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对精英潜水员在静息和运动性屏气时心血管反应的逐搏分析。

A beat-by-beat analysis of cardiovascular responses to dry resting and exercise apnoeas in elite divers.

作者信息

Sivieri Andrea, Fagoni Nazzareno, Bringard Aurélien, Capogrosso Michela, Perini Renza, Ferretti Guido

机构信息

Dipartimento di Scienze Cliniche E Sperimentali, Università di Brescia, Brescia, Italy.

出版信息

Eur J Appl Physiol. 2015 Jan;115(1):119-28. doi: 10.1007/s00421-014-2992-9. Epub 2014 Sep 13.

Abstract

PURPOSE

Cardiovascular responses during resting apnoea include three phases: (1) a dynamic phase of rapid changes, lasting at most 30 s; (2) a subsequent steady phase; and (3) a further dynamic phase, with a continuous decrease in heart rate (HR) and an increase in blood pressure. The interpretation was that the end of the steady phase corresponds to the physiological apnoea breaking point. This being so, during exercise apnoeas, the steady phase would be shorter, and the rate of cardiovascular changes in the subsequent unsteady phase would be faster than at rest.

METHODS

To test these hypotheses, we measured beat-by-beat systolic (SBP), diastolic, and mean blood pressures (MBP), HR, and stroke volume (SV) in six divers during dry resting (duration 239.4 ± 51.6 s) and exercise (30 W on cycle ergometer, duration 88.2 ± 20.9 s) maximal apnoeas, and we computed cardiac output ([Formula: see text]) and total peripheral resistance (TPR).

RESULTS

Compared to control, at the beginning of resting (R1) and exercising (E1) apnoeas, SBP and MBP decreased and HR increased. SV and [Formula: see text] fell, so that TPR remained unchanged. At rest, HR, SV, [Formula: see text], and SBP were stable during the subsequent phase; this steady phase was missing in exercise apnoeas. Subsequently, at rest (R3) and at exercise (E2), HR decreased and SBP increased continuously. SV returned to control values. Since [Formula: see text] remained unchanged, TPR grew.

CONCLUSIONS

The lack of steady phase during exercise apnoeas suggests that the conditions determining R3 were already attained at the end of E1. This being so, E2 would correspond to R3.

摘要

目的

静息性呼吸暂停期间的心血管反应包括三个阶段:(1)快速变化的动态阶段,持续时间最长30秒;(2)随后的稳定阶段;(3)进一步的动态阶段,心率(HR)持续下降,血压升高。有一种解释认为,稳定阶段的结束对应于生理性呼吸暂停断点。倘若如此,在运动性呼吸暂停期间,稳定阶段会更短,随后不稳定阶段中心血管变化的速率会比静息时更快。

方法

为了验证这些假设,我们测量了6名潜水员在静息(持续时间239.4±51.6秒)和运动(在自行车测力计上施加30瓦功率,持续时间88.2±20.9秒)时最大呼吸暂停期间的逐搏收缩压(SBP)、舒张压和平均血压(MBP)、心率和每搏输出量(SV),并计算了心输出量([公式:见正文])和总外周阻力(TPR)。

结果

与对照组相比,在静息(R1)和运动(E1)性呼吸暂停开始时,SBP和MBP下降,HR升高。SV和[公式:见正文]下降,因此TPR保持不变。在静息时,HR、SV、[公式:见正文]和SBP在随后阶段保持稳定;运动性呼吸暂停中没有这个稳定阶段。随后,在静息(R3)和运动(E2)时,HR持续下降,SBP持续升高。SV恢复到对照值。由于[公式:见正文]保持不变,TPR升高。

结论

运动性呼吸暂停期间缺乏稳定阶段表明,决定R3的条件在E1结束时就已达到。倘若如此,E2将对应于R3。

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