Skip to main content
Erschienen in: European Journal of Applied Physiology 4/2022

20.01.2022 | Original Article

Global longitudinal strain assessment of cardiac function and extravascular lung water formation after diving using semi-closed circuit rebreather

verfasst von: María Martinez-Villar, Antonio Tello-Montoliu, Agustín Olea, Ángel Pujante, Daniel Saura, Silvia Martín, Nereo Venero, Ana Carneiro-Mosquera, Nuria Ruiz de Pascual, Noelia Valero, Miguel Martinez-Herrera, Inmaculada Ramírez-Macías, Juan Antonio Vilchez, Miguel García Navarro, Gonzalo de la Morena, Domingo Pascual

Erschienen in: European Journal of Applied Physiology | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of the present investigation is to study the relationship of ventricular global longitudinal strain (GLS) and ultrasound lung comets (ULC) formation to establish a link between extravascular pulmonary water formation and cardiac contractile dysfunction.

Methods

This is a prospective observational study including 14 active military divers. The subjects performed two sea dives of 120 min each with a semi-closed SCUBA circuit at 10 m depth. Divers were examined at baseline, 15 min (D1) and 60 min (D2) after diving. The evaluation included pulmonary and cardiac echography (including speckle tracking techniques). Blood samples were drawn at baseline and after diving, assessing hs-TnT and Endothelin-1.

Results

ULC were detected in 9 (64.2%) and 8 (57.1%) of the subjects after D1 and D2 respectively. No differences were found in right and left ventricular GLS after both immersions (RV: Baseline:  – 17.9 4.9 vs. D1:  – 17.2 6.5 and D2:  – 16.7 5.8 s−1; p = 0.757 and p = 0.529; LV: Baseline:  – 17.0 2.3 vs. D1:  – 17.4 2.1 and D2:  – 16.9 2.2 s−1; p = 0.546 and p = 0.783). However, a decrease in atrial longitudinal strain parameters have been detected after diving (RA: Baseline: 35.5 9.2 vs. D1: 30.3 12.8 and D2: 30.7 13.0 s−1; p = 0.088 and p = 0.063; LA: Baseline: 39.0 10.0 vs. D1: 31.6 6.1 and D2: 32.4 10.6 s−1; p = 0.019 and p = 0.054).

