Universität zu Köln

Eichhorn, L., Doerner, J., Luetkens, J. A., Lunkenheimer, J. M., Dolscheid-Pommerich, R. C., Erdfelder, F., Fimmers, R., Nadal, J., Stoffel-Wagner, B., Schild, H. H., Hoeft, A., Zur, B. and Naehle, C. P. (2018). Cardiovascular magnetic resonance assessment of acute cardiovascular effects of voluntary apnoea in elite divers. J. Cardiov. Magn. Reson., 20. LONDON: BIOMED CENTRAL LTD. ISSN 1532-429X

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Abstract

Background: Prolonged breath holding results in hypoxemia and hypercapnia. Compensatory mechanisms help maintain adequate oxygen supply to hypoxia sensitive organs, but burden the cardiovascular system. The aim was to investigate human compensatory mechanisms and their effects on the cardiovascular system with regard to cardiac function and morphology, blood flow redistribution, serum biomarkers of the adrenergic system and myocardial injury markers following prolonged apnoea. Methods: Seventeen elite apnoea divers performed maximal breath-hold during cardiovascular magnetic resonance imaging (CMR). Two breath-hold sessions were performed to assess (1) cardiac function, myocardial tissue properties and (2) blood flow. In between CMR sessions, a head MRI was performed for the assessment of signs of silent brain ischemia. Urine and blood samples were analysed prior to and up to 4 h after the first breath-hold. Results: Mean breath-hold time was 297 +/- 52 s. Left ventricular (LV) end-systolic, end-diastolic, and stroke volume increased significantly (p < 0.05). Peripheral oxygen saturation, LV ejection fraction, LV fractional shortening, and heart rate decreased significantly (p < 0.05). Blood distribution was diverted to cerebral regions with no significant changes in the descending aorta. Catecholamine levels, high-sensitivity cardiac troponin, and NT-pro-BNP levels increased significantly, but did not reach pathological levels. Conclusion: Compensatory effects of prolonged apnoea substantially burden the cardiovascular system. CMR tissue characterisation did not reveal acute myocardial injury, indicating that the resulting cardiovascular stress does not exceed compensatory physiological limits in healthy subjects. However, these compensatory mechanisms could overly tax those limits in subjects with pre-existing cardiac disease. For divers interested in competetive apnoea diving, a comprehensive medical exam with a special focus on the cardiovascular system may be warranted.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eichhorn, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Doerner, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luetkens, J. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lunkenheimer, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dolscheid-Pommerich, R. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Erdfelder, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fimmers, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nadal, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffel-Wagner, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schild, H. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoeft, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zur, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Naehle, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-182768
DOI:	10.1186/s12968-018-0455-x
Journal or Publication Title:	J. Cardiov. Magn. Reson.
Volume:	20
Date:	2018
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1532-429X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE SLEEP-APNEA; BREATH-HOLD DIVERS; ARTERIAL OXYGEN-SATURATION; SYMPATHETIC-NERVOUS-SYSTEM; DIVING RESPONSE; BLOOD-PRESSURE; SURFACE-AREA; HYPOXIA; HYPERCAPNIA; EFFICIENCY Multiple languages Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18276