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在极冷潜水条件下连续潜水四天期间,海军潜水员的心脏功能变化。

Changes in cardiac function in Navy divers during four days of successive dives in very cold diving conditions.

机构信息

Field Medicine Unit, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland.

Department of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Clin Physiol Funct Imaging. 2023 Jul;43(4):291-296. doi: 10.1111/cpf.12814. Epub 2023 Feb 14.

Abstract

INTRODUCTION AND METHODS

There is limited knowledge of cumulative effect of repetitive cold-water diving on cardiac function. Single cold dives cause some known cardiological risks, such as malign arrhythmia, due to a concurrent activation of the sympathetic and parasympathetic autonomic nervous system. A previous study from warmer water dives has shown that successive dives cause a decrease in vagal tone and a less responsive cardiovascular system. The aim of this study was to evaluate changes in cardiac function with 2D echocardiography during 4 days of diving in near-freezing water.

RESULTS

Left ventricle systolic function measures did not show any uniform changes. E/A ratio seemed to decrease successively with the number of dives. The diastolic tissue velocity of relaxing basal septum (e') showed a decreasing trend as well. Diastolic blood pressure seemed to increase from predive (mean: 83 RR mmHg) to postdive values (mean: 87 RR mmHg) (p=NS). Heart rate decreased significantly from predive (mean: 71 bpm, range: 56-103) to postdive values (mean: 60 bpm, range: 37-88) (p < 0.03).

DISCUSSION AND CONCLUSIONS

The study was conducted in very cold condition and with limited number of divers. Results of this preliminary study suggested a decreasing trend in left ventricular diastolic function in successive cold dives. Cumulative changes in cardiac function may cause health risks that need to be considered during cold water diving operations.

摘要

简介与方法

目前对于重复冷水潜水对心脏功能的累积效应知之甚少。单次冷水潜水会导致一些已知的心脏风险,如恶性心律失常,这是由于交感和副交感自主神经系统的同时激活。先前一项来自温水潜水的研究表明,连续潜水会导致迷走神经张力降低和心血管系统反应性降低。本研究旨在评估在接近冰点的水中潜水 4 天时,二维超声心动图检查心脏功能的变化。

结果

左心室收缩功能测量值没有显示出任何一致的变化。E/A 比值似乎随着潜水次数的增加而逐渐降低。舒张期基底室间隔的组织速度(e')也呈下降趋势。舒张压似乎从潜水前(平均:83 RR 毫米汞柱)升高至潜水后(平均:87 RR 毫米汞柱)(p=NS)。心率从潜水前(平均:71 次/分,范围:56-103)显著下降至潜水后(平均:60 次/分,范围:37-88)(p<0.03)。

讨论与结论

本研究在极寒条件下进行,潜水员人数有限。初步研究结果表明,连续冷水潜水会导致左心室舒张功能呈下降趋势。心脏功能的累积变化可能会导致健康风险,在冷水潜水作业中需要加以考虑。

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