Conclusion

In the present study, no ventricular contractile dysfunction was observed. However, increase pulmonary vasoconstriction markers were present after diving.
Literatur
Zurück zum Zitat Adir Y, Shupak A, Gil A, Peled N, Keynan Y, Domachevsky L, Weiler-Ravell D (2004) Swimming-induced pulmonary edema: clinical presentation and serial lung function. Chest 126:394–399PubMedCrossRef Adir Y, Shupak A, Gil A, Peled N, Keynan Y, Domachevsky L, Weiler-Ravell D (2004) Swimming-induced pulmonary edema: clinical presentation and serial lung function. Chest 126:394–399PubMedCrossRef
Zurück zum Zitat Alenezi F, Mandawat A, Il’Giovine ZJ, Shaw LK, Siddiqui I, Tapson VF, Arges K, Rivera D, Romano MMD, Velazquez EJ, Douglas PS, Samad Z, Rajagopal S (2018) Clinical utility and prognostic value of right atrial function in pulmonary hypertension. Circ Cardiovasc Imag 11:e006984CrossRef Alenezi F, Mandawat A, Il’Giovine ZJ, Shaw LK, Siddiqui I, Tapson VF, Arges K, Rivera D, Romano MMD, Velazquez EJ, Douglas PS, Samad Z, Rajagopal S (2018) Clinical utility and prognostic value of right atrial function in pulmonary hypertension. Circ Cardiovasc Imag 11:e006984CrossRef
Zurück zum Zitat Andersson JP, Linér MH, Fredsted A, Schagatay EK (2004) Cardiovascular and respiratory responses to apneas with and without face immersion in exercising humans. J Appl Physiol 96:1005–1010PubMedCrossRef Andersson JP, Linér MH, Fredsted A, Schagatay EK (2004) Cardiovascular and respiratory responses to apneas with and without face immersion in exercising humans. J Appl Physiol 96:1005–1010PubMedCrossRef
Zurück zum Zitat Arborelius M Jr, Ballidin UI, Lilja B, Lundgren CE (1972) Hemodynamic changes in man during immersion with the head above water. Aerosp Med 43:592–598PubMed Arborelius M Jr, Ballidin UI, Lilja B, Lundgren CE (1972) Hemodynamic changes in man during immersion with the head above water. Aerosp Med 43:592–598PubMed
Zurück zum Zitat Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O (1991) Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med 325:1284–1289PubMedCrossRef Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O (1991) Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med 325:1284–1289PubMedCrossRef
Zurück zum Zitat Boussuges A, Blanc F, Carturan D (2006) Hemodynamic changes induced by recreational scuba diving. Chest 129:1337–1343PubMedCrossRef Boussuges A, Blanc F, Carturan D (2006) Hemodynamic changes induced by recreational scuba diving. Chest 129:1337–1343PubMedCrossRef
Zurück zum Zitat Boussuges A, Ayme K, Chaumet G, Albier E, Borgnetta M, Gavarry O (2017) Observational study of potential risk factors of immersion pulmonary edema in healthy divers: exercise intensity is the main contributor. Sports Med Open 3:35PubMedPubMedCentralCrossRef Boussuges A, Ayme K, Chaumet G, Albier E, Borgnetta M, Gavarry O (2017) Observational study of potential risk factors of immersion pulmonary edema in healthy divers: exercise intensity is the main contributor. Sports Med Open 3:35PubMedPubMedCentralCrossRef
Zurück zum Zitat Carter EA, Mayo JR, MacInnis MJ, McKenzie DC, Koehle MS (2014) Individual susceptibility to high altitude and immersion pulmonary edema and pulmonary lymphatics. Aviat Space Environ Med 85:9–14PubMedCrossRef Carter EA, Mayo JR, MacInnis MJ, McKenzie DC, Koehle MS (2014) Individual susceptibility to high altitude and immersion pulmonary edema and pulmonary lymphatics. Aviat Space Environ Med 85:9–14PubMedCrossRef
Zurück zum Zitat Castagna O, Gempp E, Poyet R, Schmid B, Desruelle AV, Crunel V, Maurin A, Choppard R, MacIver DH (2017) Cardiovascular mechanisms of extravascular lung water accumulation in divers. Am J Cardiol 119:929–932PubMedCrossRef Castagna O, Gempp E, Poyet R, Schmid B, Desruelle AV, Crunel V, Maurin A, Choppard R, MacIver DH (2017) Cardiovascular mechanisms of extravascular lung water accumulation in divers. Am J Cardiol 119:929–932PubMedCrossRef
Zurück zum Zitat Castagna O, Regnard J, Gempp E, Louge P, Brocq FX, Schmid B, Desruelle AV, Crunel V, Maurin A, Chopard R, MacIver DH (2018) The key roles of negative pressure breathing and exercise in the development of interstitial pulmonary edema in professional male SCUBA divers. Sports Med Open 4:1PubMedPubMedCentralCrossRef Castagna O, Regnard J, Gempp E, Louge P, Brocq FX, Schmid B, Desruelle AV, Crunel V, Maurin A, Chopard R, MacIver DH (2018) The key roles of negative pressure breathing and exercise in the development of interstitial pulmonary edema in professional male SCUBA divers. Sports Med Open 4:1PubMedPubMedCentralCrossRef
