A neoprene vest hastens dyspnoea and leg fatigue during exercise testing: entangled breathing and cardiac hindrance?

Symptoms and contributing factors of immersion pulmonary oedema (IPO) are not observed during non-immersed heart and lung function assessments. We report a case in which intense snorkelling led to IPO, which was subsequently investigated by duplicating cardiopulmonary exercise testing with (neoprene vest test - NVT) and without (standard test - ST) the wearing of a neoprene vest. The two trials utilised the same incremental cycling exercise protocol.

Broad individual immersion-scattering of respiratory compliance likely substantiates dissimilar breathing mechanics.

Head-out water immersion alters respiratory compliance which underpins defining pressure at a "Lung centroid" and the breathing "Static Lung Load". In diving medicine as in designing dive-breathing devices a single value of lung centroid pressure is presumed as everyone's standard. On the contrary, we considered that immersed respiratory compliance is disparate among a homogenous adult group (young, healthy, sporty).

Increased expression of blood muscarinic receptors in patients with reflex syncope.

Aims: Pathophysiology of reflex syncope is not fully understood but a vagal overactivity might be involved in this syncope. Previously, overexpression of muscarinic M2 receptors and acetylcholinesterase was found in particular in the heart and in lymphocytes of rabbits with vagal overactivity as well as in hearts of Sudden Infant Death Syndromes. The aim of this present study was to look at M2 receptor expression in blood of patients with reflex syncope.

Influence of Training Load and Altitude on Heart Rate Variability Fatigue Patterns in Elite Nordic Skiers.

We aimed to analyse the relationship between training load/intensity and different heart rate variability (HRV) fatigue patterns in 57 elite Nordic-skiers. 1063 HRV tests were performed during 5 years. R-R intervals were recorded in resting supine (SU) and standing (ST) positions.

Immersion pulmonary oedema in a healthy diver not exposed to cold or strenuous exercise.

In healthy divers, the occurrence of immersion pulmonary oedema (IPE) is commonly caused by contributory factors including strenuous exercise, cold water and negative-pressure breathing. Contrary to this established paradigm, this case reports on a 26-year-old, well-trained combat swimmer who succumbed to acute IPE during static immersion in temperate (21°C) water, while using a front-mounted counterlung rebreather. The incident occurred during repeated depth-controlled ascent practice at the French military diving school.

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

Background: Immersion pulmonary edema is potentially a catastrophic condition; however, the pathophysiological mechanisms are ill-defined. This study assessed the individual and combined effects of exertion and negative pressure breathing on the cardiovascular system during the development of pulmonary edema in SCUBA divers.

Methods: Sixteen male professional SCUBA divers performed four SCUBA dives in a freshwater pool at 1 m depth while breathing air at either a positive or negative pressure both at rest or with exercise.

Monitoring Fatigue Status with HRV Measures in Elite Athletes: An Avenue Beyond RMSSD?

Among the tools proposed to assess the athlete's "fatigue," the analysis of heart rate variability (HRV) provides an indirect evaluation of the settings of autonomic control of heart activity. HRV analysis is performed through assessment of time-domain indices, the square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals (RMSSD) measured during short (5 min) recordings in supine position upon awakening in the morning and particularly the logarithm of RMSSD (LnRMSSD) has been proposed as the most useful resting HRV indicator. However, if RMSSD can help the practitioner to identify a global "fatigue" level, it does not allow discriminating different types of fatigue.

Catecholamine use is associated with enterocyte damage in critically ill patients.

Small bowel damage is frequent but underdiagnosed among critically ill patients with shock. High catecholamine doses may have a deleterious effect on mesenteric blood flow. Plasma intestinal fatty acid-binding protein (I-FABP) concentration is a marker of enterocyte damage, whereas plasma citrulline concentration is a marker of functional enterocyte mass.

Thermal and metabolic responses of military divers during a 6-hour static dive in cold water.

Background: Human thermal responses during prolonged whole-body immersion in cold water are of interest for the military, especially French SEALS. This study aims at describing the thermo-physiological responses.

Methods: There were 10 male military divers who were randomly assigned to a full immersion in neutral (34 degrees C), moderately cold (18 degrees C), and cold (10 degrees C) water wearing their operational protective devices (5.

Effect of head-out water immersion on vascular function in healthy subjects.

Immersion in thermoneutral water increases cardiac output and peripheral blood flow and reduces systemic vascular resistance. This study examined the effects of head-out water immersion on vascular function. Twelve healthy middle-aged males were immersed during 60 min in the seated position, with water at the level of xiphoid.

Fatigue shifts and scatters heart rate variability in elite endurance athletes.

Purpose: This longitudinal study aimed at comparing heart rate variability (HRV) in elite athletes identified either in 'fatigue' or in 'no-fatigue' state in 'real life' conditions.

Methods: 57 elite Nordic-skiers were surveyed over 4 years. R-R intervals were recorded supine (SU) and standing (ST).

Evaluation of cardiorespiratory fitness using three field tests in obese adolescents: validity, sensitivity and prediction of peak VO2.

Objectives: Evaluation of cardiorespiratory fitness in obese adolescents is necessary to develop personalised retraining programmes. We aimed to measure cardiorespiratory fitness using 3 field tests, and to evaluate their validity and sensitivity compared to values obtained by laboratory tests.

