The Key Roles of Negative Pressure Breathing and Exercise in the Development of Interstitial Pulmonary Edema in Professional Male SCUBA Divers

Castagna, Olivier; Regnard, Jacques; Gempp, Emmanuel; Louge, Pierre; Brocq, François Xavier; Schmid, Bruno; Desruelle, Anne-Virginie; Crunel, Valentin; Maurin, Adrien; Chopard, Romain; MacIver, David Hunter

doi:10.1186/s40798-017-0116-x

Sports Medicine - Open

Table 2 Cardiac variables assessed through transthoracic echography in-water at start and end of each dive session

From: The Key Roles of Negative Pressure Breathing and Exercise in the Development of Interstitial Pulmonary Edema in Professional Male SCUBA Divers

	Static PPB		Static NPB		Exercise PPB		Exercise NPB
	Pre-dive (A)	Post-dive (A′)	Pre-dive (B)	Post-dive (B′)	Pre-dive (C)	Post-dive (C′)	Pre-dive (D)	Post-dive (D′)
Right heart
IVC diameter (cm)	1.7 ± 0.1	1.8 ± 0.1^a	1.7 ± 0.1	1.8 ± 0.1^a	1.7 ± 0.2	2.5 ± 0.7^ab	1.7 ± 0.1	3.2 ± 0.5^abc
RA area (cm²)	12.4 ± 1.5	14.8 ± 2.5^a	12.2 ± 1.6	14.2 ± 2.3^a	12.3 ± 1.8	18.2 ± 2.7^ab	11.9 ± 1.5	22.1 ± 3.0^abc
RVED area (cm²)	19.1 ± 2.5	22.9 ± 3.1	18.9 ± 2.3	21.9 ± 2.6	18.9 ± 2.4	25.9 ± 3.2^ab	19.7 ± 2.4	28.2 ± 4.5^abc
RVES area (cm²)	11.9 ± 2.7	11.8 ± 2.6	12.2 ± 2.3	11.9 ± 3.2	12.8 ± 2.9	12.4 ± 2.4	12.2 ± 1.9	12.7 ± 2.9
RVFAC (%)	37.6 ± 10	45.1 ± 8.4	25.1 ± 6.9	45.3 ± 7.2	35.9 ± 9.2	52.1 ± 7.7^ab	33.4 ± 9.7	55.7 ± 7.3^ab
TAPSE (mm)	20.7 ± 1.2	21.6 ± 1.4	20.8 ± 1.2	21.8 ± 1.2^a	21.5 ± 1.1	24.4 ± 1.5^ab	20.6 ± 1.1	28.6 ± 1.7^abc
_SPAP (mmHg)	7.6 ± 1.1	13.7 ± 2.5^a	7.2 ± 1.2	13.1 ± 2.2^a	7.2 ± 0.7	20.2 ± 2.1^ab	7.5 ± 0.7	24.5 ± 2.9^abc
Left heart
LA area (cm²)	13.5 ± 1.2	14.9 ± 1.3^a	13.1 ± 1.0	14.5 ± 1.1^a	13.4 ± 1.6	15.1 ± 1.7^a	13.7 ± 2.2	16.4 ± 2.8^a
LVEF (%)	63.7 ± 2.6	65.1 ± 2.4	64.7 ± 2.6	64.67 ± 2.1	63.6 ± 3.1	64.9 ± 2.5	65.1 ± 2.1	65.9 ± 1.7
SV (mL)	74.8 ± 3.1	75.1 ± 3.1	75.8 ± 2.6	73.1 ± 2.1	74.6 ± 2.3	74.1 ± 2.7	75.6 ± 3.5	75.5 ± 2.4
HR (bpm)	58.8 ± 4.9	50.1 ± 4.6^a	61.4 ± 4.7	51.3 ± 4.4^a	57.4 ± 6.1	111.6 ± 6.1^ab	60.1 ± 5.5	109.8 ± 5.5^ab
CO (L m⁻¹)	4.4 ± 0.6	3.8 ± 0.5^a	4.7 ± 0.5	3.7 ± 0.4^a	4.3 ± 0.6	8.3 ± 0.7^ab	4.6 ± 0.6	8.3 ± 0.7^ab
LVED area (cm²)	33.2 ± 3.1	32.6 ± 4.1	32.2 ± 3.7	35.4 ± 3.1^a	33.3 ± 4.3	33.1 ± 3.7	32.9 ± 3.7	32.7 ± 2.7^b
LVES area (cm²)	18.2 ± 1.5	17.9 ± 1.4	17.6 ± 1.2	17.8 ± 1.4	18.2 ± 1.4	17.7 ± 1.5	17.3 ± 1.2	18.0 ± 1.4
RV/LV area (%)	57.2 ± 2.8	67.3 ± 2.6^a	58.8 ± 2.2	61.7 ± 2.9^a	57.0 ± 2.8	78.5 ± 4.5^ab	56.8 ± 1.9	85.9 ± 8.3^ab
E (m s⁻¹)	0.79 ± 0.05	0.82 ± 0.04	0.79 ± 0.06	0.82 ± 0.04	0.78 ± 0.06	0.85 ± 0.04	0.78 ± 0.06	0.88 ± 0.05
A (m s⁻¹)	0.54 ± 0.13	0.48 ± 0.06^a	0.52 ± 0.10	0.49 ± 0.05^a	0.54 ± 0.11	0.45 ± 0.07^ab	0.53 ± 0.12	0.41 ± 0.07^abc
EDT (ms)	223 ± 11.6	201 ± 11.3^a	225 ± 12.5	201 ± 14.3^a	223 ± 12.3	192 ± 11.3^ab	223 ± 11.1	184 ± 10.2^abc
E/A	1.53 ± 0.31	1.75 ± 0.13^a	1.56 ± 0.20	1.67 ± 0.09^a	1.49 ± 0.22	1.92 ± 0.22^ab	1.53 ± 0.24	2.18 ± 0.25^ab

Cardiac dimensions and functional parameters were determined at start and end of each 30-min dive. Time- and condition-linked differences in each variable were assessed using two-way repeated-measures analysis of variance (with the post hoc test).
Static PPB static (rest) dive with positive pressure breathing setting, Static NPB static dive with negative pressure breathing setting, Exercise PPB and Exercise NPB exercises dives with respectively positive and negative pressure breathing conditions, IVC diameter inferior vena cava diameter, RA area right atrial area, RVED area right ventricle end-diastolic area, RVES area right ventricle end-systolic area, RVFAC right ventricle fractional area change, TAPSE tricuspid annular plane systolic excursion, sPAP systolic pulmonary arterial pressure, LA area left atrial area, LVEF left ventricle ejection fraction, SV left stroke volume, HR heart rate, CO cardiac output, LVED area left ventricle end-diastolic area, LVES area left ventricle end-systolic area, RV/LV ratio of right to left ventricles end-diastolic area, E peak early diastolic left ventricular filling velocity, A late diastolic left ventricular filling velocity, EDT E peak deceleration time (early left ventricular filling deceleration time), E/A ratio of E to A velocities
^aPost-dive different from pre-dive in the same session
^bPost-exercise different from post-static counterpart (similar transpulmonary pressure breathing)
^cPost-exercise NPB different from post-exercise PPB

Back to article page