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Cardiac hypoxic resistance and decreasing lactate during maximum apnea in elite breath hold divers

Kjeld, Thomas ; Møller, Jakob ; Fogh, Kristian ; Hansen, Egon Godthaab ; Arendrup, Henrik Christian ; Isbrand, Anders Brenøe ; Zerahn, Bo ; Højberg, Jens ; Ostenfeld, Ellen LU orcid and Thomsen, Henrik , et al. (2021) In Scientific Reports 11(1).
Abstract

Breath-hold divers (BHD) enduring apnea for more than 4 min are characterized by resistance to release of reactive oxygen species, reduced sensitivity to hypoxia, and low mitochondrial oxygen consumption in their skeletal muscles similar to northern elephant seals. The muscles and myocardium of harbor seals also exhibit metabolic adaptations including increased cardiac lactate-dehydrogenase-activity, exceeding their hypoxic limit. We hypothesized that the myocardium of BHD possesses similar adaptive mechanisms. During maximum apnea 15O-H2O-PET/CT (n = 6) revealed no myocardial perfusion deficits but increased myocardial blood flow (MBF). Cardiac MRI determined blood oxygen level dependence oxygenation (n = 8) after 4 min of apnea was... (More)

Breath-hold divers (BHD) enduring apnea for more than 4 min are characterized by resistance to release of reactive oxygen species, reduced sensitivity to hypoxia, and low mitochondrial oxygen consumption in their skeletal muscles similar to northern elephant seals. The muscles and myocardium of harbor seals also exhibit metabolic adaptations including increased cardiac lactate-dehydrogenase-activity, exceeding their hypoxic limit. We hypothesized that the myocardium of BHD possesses similar adaptive mechanisms. During maximum apnea 15O-H2O-PET/CT (n = 6) revealed no myocardial perfusion deficits but increased myocardial blood flow (MBF). Cardiac MRI determined blood oxygen level dependence oxygenation (n = 8) after 4 min of apnea was unaltered compared to rest, whereas cine-MRI demonstrated increased left ventricular wall thickness (LVWT). Arterial blood gases were collected after warm-up and maximum apnea in a pool. At the end of the maximum pool apnea (5 min), arterial saturation decreased to 52%, and lactate decreased 20%. Our findings contrast with previous MR studies of BHD, that reported elevated cardiac troponins and decreased myocardial perfusion after 4 min of apnea. In conclusion, we demonstrated for the first time with 15O-H2O-PET/CT and MRI in elite BHD during maximum apnea, that MBF and LVWT increases while lactate decreases, indicating anaerobic/fat-based cardiac-metabolism similar to diving mammals.

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publication status
published
subject
keywords
Adaptation, Physiological, Adult, Apnea/metabolism, Blood Gas Analysis, Blood Pressure, Breath Holding, Diving, Female, Heart Rate, Hemodynamics, Humans, Hypoxia/metabolism, Magnetic Resonance Imaging, Male, Middle Aged, Myocardium/metabolism, Positron Emission Tomography Computed Tomography
in
Scientific Reports
volume
11
issue
1
article number
2545
publisher
Nature Publishing Group
external identifiers
  • scopus:85099801849
  • pmid:33510292
ISSN
2045-2322
DOI
10.1038/s41598-021-81797-1
language
English
LU publication?
yes
id
6be0daaa-713b-4769-b9f1-c1b1915da897
date added to LUP
2022-03-16 11:12:53
date last changed
2024-03-21 06:18:01
@article{6be0daaa-713b-4769-b9f1-c1b1915da897,
  abstract     = {{<p>Breath-hold divers (BHD) enduring apnea for more than 4 min are characterized by resistance to release of reactive oxygen species, reduced sensitivity to hypoxia, and low mitochondrial oxygen consumption in their skeletal muscles similar to northern elephant seals. The muscles and myocardium of harbor seals also exhibit metabolic adaptations including increased cardiac lactate-dehydrogenase-activity, exceeding their hypoxic limit. We hypothesized that the myocardium of BHD possesses similar adaptive mechanisms. During maximum apnea 15O-H2O-PET/CT (n = 6) revealed no myocardial perfusion deficits but increased myocardial blood flow (MBF). Cardiac MRI determined blood oxygen level dependence oxygenation (n = 8) after 4 min of apnea was unaltered compared to rest, whereas cine-MRI demonstrated increased left ventricular wall thickness (LVWT). Arterial blood gases were collected after warm-up and maximum apnea in a pool. At the end of the maximum pool apnea (5 min), arterial saturation decreased to 52%, and lactate decreased 20%. Our findings contrast with previous MR studies of BHD, that reported elevated cardiac troponins and decreased myocardial perfusion after 4 min of apnea. In conclusion, we demonstrated for the first time with 15O-H2O-PET/CT and MRI in elite BHD during maximum apnea, that MBF and LVWT increases while lactate decreases, indicating anaerobic/fat-based cardiac-metabolism similar to diving mammals.</p>}},
  author       = {{Kjeld, Thomas and Møller, Jakob and Fogh, Kristian and Hansen, Egon Godthaab and Arendrup, Henrik Christian and Isbrand, Anders Brenøe and Zerahn, Bo and Højberg, Jens and Ostenfeld, Ellen and Thomsen, Henrik and Gormsen, Lars Christian and Carlsson, Marcus}},
  issn         = {{2045-2322}},
  keywords     = {{Adaptation, Physiological; Adult; Apnea/metabolism; Blood Gas Analysis; Blood Pressure; Breath Holding; Diving; Female; Heart Rate; Hemodynamics; Humans; Hypoxia/metabolism; Magnetic Resonance Imaging; Male; Middle Aged; Myocardium/metabolism; Positron Emission Tomography Computed Tomography}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Cardiac hypoxic resistance and decreasing lactate during maximum apnea in elite breath hold divers}},
  url          = {{http://dx.doi.org/10.1038/s41598-021-81797-1}},
  doi          = {{10.1038/s41598-021-81797-1}},
  volume       = {{11}},
  year         = {{2021}},
}