Zurück zum Zitat Cochard G, Arvieux J, Lacour JM, Madouas G, Mongredien H, Arvieux CC (2005) Pulmonary edema in scuba divers: recurrence and fatal outcome. Undersea Hyperb Med 32:39–44PubMed Cochard G, Arvieux J, Lacour JM, Madouas G, Mongredien H, Arvieux CC (2005) Pulmonary edema in scuba divers: recurrence and fatal outcome. Undersea Hyperb Med 32:39–44PubMed
Zurück zum Zitat Demoulin R, Poyet R, Castagna O, Gempp E, Druelle A, Schmitt P, Capilla E, Rohel G, Pons F, Jégo C, Brocq FX, Cellarier GR (2020) Epidemiological, clinical, and echocardiographic features of twenty “Takotsubo-like” reversible myocardial dysfunction cases with normal coronarography following immersion pulmonary oedema. Acta Cardiol 76:296–302PubMedCrossRef Demoulin R, Poyet R, Castagna O, Gempp E, Druelle A, Schmitt P, Capilla E, Rohel G, Pons F, Jégo C, Brocq FX, Cellarier GR (2020) Epidemiological, clinical, and echocardiographic features of twenty “Takotsubo-like” reversible myocardial dysfunction cases with normal coronarography following immersion pulmonary oedema. Acta Cardiol 76:296–302PubMedCrossRef
Zurück zum Zitat Gempp E, Louge P, Henckes A, Demaistre S, Heno P, Blatteau JE (2013) Reversible myocardial dysfunction and clinical outcome in scuba divers with immersion pulmonary edema. Am J Cardiol 111:1655–1659PubMedCrossRef Gempp E, Louge P, Henckes A, Demaistre S, Heno P, Blatteau JE (2013) Reversible myocardial dysfunction and clinical outcome in scuba divers with immersion pulmonary edema. Am J Cardiol 111:1655–1659PubMedCrossRef
Zurück zum Zitat Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, Kimura S, Masaki T, Duguid WP, Stewart DJ (1993) Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med 328:1732–1739PubMedCrossRef Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, Kimura S, Masaki T, Duguid WP, Stewart DJ (1993) Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med 328:1732–1739PubMedCrossRef
Zurück zum Zitat Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E (2004) Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 93:1265–1270PubMedCrossRef Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E (2004) Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 93:1265–1270PubMedCrossRef
Zurück zum Zitat Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1-39.e14PubMedCrossRef Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1-39.e14PubMedCrossRef
Zurück zum Zitat Lichtenstein D, Mézière G, Biderman P, Gepner A, Barré O (1997) The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 156:1640–1646PubMedCrossRef Lichtenstein D, Mézière G, Biderman P, Gepner A, Barré O (1997) The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 156:1640–1646PubMedCrossRef
Zurück zum Zitat Loeffler B, Maire J (1994) Radioimmunological determination of endothelin peptides in human plasma: a methodological approach. Endothelium 1:273–286CrossRef Loeffler B, Maire J (1994) Radioimmunological determination of endothelin peptides in human plasma: a methodological approach. Endothelium 1:273–286CrossRef
Zurück zum Zitat Löllgen H, von Nieding G, Koppenhagen K, Kersting F, Just H (1981) Hemodynamic response to graded water immersion. Klin Wochenschr 59:623–628PubMedCrossRef Löllgen H, von Nieding G, Koppenhagen K, Kersting F, Just H (1981) Hemodynamic response to graded water immersion. Klin Wochenschr 59:623–628PubMedCrossRef
Zurück zum Zitat Louge P, Coulange M, Beneton F, Gempp E, Le Pennetier O, Algoud M, Dubourg L, Naibo P, Marlinge M, Michelet P, Vairo D, Kipson N, Kerbaul F, Jammes Y, Jones IM, Steinberg JG, Ruf J, Guieu R, Boussuges A, Fenouillet E (2016) Pathophysiological and diagnostic implications of cardiac biomarkers and antidiuretic hormone release in distinguishing immersion pulmonary edema from decompression sickness. Medicine (baltimore) 95:e4060CrossRef Louge P, Coulange M, Beneton F, Gempp E, Le Pennetier O, Algoud M, Dubourg L, Naibo P, Marlinge M, Michelet P, Vairo D, Kipson N, Kerbaul F, Jammes Y, Jones IM, Steinberg JG, Ruf J, Guieu R, Boussuges A, Fenouillet E (2016) Pathophysiological and diagnostic implications of cardiac biomarkers and antidiuretic hormone release in distinguishing immersion pulmonary edema from decompression sickness. Medicine (baltimore) 95:e4060CrossRef
