Setting sail for Paris 2024: Retrospective analysis of world-class ILCA 7 Olympic sailors' cardiorespiratory fitness (2015-2020).

The aim of this retrospective analysis was to provide a more comprehensive understanding of the cardiorespiratory profile of world-class ILCA-7 sailors (n = 3, all males), through a longitudinal evaluation offering real-world data on physiological profile and exercise intensity domains. The cardiopulmonary exercise testing (CPET) was performed by the same researchers using the same equipment during the study. Assessments took place twice a year, aligning with major international competition preparations. Participants trained and competed at the same sailing club in Split, Croatia, under consistent supervision from the same team throughout the study, winning a total of 21 medals at major international competitions. The recorded V ̇ O 2 peak ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{peak}}}}$ ranged from 51.7 ± 1.6 to 61.9 ± 3.0 mL min-1 kg-1, respectively. Similarly, peak power output varied from 352 ± 10 to 426 ± 34 W. The changes in physiological responses at the ventilatory thresholds were proportional to the changes in peak cardiorespiratory fitness capacity. Interestingly, the oxygen pulse measured in 2015 was 25 ± 1 mL O2 beat-1. Over the subsequent 6 years, the O2 pulse marginally increased and appeared to stabilize at 27 ± 1 mL O2 beat-1 in 2020, when these athletes were 32 ± 3 years old. This work offers a broader understanding of world-class Olympic sailors' cardiorespiratory fitness, going beyond the standard assessment of peak V ̇ O 2 ${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ to incorporate an analysis of ventilatory thresholds. While a direct link between cardiorespiratory fitness and competitive success remains ambiguous, the importance of a well-rounded aerobic capacity for excellence in ILCA-7 sailing class is evident. HIGHLIGHTS: What is the central question of this study? What are the temporal changes in the physiological profiles of three world-class ILCA-7 sailors? What is the main finding and its importance? Data on oxygen pulse adjustments suggest the involvement of compensatory cardiovascular mechanisms, likely associated with the isometric and quasi-isometric contractions inherent in ILCA-7 sailing. This is evidenced by the absence of an age-related increase in oxygen pulse, a phenomenon often observed in endurance athletes throughout their competitive careers.

Do freedivers and spearfishermen differ in local muscle oxygen saturation and anaerobic power?

BACKGROUND: Freediving is defined as an activity where athletes repetitively dive and are exposed to long efforts with limited oxygen consumption. Therefore, anaerobic features are expected to be an important facet of diving performance. This study aimed to investigate differences in anaerobic capacity and local muscle oxygenation in spearfisherman and freedivers. METHODS: The sample of participants included 17 male athletes (nine freedivers, and eight spearfishermen), with an average age of 37.0±8.8 years, training experience of 10.6±9.5 years, body mass of 82.5±9.5 kg and height of 184.2±5.7 cm. Anthropometric characteristics included: body mass, body height, seated height, and body fat percentage. Wingate anaerobic test was conducted, during which local muscle oxygenation was measured with a NIRS device (Moxy monitor). Wingate power outputs were measured (peak power [W/kg] and average power [W/kg]), together with muscle oxygenation variables (baseline oxygen saturation [%], desaturation slope [%/s], minimum oxygen saturation [%], half time recovery [s], and maximum oxygen saturation [%]). RESULTS: The differences were not obtained between freedivers and spearfisherman in power outputs (peak power (9.24±2.08 spearfisherman; 10.68±1.04 freedivers; P=0.14); average power (6.85±0.95 spearfisherman; 7.44±0.60 freedivers; P=0.15) and muscle oxygenation parameters. However, analysis of effect size showed a moderate effect in training experience (0.71), PP (0.89), AP (0.75), Desat slope mVLR (0.66), half time recovery mVLR (0.90). CONCLUSIONS: The non-existence of differences between freedivers and spearfishermen indicates similar training adaptations to the anaerobic demands. However, the results show relatively low anaerobic capacities of our divers that could serve as an incentive for the further development of these mechanisms.

Larger splenic emptying correlate with slower EPOC kinetics in healthy men and women during supine cycling.

