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健康男性模拟潜水旅行对肺动脉压的影响。

Effect of simulated diving trips on pulmonary artery pressure in healthy men.

机构信息

Department of Sports Medicine, Medical Clinic V, University of Tuebingen, Silcherstrasse 5, 72076, Tübingen, Germany.

出版信息

Clin Res Cardiol. 2012 Dec;101(12):947-53. doi: 10.1007/s00392-012-0482-9. Epub 2012 Jun 14.

Abstract

BACKGROUND

Environmental stresses, such as immersion, cold, and venous gas microbubbles, have been shown to contribute to an increase in pulmonary artery pressure (PAP) after single SCUBA dives. This study was carried out to investigate PAP changes following a dry chamber dive.

METHODS

17 male divers [mean age 32 years, standard deviation (SD) 7 years, mean body mass index 26 kg m(-2) (SD 3 kg m(-2))] participated in the study. Heart disease was ruled out by ECG, stress-ECG and transthoracic echocardiography in all subjects. Echocardiographic assessment of PAP (peak gradient at pulmonary and tricuspid valve), acceleration time (AT), ejection time (ET) and the ratio AT/ET as an estimate of PAP was performed directly prior to, directly, and 20 and 80 min after a simulated dive (maximal pressure 600 kPa, duration 60 min).

RESULTS

AT/ET decreased from 0.40 (SD 0.03) to 0.34 (SD 0.03) directly after the dive (p = <0.0001), which was statistically significant, whereas 80 min after decompression, AT/ET tended to return to baseline levels (0.36, SD 0.03; p = 0.001). Other echocardiographic indices, e.g. ET, systolic PAP, and heart rate, did not change significantly after the dive. No gas microbubbles were detected during or after decompression.

CONCLUSIONS

A transient decrease of both AT and AT/ET following a simulated hyperbaric dry chamber dive indicated an increase in mean PAP in healthy men. We speculate that factors other than immersion, cold, or gas microbubbles may contribute to an elevation of PAP after a single hyperbaric exposure.

摘要

背景

环境压力,如浸没、寒冷和静脉气体微泡,已被证明会导致单次 SCUBA 潜水后肺动脉压(PAP)升高。本研究旨在调查干式舱潜水后 PAP 的变化。

方法

17 名男性潜水员[平均年龄 32 岁,标准差(SD)7 岁,平均体重指数 26 kg m(-2)(SD 3 kg m(-2))]参与了这项研究。所有受试者均通过心电图、应激心电图和经胸超声心动图排除心脏病。直接潜水前、潜水后直接和 20、80 分钟时,使用超声心动图评估 PAP(肺动脉瓣和三尖瓣的峰值梯度)、加速时间(AT)、射血时间(ET)和 AT/ET 比值(作为 PAP 的估计值)。

结果

潜水后 AT/ET 从 0.40(SD 0.03)降至 0.34(SD 0.03)(p <0.0001),具有统计学意义,而减压 80 分钟后,AT/ET 趋于恢复到基线水平(0.36,SD 0.03;p = 0.001)。其他超声心动图指标,如 ET、收缩期 PAP 和心率,潜水后没有明显变化。在减压过程中和减压后均未检测到气体微泡。

结论

模拟高压干式舱潜水后 AT 和 AT/ET 的短暂下降表明健康男性的平均 PAP 升高。我们推测,单次高压暴露后 PAP 升高可能与浸没、寒冷或气体微泡以外的因素有关。

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