Zurück zum Zitat MacIver DH, Clark AL (2015) The vital role of the right ventricle in the pathogenesis of acute pulmonary edema. Am J Cardiol 115:992–1000PubMedCrossRef MacIver DH, Clark AL (2015) The vital role of the right ventricle in the pathogenesis of acute pulmonary edema. Am J Cardiol 115:992–1000PubMedCrossRef
Zurück zum Zitat Mahon RT, Kerr S, Amundson D, Parrish JS (2002) Immersion pulmonary edema in special forces combat swimmers. Chest 122:383–384PubMedCrossRef Mahon RT, Kerr S, Amundson D, Parrish JS (2002) Immersion pulmonary edema in special forces combat swimmers. Chest 122:383–384PubMedCrossRef
Zurück zum Zitat Marabotti C, Scalzini A, Menicucci D, Passera M, Bedini R, L’Abbate A (2013) Cardiovascular changes during SCUBA diving: an underwater Doppler echocardiographic study. Acta Physiol 209:62–68CrossRef Marabotti C, Scalzini A, Menicucci D, Passera M, Bedini R, L’Abbate A (2013) Cardiovascular changes during SCUBA diving: an underwater Doppler echocardiographic study. Acta Physiol 209:62–68CrossRef
Zurück zum Zitat Marinovic J, Ljubkovic M, Obad A, Breskovic T, Salamunic I, Denoble PJ, Dujic Z (2010) Assessment of extravascular lung water and cardiac function in trimix SCUBA diving. Med Sci Sports Exerc 42:1054–1061PubMedCrossRef Marinovic J, Ljubkovic M, Obad A, Breskovic T, Salamunic I, Denoble PJ, Dujic Z (2010) Assessment of extravascular lung water and cardiac function in trimix SCUBA diving. Med Sci Sports Exerc 42:1054–1061PubMedCrossRef
Zurück zum Zitat Minkes RK, Bellan JA, Saroyan RM, Kerstein MD, Coy DH, Murphy WA, Nossaman BD, McNamara DB, Kadowitz PJ (1990) Analysis of cardiovascular and pulmonary responses to endothelin-1 and endothelin-3 in the anesthetized cat. J Pharmacol Exp Ther 253:1118–1125PubMed Minkes RK, Bellan JA, Saroyan RM, Kerstein MD, Coy DH, Murphy WA, Nossaman BD, McNamara DB, Kadowitz PJ (1990) Analysis of cardiovascular and pulmonary responses to endothelin-1 and endothelin-3 in the anesthetized cat. J Pharmacol Exp Ther 253:1118–1125PubMed
Zurück zum Zitat Moon RE, Martina SD, Peacher DF, Potter JF, Wester TE, Cherry AD, Natoli MJ, Otteni CE, Kernagis DN, White WD, Freiberger JJ (2016) Swimming-induced pulmonary edema: pathophysiology and risk reduction with Sildenafil. Circulation 133:988–996PubMedPubMedCentralCrossRef Moon RE, Martina SD, Peacher DF, Potter JF, Wester TE, Cherry AD, Natoli MJ, Otteni CE, Kernagis DN, White WD, Freiberger JJ (2016) Swimming-induced pulmonary edema: pathophysiology and risk reduction with Sildenafil. Circulation 133:988–996PubMedPubMedCentralCrossRef
Zurück zum Zitat Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, Marino P, Smiseth OA, De Keulenaer G, Leite-Moreira AF, Borbély A, Edes I, Handoko ML, Heymans S, Pezzali N, Pieske B, Dickstein K, Fraser AG, Brutsaert DL (2007) How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 28:2539–2550PubMedCrossRef Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, Marino P, Smiseth OA, De Keulenaer G, Leite-Moreira AF, Borbély A, Edes I, Handoko ML, Heymans S, Pezzali N, Pieske B, Dickstein K, Fraser AG, Brutsaert DL (2007) How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 28:2539–2550PubMedCrossRef
Zurück zum Zitat Peacher DF, Pecorella SR, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Walker AJ, Gill M, Kernagis D, Uguccioni D, Moon RE (2010) Effects of hyperoxia on ventilation and pulmonary hemodynamics during immersed prone exercise at 4.7 ATA: possible implications for immersion pulmonary edema. J Appl Physiol (1985) 109:68–78CrossRef Peacher DF, Pecorella SR, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Walker AJ, Gill M, Kernagis D, Uguccioni D, Moon RE (2010) Effects of hyperoxia on ventilation and pulmonary hemodynamics during immersed prone exercise at 4.7 ATA: possible implications for immersion pulmonary edema. J Appl Physiol (1985) 109:68–78CrossRef
Zurück zum Zitat Peacher DF, Martina SD, Otteni CE, Wester TE, Potter JF, Moon RE (2015) Immersion pulmonary edema and comorbidities: case series and updated review. Med Sci Sports Exerc 47:1128–1134PubMedCrossRef Peacher DF, Martina SD, Otteni CE, Wester TE, Potter JF, Moon RE (2015) Immersion pulmonary edema and comorbidities: case series and updated review. Med Sci Sports Exerc 47:1128–1134PubMedCrossRef
Zurück zum Zitat Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G (2006) Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiogr 19(3):356–363PubMedCrossRef Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G (2006) Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiogr 19(3):356–363PubMedCrossRef