PURPOSE: The present study investigated whether larger splenic emptying augments faster excess post-exercise O2 consumption (EPOC) following aerobic exercise cessation. METHODS: Fifteen healthy participants (age 24 ± 4, 47% women) completed 3 laboratory visits at least 48-h apart. After obtaining medical clearance and familiarizing themselves with the test, they performed a ramp-incremental test in the supine position until task failure. At their final visit, they completed three step-transition tests from 20 W to a moderate-intensity power output (PO), equivalent to [Formula: see text]O2 at 90% gas exchange threshold, where data on metabolic, cardiovascular, and splenic responses were recorded simultaneously. After step-transition test cessation, EPOCfast was recorded, and the first 10 min of the recovery period was used for further analysis. Blood samples were collected before and immediately after the end of exercise. RESULTS: In response to moderate-intensity supine cycling ([Formula: see text]O2 = ~ 2.1 L·min-1), a decrease in spleen volume of ~ 35% (p = 0.001) was observed, resulting in a transient increase in red cell count of ~ 3-4% (p = 0.001) in mixed venous blood. In parallel, mean blood pressure, heart rate, and stroke volume increased by 30-100%, respectively. During recovery, mean τ[Formula: see text]O2 was 45 ± 18 s, the amplitude was 2.4 ± 0.5 L·min-1, and EPOCfast was 1.69 L·O2. Significant correlations were observed between the percent change in spleen volume and (i) EPOCfast (r = - 0.657, p = 0.008) and (ii) τ[Formula: see text]O2 (r = - 0.619, p = 0.008), but not between the change in spleen volume and (iii) [Formula: see text]O2 peak (r = 0.435, p = 0.105). CONCLUSION: Apparently, during supine cycling, individuals with larger spleen emptying tend to have slower [Formula: see text] O2 recovery kinetics and a greater EPOCfast.

Determination of exercise intensity domains during upright versus supine cycling: a methodological study.

Background: There is a growing interest among the research community and clinical practitioners to investigate cardiopulmonary exercise test (CPET) procedures and protocols utilized in supine cycling. Materials and Methods: The current study investigated the effects of posture on indicators of exercise intensity including gas exchange threshold (GET), respiratory compensation point (RCP), and the rate of peak oxygen uptake (V̇O2 peak), as well as the role of V̇O2 mean response time (MRT) in determining exercise intensity domains in nineteen healthy men (age: 22 ± 3 years). Two moderate-intensity step-transitions from 20 to 100 Watt (W) were completed, followed by a maximal CPET. After completing the ramp test, participants performed a constant-load at 90% of their attained peak power output (PPO). Results: No differences were observed in the V̇O2 MRT between the two positions, although the phase II-time constant (τV̇O2p) was 7 s slower in supine position compared to upright (p = 0.001). The rate of O2 uptake in the supine position at GET and RCP were lower compared to the upright position (208 ± 200 mL·min-1 (p = 0.007) and 265 ± 235 mL·min-1 (p = 0.012) respectively). Besides, V̇O2 peak was significantly decreased (by 6%, p = 0.002) during supine position. These findings were confirmed by the wide limits of agreement between the measures of V̇O2 in different postures (V̇O2 peak: -341 to 859; constant-load test: -528 to 783; GET: -375 to 789; RCP: -520 to 1021 all in mL·min-1). Conclusion: Since an accurate identification of an appropriate power output (PO) from a single-visit CPET remains a matter of debate, especially for supine cycling, we propose that moderate-intensity step-transitions preceding a ramp CPET could be a viable addition to ensure appropriate exercise-intensity domain determination, in particular upon GET-based prescription.

No differences in splenic emptying during on-transient supine cycling between aerobically trained and untrained participants.

PURPOSE: The role of splenic emptying in O2 transport during aerobic exercise still remains a matter of debate. Our study compared the differences in spleen volume changes between aerobically trained and untrained individuals during step-transition supine cycling exercise at moderate-intensity. We also examined the relationship between spleen volume changes, erythrocyte release, and O2 uptake parameters. METHODS: Fourteen healthy men completed all study procedures, including a detailed medical examination, supine maximal O2 uptake ([Formula: see text] max.) test, and three step-transitions from 20 W to a moderate-intensity power output, equivalent to [Formula: see text] uptake at 90% gas exchange threshold. During these step-transitions pulmonary [Formula: see text], near-infrared spectroscopy of the vastus lateralis, and cardiovascular responses were continuously measured. In parallel, minute-by-minute ultrasonic measurements of the spleen were performed. Blood samples were taken before and immediately after step-transition cycling. RESULTS: On average, [Formula: see text] max. was 10 mL kg min-1 (p = 0.001) higher in trained compared to their aerobically untrained peers. In response to supine step-transition cycling, the splenic volume was significantly reduced, and the largest reduction (~ 106 to 115 mL, ~ 38%, p = 0.001) was similar in both aerobically trained and untrained individuals. Erythrocyte concentration and platelet count transiently increased after exercise cessation, with no differences observed between groups. However, the vastus lateralis deoxygenation amplitude was 30% (p = 0.001) greater in trained compared to untrained individuals. No associations existed between: (i) spleen volumes at rest (ii) spleen volume changes (%), (iii) resting hematocrit and oxygen uptake parameters. CONCLUSION: Greater splenic emptying and subsequent erythrocyte release do not lead to a slower [Formula: see text], regardless of individual [Formula: see text] max. readings.

