Universität zu Köln

Doerner, J., Eichhorn, L., Luetkens, J. A., Lunkenheimer, J. N., Albers, J., Nadal, J., Schild, H. H. and Naehle, C. P. (2018). Effects of repetitive prolonged breath-hold in elite divers on myocardial fibrosis and cerebral morphology. Eur. J. Radiol., 103. S. 13 - 19. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Background: Prolonged apnea by breath-hold (BH) divers leads to hypoxemia and compensatory mechanisms of the cardiovascular system (i.e. increase of total peripheral resistance, increase of systolic blood-pressure, left-ventricular enlargement) to maintain oxygen supply to oxygen sensitive organs such as the brain. All these changes may result in structural myocardial or subclinical brain alterations. Therefore, the aim of this study was to investigate mid-term effects of repetitive prolonged apnea using cardiac magnetic resonance imaging (CMR) and magnetic resonance imaging of the brain. Materials and methods: 17 elite BH divers (15 males) were investigated at baseline, from whom 9 (7 males) were investigated again at follow-up one year later. CMR included functional imaging and tissue characterization using T1-and T2-mapping as well as late gadolinium enhancement. Results were compared intra-individually and with 50 age matched controls. Results: Mean BH time were 297 +/- 52 s (entire cohort) and 315 +/- 56 s (sub-cohort) at initial, and 334 +/- 104 s at follow-up examination. Apnea resulted in a progressive increase of the left ventricle and impaired function, whichfully resolved after cessation of apnea. At rest, no dilation of the left ventricle was notable (LV-EDV: 106.7 +/- 28.8 ml; LV-EDV/BSA: 52.2 +/- 12.7 ml/m(2)). Compared to controls, the apnea group showed significantly lower volumes (LV-EDV: 106.7 +/- 28.8 ml vs. 140.9 +/- 36.3 ml, p = .008; LV-EDV/BSA: 52.2 +/- 12.7 ml/m(2) vs. 73.7 +/- 12.8 ml/m2). In contrast, LV-EF showed no significant differences between both groups (61.0 +/- 7.0% vs. 60.9 +/- 3.6%). T1-and T2-mapping revealed no significant differences, neither intra-individually nor in comparison with age matched controls. (T1 pre-contrast: 974.1 +/- 12.9 ms vs. 969.4 +/- 29.0 ms, p = .2; T1 post-contrast: 368.9 +/- 38.5 ms vs. 966.7 +/- 40.5 ms, p = .4; ECV: 29.2 +/- 1.5% vs. 29.8 +/- 1.6%, p = .3; T2. 52 +/- 2 ms vs. 52 +/- 3 ms; p = .4). Except for one old embolic lesion no structural changes were found in brain imaging. Conclusion: Although, prolonged apnea leads to impressive adaptions of the cardiovascular system (i.e. dilation of the left ventricle) and hypertension due to peripheral vasoconstriction no mid-term morphological changes could be observed in both, the myocardium and the brain. BH divers are suitable as a model to investigate acute physiological changes of prolonged apnea and hypoxemia, but not as a model for chronic alterations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doerner, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorn, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luetkens, J. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lunkenheimer, J. N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Albers, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nadal, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schild, H. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Naehle, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-183310
DOI:	10.1016/j.ejrad.2018.03.020
Journal or Publication Title:	Eur. J. Radiol.
Volume:	103
Page Range:	S. 13 - 19
Date:	2018
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOVASCULAR MAGNETIC-RESONANCE; IDIOPATHIC DILATED CARDIOMYOPATHY; CEREBROVASCULAR RISK-FACTORS; BLOOD-PRESSURE; SLEEP-APNEA; DYSFUNCTION; HYPERTENSION; EXERCISE; HUMANS; HEART Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18331