Zurück zum Zitat Pons M, Blickenstorfer D, Oechslin E, Hold G, Greminger P, Franzeck UK, Russi EW (1995) Pulmonary oedema in healthy persons during scubadiving and swimming. Eur Respir J 8:762–767PubMed Pons M, Blickenstorfer D, Oechslin E, Hold G, Greminger P, Franzeck UK, Russi EW (1995) Pulmonary oedema in healthy persons during scubadiving and swimming. Eur Respir J 8:762–767PubMed
Zurück zum Zitat Potter E, Marwick TH (2018) Assessment of left ventricular function by echocardiography: the case for routinely adding global longitudinal strain to ejection fraction. JACC Cardiovasc Imaging 11:260–274PubMedCrossRef Potter E, Marwick TH (2018) Assessment of left ventricular function by echocardiography: the case for routinely adding global longitudinal strain to ejection fraction. JACC Cardiovasc Imaging 11:260–274PubMedCrossRef
Zurück zum Zitat Rai AB, Lima E, Munir F, Faisal Khan A, Waqas A, Bughio S, ulHaq E, Attique HB, Rahman ZU (2015) Speckle tracking echocardiography of the right atrium: the neglected chamber. Clin Cardiol 38:692–697PubMedPubMedCentralCrossRef Rai AB, Lima E, Munir F, Faisal Khan A, Waqas A, Bughio S, ulHaq E, Attique HB, Rahman ZU (2015) Speckle tracking echocardiography of the right atrium: the neglected chamber. Clin Cardiol 38:692–697PubMedPubMedCentralCrossRef
Zurück zum Zitat Sartori C, Vollenweider L, Löffler BM, Delabays A, Nicod P, Bärtsch P, Scherrer U (1999) Exaggerated endothelin release in high-altitude pulmonary edema. Circulation 99:2665–2668PubMedCrossRef Sartori C, Vollenweider L, Löffler BM, Delabays A, Nicod P, Bärtsch P, Scherrer U (1999) Exaggerated endothelin release in high-altitude pulmonary edema. Circulation 99:2665–2668PubMedCrossRef
Zurück zum Zitat Sartori C, Allemann Y, Scherrer U (2007) Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema. Respir Physiol Neurobiol 159:338–349PubMedCrossRef Sartori C, Allemann Y, Scherrer U (2007) Pathogenesis of pulmonary edema: learning from high-altitude pulmonary edema. Respir Physiol Neurobiol 159:338–349PubMedCrossRef
Zurück zum Zitat Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH (2014) Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review. J Am Coll Cardiol 63:2751–2768PubMedCrossRef Thavendiranathan P, Poulin F, Lim KD, Plana JC, Woo A, Marwick TH (2014) Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy: a systematic review. J Am Coll Cardiol 63:2751–2768PubMedCrossRef
Zurück zum Zitat Ware LB, Matthay MA (2005) Clinical practice. Acute pulmonary edema. N Engl J Med 353:2788–2796PubMedCrossRef Ware LB, Matthay MA (2005) Clinical practice. Acute pulmonary edema. N Engl J Med 353:2788–2796PubMedCrossRef
Zurück zum Zitat Wester TE, Cherry AD, Pollock NW, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Alford EL, Walker AJ, Uguccioni DM, Kernagis D, Moon RE (2009) Effects of head and body cooling on hemodynamics during immersed prone exercise at 1 ATA. J Appl Physiol (2009) 106:691–700PubMedCrossRef Wester TE, Cherry AD, Pollock NW, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Alford EL, Walker AJ, Uguccioni DM, Kernagis D, Moon RE (2009) Effects of head and body cooling on hemodynamics during immersed prone exercise at 1 ATA. J Appl Physiol (2009) 106:691–700PubMedCrossRef
Zurück zum Zitat Wilmshurst PT, Nuri M, Crowther A, Webb-Peploe MM (1989) Cold-induced pulmonary oedema in scuba divers and swimmers and subsequent development of hypertension. Lancet 1:62–65PubMedCrossRef Wilmshurst PT, Nuri M, Crowther A, Webb-Peploe MM (1989) Cold-induced pulmonary oedema in scuba divers and swimmers and subsequent development of hypertension. Lancet 1:62–65PubMedCrossRef
Metadaten
Titel
Global longitudinal strain assessment of cardiac function and extravascular lung water formation after diving using semi-closed circuit rebreather
verfasst von
María Martinez-Villar
Antonio Tello-Montoliu
Agustín Olea
Ángel Pujante
Daniel Saura
Silvia Martín
Nereo Venero
Ana Carneiro-Mosquera
Nuria Ruiz de Pascual
Noelia Valero
Miguel Martinez-Herrera
Inmaculada Ramírez-Macías
Juan Antonio Vilchez
Miguel García Navarro
Gonzalo de la Morena
Domingo Pascual
Publikationsdatum
20.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Applied Physiology / Ausgabe 4/2022
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-022-04887-6