A Randomized Crossover Trial on the Acute Cardiovascular Demands During Flywheel Exercise.

In a randomized crossover trial, we examined whether age plays a role in the mean arterial pressure (MAP) response during a vigorous flywheel exercise of varying load. We hypothesized that the magnitude of increase in the MAP during the flywheel exercise would increase in proportion to advancing age, thereby imposing a significant challenge to the cardiovascular system. A total of 30 participants of both sexes (age range from 20-55 y, 37% women) underwent a detailed medical examination, and their maximal oxygen uptake was determined. They performed a squat exercise (2 sets × 7 repetitions) on a flywheel ergometer at three randomly assigned moments of inertia set at 0.025, 0.05, and 0.075 kg m2, while the cardiovascular response was continuously recorded via a Task force monitor. Compared to the resting values, robust rises in the MAP were observed during all three flywheel loads, reaching the highest value of 179 ± 4 mmHg (p = 0.001) during the highest load. In parallel, the cardiac index (cardiac output normalized by the body surface area) was two-fold greater during all the flywheel loads compared to rest, and at a high load, exclusively, the total peripheral resistance increased by 11% (p = 0.001). The rise in heart rate compensated for a load-dependent drop in the stroke index (stroke volume normalized by the body surface area). In our study population, no correlations were observed between the relative increase in the MAP and the participants' age for the three flywheel loads. The present findings suggest that the larger moments of inertia impose a substantial burden to the cardiovascular system, without apparent associated age-differences of the relative magnitude of MAP rise throughout the exercise.

Spleen emptying does not correlate with faster oxygen kinetics during a step-transition supine cycling.

This manuscript quantified spleen volume changes and examined the relationship between those changes and oxygen uptake kinetics during supine cycling. Ten volunteers (age = 22 ± 3), completed 3 step transitions from 20 W to their power output at 90% gas exchange threshold. Ultrasonic measurements of the spleen were performed each minute. The largest spleen volume reduction was 105 mL (p = 0.001). No associations existed between i) spleen volumes at rest; and ii) spleen volume changes (%) and tau pulmonary oxygen uptake (τV̇O2p). Larger resting spleen volume and greater emptying do not correlate with a faster τV̇O2p. Novelty: Greater splenic contractions do not augment τV̇O2p, irrespective of spleen emptying and subsequent erythrocyte release.

Independent influence of age on heart rate recovery after flywheel exercise in trained men and women.

The present study examined whether differences in the heart rate recovery following flywheel exercise cessation were associated with differences in maximal oxygen uptake ([Formula: see text]O2 max.), age and sex in trained adults. Eleven men (age range 22-49 years, [Formula: see text]O2 max. = 43.6 ± 7.6 mL kg min-1) and ten women (age range 20-53 years, [Formula: see text]O2 max. = 38.0 ± 5.7 mL kg min-1) were randomly assigned to complete a squat-exercise on the flywheel ergometer set at three different moments of inertia, while their cardiovascular responses were continuously monitored. During the flywheel exercise the mean arterial pressure rose by ~ 35 to 40% (p = .001), and the increment was more robust in men than women. The cardiac index was two-fold greater across both sexes compared to the baseline (p = .001), while the rise in heart rate (~ 144 bpm) was more pronounced in women to compensate for their load-dependent stroke index decline (p = .001). The load-independent time-course changes in heart rate recovery markers were comparable between the sexes. When these indicators were pooled, a stepwise regression revealed age as the only relevant predictor of both fast and slow components of the heart rate recovery (~ 30% of the shared variance explained, p = .014). The present data suggest that the heart rate recovery declines with age, irrespective of sex, or well-preserved cardiorespiratory fitness in moderately-trained adults.

