Division of Cardiology, Department of Internal Medicine, Bucheon Sejong Hospital, Bucheon, South Korea (H.L., D.S.L., J.P., C.K., J.J.).
Department of Biostatistics, College of Medicine, Korea University, Seoul, South Korea (J.L.).
Ann Intern Med. 2023 Jul;176(7):934-939. doi: 10.7326/M23-0260. Epub 2023 Jul 11.
In previous studies, the prevalence of patent foramen ovale (PFO) has been reported to be higher in scuba divers who experienced decompression illness (DCI) than in those who did not.
To assess the association between PFO and DCI in scuba divers.
Prospective cohort study.
Tertiary cardiac center in South Korea.
One hundred experienced divers from 13 diving organizations who did more than 50 dives per year.
Participants had transesophageal echocardiography with a saline bubble test to determine the presence of a PFO and were subsequently divided into high- and low-risk groups. They were followed using a self-reported questionnaire while blinded to their PFO status. All of the reported symptoms were adjudicated in a blinded manner. The primary end point of this study was PFO-related DCI. Logistic regression analysis was done to determine the odds ratio of PFO-related DCI.
Patent foramen ovale was seen in 68 divers (37 at high risk and 31 at low risk). Patent foramen ovale-related DCI occurred in 12 divers in the PFO group (non-PFO vs. high-risk PFO vs. low-risk PFO: 0 vs. 8.4 vs. 2.0 incidences per 10 000 person-dives; = 0.001) during a mean follow-up of 28.7 months. Multivariable analysis showed that high-risk PFO was independently associated with an increased risk for PFO-related DCI (odds ratio, 9.34 [95% CI, 1.95 to 44.88]).
The sample size was insufficient to assess the association between low-risk PFO and DCI.
High-risk PFO was associated with an increased risk for DCI in scuba divers. This finding indicates that divers with high-risk PFO are more susceptible to DCI than what has been previously reported and should consider either refraining from diving or adhering to a conservative diving protocol.
Sejong Medical Research Institute.
在之前的研究中，曾报道经历减压病（DCI）的水肺潜水员比未经历减压病的潜水员中卵圆孔未闭（PFO）的患病率更高。
评估 PFO 与水肺潜水员 DCI 之间的关联。
前瞻性队列研究。
韩国一家三级心脏中心。
13 个潜水组织的 100 名经验丰富的潜水员，他们每年潜水超过 50 次。
参与者接受经食管超声心动图盐水泡测试以确定 PFO 的存在，随后根据风险分为高风险和低风险组。他们使用自我报告的问卷进行随访，同时对 PFO 状态不知情。所有报告的症状均以盲法进行裁决。本研究的主要终点是与 PFO 相关的 DCI。进行逻辑回归分析以确定 PFO 相关 DCI 的优势比。
68 名潜水员（高危 37 名，低危 31 名）中存在 PFO。PFO 组中有 12 名潜水员发生了与 PFO 相关的 DCI（非 PFO 与高危 PFO 与低危 PFO：每 10000 人潜水 0 与 8.4 与 2.0 例；=0.001），平均随访 28.7 个月。多变量分析显示，高危 PFO 与 PFO 相关 DCI 的风险增加独立相关（优势比，9.34 [95%CI，1.95 至 44.88]）。
样本量不足以评估低危 PFO 与 DCI 之间的关联。
高危 PFO 与水肺潜水员 DCI 的风险增加相关。这一发现表明，高危 PFO 的潜水员比之前报道的更容易患 DCI，应考虑要么避免潜水，要么遵守保守的潜水协议。
世宗医学研究所。