Weitere Artikel der Ausgabe 4/2022

European Journal of Applied Physiology 4/2022 Zur Ausgabe

Neu im Fachgebiet Arbeitsmedizin

Das Geschlechterparadoxon in der gesundheitlich beeinträchtigten Lebenszeit – Ende eines Mythos?

Beginnend mit den 1920er-Jahren hat sich eine Vorstellung über die Geschlechterdifferenzen in Gesundheit und Mortalität etabliert, die von Lorber und Moore in dem einprägsamen Satz: „Women get sicker, but men die quicker“, zusammengefasst wurde [ 1 …, S. 13]. Tatsächlich erscheinen vor dem Hintergrund der höheren Lebenserwartung der Frauen die Studienergebnisse zu den Geschlechterdifferenzen in der Morbidität überraschend, wonach Frauen im Durchschnitt einen schlechteren Gesundheitszustand aufweisen als Männer [

Gesunde Lebenserwartung: Ein kritischer Blick auf Nutzen und Potenziale des demographischen Gesundheitsindikators

Open Access Leitthema

Die demographische Alterung hat vielfältige gesellschaftliche Konsequenzen, deren Ausmaß wesentlich vom Gesundheitszustand der Bevölkerung abhängt. Um diesen analysieren und bewerten zu können, wurden spezielle Kennziffern entwickelt, die in …

Wie hat sich die Lebenserwartung ohne funktionelle Einschränkungen in Deutschland entwickelt? Eine Analyse mit Daten des Deutschen Alterssurveys (DEAS)

Deutschland erfährt, wie andere Hocheinkommensstaaten, aufgrund kontinuierlich rückläufiger Mortalität und niedriger Geburtenraten tiefgreifende demografische Veränderungen. Der demografische Wandel führt in Deutschland zu einem zunehmend höheren …

Hitzeschutz im Fokus der hessischen Betreuungs- und Pflegeaufsicht

Open Access Klimawandel Übersichtsartikel

Im Sommer 2023 kündigte das Bundesministerium für Gesundheit (BMG) einen nationalen Hitzeschutzplan an und forderte die Länder auf, zu prüfen, „ob die Warnstufen des [Deutschen Wetterdienstes] DWD mit der Durchführung von Akutmaßnahmen …