Design: Longitudinal interventional study in obese adolescents admitted to a rehabilitation centre for a 9-month programme of obesity management.

Enterocyte damage in critically ill patients is associated with shock condition and 28-day mortality.

Objectives: Small bowel dysfunction in critically ill patients is frequent, underdiagnosed, and associated with poor prognosis. Intestinal fatty acid-binding protein is a marker of enterocyte damage, and plasma citrulline concentration is a marker of functional enterocyte mass. Primary objective was to identify factors associated with intestinal fatty acid-binding protein in critically ill patients.

Effects of an in-patient treatment program based on regular exercise and a balanced diet on high molecular weight adiponectin, resistin levels, and insulin resistance in adolescents with severe obesity.

Adiponectin, the most abundant hormone produced by adipose tissue, circulates in 3 isoforms, including high molecular weight (HMW) adiponectin. The latter has been suggested to be a better predictor of metabolic disturbances and insulin resistance associated with obesity. This study investigated changes in total and HMW adiponectin, resistin, and homeostasis model assessment (HOMA) during a 9-month in-patient treatment program based on physical exercise and a balanced diet in 32 severely obese adolescents.

Detection of interstitial lung disease in systemic sclerosis through partitioning of lung transfer for carbon monoxide.

Background: Interstitial lung disease (ILD) is a leading cause of death in systemic sclerosis (SSc). Sensitivities and specificities of the current pulmonary function tests (PFTs) for the detection of ILD in SSc are poor.

Objective: To determine whether diffusion capacity of the lungs for carbon monoxide (DLCO) partitioned into membrane conductance for CO (DmCO) and alveolar capillary blood volume (Vcap) could provide more sensitive clues to ILD than current PFTs.

Relevance of water gymnastics in rehabilitation programs in patients with chronic heart failure or coronary artery disease with normal left ventricular function.

Background: Exercise training is included in cardiac rehabilitation programs to enhance physical capacity and cardiovascular function. Among the existing rehabilitation programs, exercises in water are increasingly prescribed. However, it has been questioned whether exercises in water are safe and relevant in patients with stable chronic heart failure (CHF), coronary artery disease (CAD) with normal systolic left ventricular function.

Hyperoxia-induced alterations in cardiovascular function and autonomic control during return to normoxic breathing.

Hyperoxia causes hemodynamic alterations. We hypothesized that cardiovascular and autonomic control changes last beyond the end of hyperoxic period into normoxia. Ten healthy volunteers were randomized to breathe either medical air or 100% oxygen for 45 min in a double-blind study design.

Intermittent versus constant aerobic exercise: effects on arterial stiffness.

Aerobic exercises (of sufficient duration and intensity) decreases arterial stiffness. However, the direct relationship between the type of aerobic exercise (i.e.

Whole body immersion and hydromineral homeostasis: effect of water temperature.

This experiment was designed to assess the effects of prolonged whole body immersion (WBI) in thermoneutral and cold conditions on plasma volume and hydromineral homeostasis.10 navy "combat swimmers" performed three static 6-h immersions at 34 degrees C (T34), 18 degrees C (T18) and 10 degrees C (T10). Rectal temperature, plasma volume (PV) changes, plasma proteins, plasma and urine ions, plasma osmolality, renin, aldosterone and antidiuretic hormone (ADH) were measured.

Haemodynamic changes after prolonged water immersion.

Thermoneutral water immersion increases cardiac preload and changes the neuroendocrine settings of blood volume regulation. The resulting marked diuresis may lead to significant haemodynamic changes after the end of a prolonged water immersion. Ten volunteers underwent 6 h of complete thermoneutral water immersion.

Training-induced increase in nitric oxide metabolites in chronic heart failure and coronary artery disease: an extra benefit of water-based exercises?

Background: Rehabilitation programs involving immersed exercises are more and more frequently used, with severe cardiac patients as well.

Design: This study investigated whether a rehabilitation program including water-based exercises has additional effects on the cardiovascular system compared with a traditional land-based training in heart disease patients.

Methods: Twenty-four male stable chronic heart failure patients and 24 male coronary artery disease patients with preserved left ventricular function participated in the study.

Heart rate variability in preterm infants and maternal smoking during pregnancy.

Objective: Tobacco smoke exposure increases the risk of premature birth and of dying of sudden infant death syndrome (SIDS). Prematurity significantly increases the risk of dying of SIDS, but mechanisms underlying this epidemiological finding are unclear. The cumulated effect of both prematurity and prenatal exposure to nicotine on autonomic heart rate control has not been studied.

Cardiovascular autonomic control during short-term thermoneutral and cool head-out immersion.

Background: Moderately cold head-out water immersion stimulates both baro- and cold-receptors, and triggers complex and contradictory effects on the cardiovascular system and its autonomic nervous control.

Objectives: To assess the effects of water immersion and cold on cardiovascular status and related autonomic nervous activity.

Methods: Hemodynamic variables and indexes of autonomic nervous activity (analysis of heart rate and blood pressure variability) were evaluated in 12 healthy subjects during 3 exposures of 20 min each in the upright position, i.