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Cerebrovascular Regulation in Breath‐Hold Divers with Chronic Exposure to Long‐Duration Apneas

2019· article· en· W3176423768 on OpenAlexaffabout
M. Erin Moir, Emilie Woehrle, S. Smith, Stephen A. Klassen, Brad Matushewski, Duško Kozić, Željko Dujić, Otto Barak, J. Kevin Shoemaker

Bibliographic record

VenueThe FASEB Journal · 2019
Typearticle
Languageen
FieldMedicine
TopicCardiovascular and Diving-Related Complications
Canadian institutionsWestern University
Fundersnot available
KeywordsMedicineCerebral autoregulationHypercapniaBlood pressureAnesthesiaCerebral blood flowTranscranial DopplerHeart rateCerebral perfusion pressurePhotoplethysmogramCardiologyMiddle cerebral arteryPopulationVascular resistanceBreathingHemodynamicsInternal medicineAutoregulationIschemiaAcidosis

Abstract

fetched live from OpenAlex

Breath‐hold divers (BHD) are exposed to repeated long‐duration apneas during training and competition. With long‐duration apneas divers experience severe hypoxia and hypercapnia with large increases in blood pressure. This blood pressure response is critical to elevate brain perfusion and oxygen delivery above that enabled by cerebral vasodilation alone. Despite studies regarding cerebral perfusion in BHD during prolonged apneas, no studies have evaluated cerebrovascular regulatory mechanisms in this population. The current investigation tested the hypothesis that BHD would demonstrate impaired dynamic cerebral autoregulation. Seventeen BHD (3 females; 33 ± 9 years; 11 ± 9 years diving) and seventeen healthy controls (4 females; 26 ± 9 years) completed two or three repeated sit‐to‐stand trials during spontaneous breathing and poikilocapnic conditions. Heart rate (HR), finger arterial blood pressure (BP), and cerebral blood flow velocity (CBFV) from the right middle cerebral artery were measured continuously with three‐lead electrocardiography, finger photoplethysmography, and transcranial Doppler ultrasonography, respectively. End‐tidal carbon dioxide partial pressure (PETCO 2 ) was measured with a gas analyzer. Offline, an index of cerebrovascular resistance (CVRi) was calculated as the quotient of mean BP and mean CBFV. The rate of the drop in CVRi relative to the change in BP provided the rate of regulation (RoR; [ΔCVRi/ΔT]/ΔBP). The sit‐to‐stand protocol elicited a similar reduction in BP between the BHD and controls (−29 ± 8 vs. −25 ± 8 mmHg; P = 0.23, d = 0.5). Despite a similar pressure stimulus between groups, BHD demonstrated slower RoR than controls (0.10 ± 0.05 vs. 0.20 ± 0.09 %·sec −1 ; P ≤ 0.001, d = 1.4). Underlying the reduced RoR in the BHD was a longer time to reach nadir CVRi or peak dilation, as estimated from CBFV, compared with the controls (7.1 ± 1.5 vs. 5.2 ± 1.3 sec; P ≤ 0.001, d = 1.4). In concert with the longer CVRi response, the time to reach peak CBFV following standing was longer in the BHD than the controls (13.1 ± 1.2 vs. 12.4 ± 1.8 sec; P = 0.04, d = 0.5). Further, the BHD demonstrated a greater increase in HR with standing than the controls (34 ± 7 vs. 28 ± 7 bpm; P = 0.02, d = 1.3). We observed lower PETCO 2 levels in the BHD than the controls during sitting (32 ± 4 vs. 37 ± 5 mmHg); standing elicited reductions in PETCO 2 in both groups (posture: P ≤ 0.001, group: P = 0.002, posture x group interaction: P = 0.57). The lower PETCO 2 (known to enhance RoR) in the BHD may have minimized between‐group differences in RoR. The data suggest impaired dynamic cerebrovascular autoregulatory mechanisms in BHD. Support or Funding Information This research was supported by the National Sciences and Engineering Research Council of Canada. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

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How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.003

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.008
GPT teacher head0.214
Teacher spread0.206 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2019
Admission routes2
Has abstractyes

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