Acute flywheel exercise does not impair the brachial artery vasodilation in healthy men of varying aerobic fitness.

BACKGROUND: The cardiovascular response to variable load exercise on a flywheel ergometer is still unknown. OBJECTIVE: This study examined the effects of flywheel exercise on cardiovascular response and brachial artery vasodilation capacity in healthy, active men. METHODS: In this cross-sectional study, nineteen men (20-57 years old) completed three laboratory visits, including a ramp exercise test to determine their maximal oxygen uptake JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic1/v/2021-04-27T091817Z/r/image-tiff max, and exercise intervention on a flywheel ergometer set at 0.075 kg·m2 moment of inertia. After the ramp test cessation, all participants were allocated into aerobically untrained (n = 10) and trained (n = 9) groups. Throughout the flywheel exercise, cardiovascular demands were continuously monitored via Finapres, while a pre/postflow-mediated dilation (FMD) assessment was performed using ultrasound imaging. RESULTS: There were no differences observed between the groups in their anthropometrics, age or resting brachial artery diameter, while the JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic2/v/2021-04-27T091817Z/r/image-tiff max was ~15% higher (P = 0.001) in trained compared to aerobically untrained group. The cardiovascular response to the flywheel exercise was similar between the groups, with peak mean arterial pressure and heart rate readings reaching ~160 mmHg and ~140 bpm, respectively. The flywheel exercise did not impair the FMD (%) response, which was comparable between the groups (P = 0.256). When these data were pooled, the regression analysis showed an inverse relationship among FMD (%), age (ß = -0.936, P = 0.001) and JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic3/v/2021-04-27T091817Z/r/image-tiffmax. (ß = -0.359, P = 0.045). CONCLUSION: Although aerobic fitness alone does not directly explain the FMD response to flywheel exercise, aerobically untrained individuals, as they get older, tend to have lower brachial artery FMD.

Long-lasting exercise involvement protects against decline in V̇O2max and V̇O2 kinetics in moderately active women.

We studied the effects of age on different physiological parameters, including those derived from (i) maximal cardiopulmonary exercise testing (CPET), (ii) moderate-intensity step transitions, and (iii) tensiomyography (TMG)-derived variables in moderately active women. Twenty-eight women (age, 19 to 53 years), completed 3 laboratory visits, including baseline data collection, TMG assessment, maximal oxygen uptake test via CPET, and a step-transition test from 20 W to a moderate-intensity cycling power output (PO), corresponding to oxygen uptake at 90% gas exchange threshold. During the step transitions, breath-by-breath pulmonary oxygen uptake, near infrared spectroscopy derived muscle deoxygenation (ΔHHb), and beat-by-beat cardiovascular response were continuously monitored. There were no differences observed between the young and middle-aged women in their maximal oxygen uptake and peak PO, while the maximal heart rate (HR) was 12 bpm lower in middle-aged compared with young (p = 0.016) women. Also, no differences were observed between the age groups in τ pulmonary oxygen uptake, ΔHHb, and τHR during on-transients. The first regression model showed that age did not attenuate the maximal CPET capacity in the studied population (p = 0.638), while in the second model a faster τ pulmonary oxygen uptake, combined with shorter TMG-derived contraction time (Tc) of the vastus lateralis (VL), were associated with a higher maximal oxygen uptake (∼30% of explained variance, p = 0.039). In conclusion, long lasting exercise involvement protects against a maximal oxygen uptake and τpulmonary oxygen uptake deterioration in moderately active women. Novelty: Faster τ pulmonary oxygen uptake and shorter Tc of the VL explain 33% of the variance in superior maximal oxygen uptake attainment. No differences between age groups were found in τ pulmonary oxygen uptake, τΔHHb, and τHR during on-transients.

The 30-15 Intermittent Fitness Test: A Reliable, Valid, and Useful Tool to Assess Aerobic Capacity in Female Basketball Players.

