < 0.05) in the EBHD compared with ND. Haematocrit was not different between groups. Capillary density was greater (+ 19%; p < 0.05) in the EBHD. The diffusion distance (R95) was lower in type I versus type II fibres for both groups (EBHD, p < 0.01; ND, p < 0.001), with a lower R95 for type I fibres in the EBHD versus ND (− 13%, p < 0.05). Myoglobin content was higher in type I than type II fibres in EBHD (+ 27%; p < 0.01) and higher in the type I fibres of EBHD than ND (+ 27%; p < 0.05). No fibre type differences in myoglobin content were observed in ND. Mitochondrial content was higher in type I than type II fibres in EBHD (+ 35%; p < 0.05), with no fibre type differences in ND or between groups. Conclusions In conclusion, EBDH demonstrate enhanced oxygen storage in both blood and skeletal muscle and a more efficient oxygen exchange capacity between blood and skeletal muscle versus ND.
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