Purpose: The purpose of this study was to determine the reliability, validity, and usefulness of 30-15 Intermittent Fitness Test (30-15IFT) in female basketball players. Methods: Nineteen female basketball players (17.82 ± 1.94 yr, 175.4 ± 7.3 cm, 67.9 ± 7.7 kg) competing in the National Croatian League performed one trial of a continuous treadmill running test and two trials of the 30-15IFT. The 30-15IFT involves 30-s runs across a 40-m course interspersed with 15 s of walking, with running speed increasing every 45 s. The continuous treadmill running test was used as the criterion for validation. Results: High to very high reliability across test-retest trials were observed for maximal oxygen uptake (VO2max) (CV = 4.9%, ICC = 0.85), the 30-15IFT end-running velocity (VIFT) (CV = 6.0%, ICC = 0.85), and maximal heart rate (HRmax) (CV = 4.8%, ICC = 0.96). Criterion validity was supported for the 30-15IFT with strong to very strong relationships with VO2max (r =0.69), VIFT (r =0.74), and HRmax (r =0.73) attained during the continuous treadmill running test. The typical error (TE) of the 30-15IFT was greater than the smallest worthwhile change for VO2max (1.16 > 0.42 ml/kg/min), VIFT (0.56 > 0.20 km/h), and HRmax (2.15 > 1.89 bpm) adjudging usefulness of the test as marginal. The TE of 0.56 km/h (90% CI = 0.44-0.77 km/h) demonstrates changes in the performance of one to two stages (0.5-1.0 km/h) are meaningful. Conclusions: The 30-15IFT possesses acceptable reliability and validity to assess maximal aerobic fitness capacity in female basketball players. While the usefulness of the 30-15IFT was marginal, meaningful changes in performance consisted of only one to two stages. The present findings support the 30-15IFT as a practical testing option for basketball practitioners to assess fitness capacities in female players.

Fluid balance and hydration status in combat sport Olympic athletes: a systematic review with meta-analysis of controlled and uncontrolled studies.

PURPOSE: Athletes in Olympic combat sports experience body water fluctuations resulting from training and intentional dehydration when making weight. Despite the popularity of urine specific gravity (USG) and urine osmolality (UOSM) measurement in characterizing fluid fluctuations, their utility remains questioned. This systematic review/meta-analysis examined the utility of urinary hydration indices in laboratory and field settings in Olympic combat sport athletes. METHODS: 27 articles met the inclusion criteria for systematic review, 15 studies were included in the meta-analysis; with USG and UOSM the main outcome variables. Meta-regression analyses evaluated the interrelationship among body mass (BM), fluid intake, and urine measures. RESULTS: Significant USG alterations were observed following different sampling time frames: dehydration (ES 0.59; 95% CI 0.46-0.72; p = 0.001), follow-up period (ES 0.31; 95% CI 0.11-0.50; p = 0.002) and rehydration (ES - 0.34; 95% CI - 0.56 to - 0.12; p = 0.003). Direct comparison of laboratory (ES 0.20; 95% CI - 0.19 to 0.59; p = 0.324) and field (ES 0.35; 95% CI 0.14-0.56; p = 0.001) sampling showed marginally trivial and small effects. Small effects on UOSM were observed following dehydration (ES 0.31; 95% CI 0.12-0.74, p = 0.15), follow-up period (ES 0.39; 95% CI 0.08-0.70, p = 0.015) and rehydration (ES - 0.45; 95% CI - 0.60 to 0.30, p = 0.001). Meta-regression analysis suggests only fluid intake predicts USG alterations (p = 0.044) during rehydration protocols. CONCLUSIONS: There were likely small changes in both USG and UOSM readings across all experimental conditions, with moderate-to-large heterogeneity in all studies, except for USG readings during dehydration protocols. The meta-regression failed to provide conclusive evidence concerning the interrelationship among urine measures, BM fluctuations, and fluid intake.

Validity and Reliability of the 30-s Continuous Jump for Anaerobic Power and Capacity Assessment in Combat Sport.

Cycling test such Wingate anaerobic test (WAnT) is used to measure anaerobic power (AP), but not anaerobic capacity (AC, i.e., the metabolic energy demand). However, in sports that do not involve cycling movements (Karate), the continuous jump for 30 s (vertical jumps for 30 s) has been extensively used to measure anaerobic performance in all young athletes. Limited information's are available concerning its validity and reliability especially in children. As such, the current study aimed to test validity and reliability of a continuous jumps test (the CJ30s), using WAnT as a reference. Thirteen female Karate kids (age: 11.07 ± 1.32 years; mass: 41.76 ± 15.32 kg; height: 152 ± 11.52 cm; training experience: 4.38 ± 2.14 years) were tested on three separate sessions. The first and second sessions were used to assess the reliability using Intra-class correlation coefficient (ICC) of CJ30s, whereas on the third session WAnT was administered. Following CJ30s and WAnT, we assessed AP (1/CJ30s, as jump height [JH], fatigue index [FI], and blood lactate [BL]; 2/WAnT, as mechanical power [P], FI, and BL) and AC as the excess post-exercise oxygen consumption (EPOC). Large/highly significant correlations were found between CJ30s and WAnT EPOCs (r = 0.730, P = 0.003), and BLs (r = 0.713, P = 0.009). Moderate/significant correlations were found between CJ30s and WAnT FIs (r = 0.640, P = 0.014), CJ30s first four jumps mean JH and WAnT peak P (r = 0.572, P = 0.032), and CJ30s mean JH and WAnT mean P (r = 0.589, P = 0.021). CJ30s showed excellent and moderate reliability (ICC) for AP (maximal JH 0.884, mean JH 0.742, FI 0.657, BL 0.653) and AC (EPOC 0.788), respectively. Correlations observed especially in terms of AC between CJ30s and WAnT provide evidence that former may adequately assess anaerobic performance for the young combat athlete. CJ30 is a reliable test and allow an easy assessment of AP and AC in karate children.

Fluid balance and hydration assessment during the weight-stable preparation phase in elite youth boxers.

This study investigated (i) the prevalence of hypohydration and (ii) association between urinary indices of hydration status and confounding factors (e.g., urine protein content, water intake) in elite youth boxers during their weight-stable phase before competition. Sixteen national champion boxers (all male, 17 ± 1 y) were measured on 3 occasions (baseline, day 3, day 10), 30-day prior to competition. Body mass, total body water, urine specific gravity (USG), osmolality (UOSM) and total protein content (TPC) were evaluated to determine hydration status and fluid balance. Overall macronutrient and water intake were assessed using dietary records. Both UOSM and USG increased from day 3 to day 10 by 16% and 0.4% (P < 0.001), despite athletes being in their weight-stability period, and regardless of ad libitum fluid intake. Hypohydration was universally prevalent among all athletes on both test days with USG: 1.027 ± 0.003 g · mL-1 and UOSM: 1035 ± 108 mOsmol · kg-1. An inverse association between mean UOSM values and mean water intake was observed (R = -0.52, P = 0.04), while TPC was not associated with any urinary dehydration markers (USG, P = 0.51; UOSM, P = 0.61). The present outcomes find that the most prevalent urinary dehydration markers used to classify hydration status in competition exhibit large variability, even during weight-stable periods.

The influence of varying inspired fractions of O2 and CO2 on the development of involuntary breathing movements during maximal apnoea.

The growing urge to breathe that occurs during breath-holding results in development of involuntary breathing movements (IBMs). The present study determined whether IBMs are initiated at critical levels of hypercapnia and/or hypoxia during maximal apnoea. Arterial blood gasses at the onset of IBM were monitored during maximal voluntary breath-holds. Eleven healthy men performed breath holds after breathing air, hyperoxic-normocapnia, hypoxic-normocapnia, and normoxic-hypercapnia. Pre-breathing of the gas mixtures facilitated the IBM onset, reducing the time-to-onset for ∼46% (hyperoxic condition) and for ∼80% (hypoxic condition) compared to the normoxic air breathing time. A strong correlation (R=0.83, P=0.002) between arterial partial pressure of CO2 (PaCO2) at IBM onset after pre-breathing hyperoxic and hypercapnic gas mixtures was observed, suggesting the existence of a possible IBM PaCO2 threshold level of ∼6.5 ± 0.5 kPa. No clear "threshold" was observed for partial pressure of arterial O2(PaO2). However, we observed that IBM onset was influenced, in part, by an interaction between PaO2 and PaCO2 levels during maximal apnoea. This study demonstrated the complex interaction between arterial blood-gases and the physiological response to maximal breath holding.

A no-decompression air dive and ultrasound lung comets.

INTRODUCTION: Increased accumulation of extravascular lung water after repetitive deep trimix dives was recently reported. This effect was evident 40 min post-dive, but in subsequent studies most signs of this lung congestion were not evident 2-3 h post-dive, indicating no major negative effects on respiratory gas exchange following deep dives. Whether this response is unique for trimix dives or also occurs in more frequent air dives is presently unknown. METHODS: A single no-decompression field dive to 33 m with 20 min bottom time was performed by 12 male divers. Multiple ultrasound lung comets (ULC), bubble grade (BG), and single-breath lung diffusing capacity (DLCO) measurements were made before and up to 120 min after the dive. RESULTS: Median BG was rather high with maximal values observed at 40 min post-dive [median 4 (4-4)]. Arterialization of bubbles from the venous side was observed only in one diver lasting up to 60 min post-dive. Despite high BG, no DCS symptoms were noted. DLCO and ULC were unchanged after the dive at any time point (DLCO(corr) was 33.6 +/- 1.9 ml x min(-1) mmHg(-1) pre-dive, 32.7 +/- 3.8 ml x min(-1) x mmHg(-1) at 60 min post-dive, and 33.2 +/- 5.3 ml x min(-1) x mmHg(-1) at 120 min post-dive; ULC count was 4.1 +/- 1.9 pre-dive, 4.9 +/- 3.3 at 20 min post-dive, and 3.3 +/- 1.9 at 60 min post-dive. DISCUSSION: These preliminary findings show no evidence of increased accumulation of extravascular lung water in male divers after a single no-decompression air dive at the limits of accepted Norwegian diving tables.

Glossopharyngeal insufflation induces cardioinhibitory syncope in apnea divers.

Apnea divers increase intrathoracic pressure voluntarily by taking a deep breath followed by glossopharyngeal insufflation. Because apnea divers sometimes experience hypotension and syncope during the maneuver, they may serve as a model to study the mechanisms of syncope. We recorded changes in hemodynamics and sympathetic vasomotor tone with microneurography during breath holding with glossopharyngeal insufflation. Five men became hypotensive and fainted during breath holding with glossopharyngeal insufflation within the first minute. In four divers, heart rate dropped suddenly to a minimum of 38 ± 4 beats/min. Therefore, cardioinhibitory syncope was more common than low cardiac output syncope.

Ultrasonic evidence of acute interstitial lung edema after SCUBA diving is resolved within 2-3h.

Recently, an increase in extravascular lung water (EVLW) accumulation with diminished left ventricular contractility within 60 min after SCUBA diving was reported. We have observed previously that diving was associated with reduced diffusing lung capacity for carbon monoxide (DLCO) and arterial oxygen pressure for up to 60-80 min postdive. Here we investigated whether increased EVLW persists 2-3h after successive deep dives in a group of seven male divers. The echocardiographic indices of pulmonary water accumulation (ultrasound lung comets (ULC)) and left ventricular function, respiratory functional measurements and arterial oxygen saturation (SaO(2)) were assessed 2-3h post diving, while venous gas bubbles (VGB) and the blood levels of NT-proBNP and proANP were analyzed 40 min after surfacing. Spirometry values, flow-volume, DLCO, SaO(2) and ULC were unchanged after each dive, except for significant increase in ULC after the second dive. Left ventricular function was reduced, while NT-proBNP and proANP levels were significantly elevated after majority of dives, suggesting a cardiac strain.

Peripheral chemoreflex regulation of sympathetic vasomotor tone in apnea divers.

OBJECTIVES: Involuntary apnea episodes in obstructive sleep apnea patients result in selective potentiation of peripheral chemoreceptor regulation of sympathetic vasomotor tone. Breath-hold diving is associated with repeated "voluntary" apnea episodes and massive arterial oxygen desaturation, which could also perturb chemoreflex function. METHODS: We measured ventilation, heart rate, blood pressure, cardiac stroke volume, and muscle sympathetic nerve activity (MSNA) during isocapnic hypoxia in 11 breath-hold divers and eleven matched control subjects. The study was carried out at least 1 month after intense apnea training. RESULTS: Baseline MSNA frequency was 30 +/- 4 bursts/min in control subjects and 31 +/- 7 bursts/min in divers (ns). During hypoxia MSNA frequency and total activity increased similarly in both groups (30 and 66% in controls and 27 and 60% in divers, respectively). MSNA remained increased after termination of hypoxia and approached baseline measurements after 20 min. Hypoxia-induced stimulation of minute ventilation was similar in both groups, although in divers it was maintained by higher tidal volumes and lower breathing frequency compared with control subjects. In both groups, hypoxia-induced tachycardia drove an increase in cardiac output whereas total peripheral resistance decreased. Blood pressure remained unchanged. INTERPRETATION: We conclude that after the end of intensive training/competition periods, apnea divers show normal peripheral chemoreflex regulation of ventilation and sympathetic vasomotor tone. Although voluntary apnea may not lead to sustained changes in sympathetic nervous system regulation, we cannot exclude the possibility that repeated sympathetic activation elicited by voluntary apnea imposes a burden on the cardiovascular system.