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Peripheral chemoreflex regulation of sympathetic vasomotor tone in apnea divers

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Abstract

Objectives

Involuntary apnea episodes in obstructive sleep apnea patients result in selective potentiation of peripheral chemoreceptor regulation of sympathetic vasomotor tone. Breath-hold diving is associated with repeated “voluntary” apnea episodes and massive arterial oxygen desaturation, which could also perturb chemoreflex function.

Methods

We measured ventilation, heart rate, blood pressure, cardiac stroke volume, and muscle sympathetic nerve activity (MSNA) during isocapnic hypoxia in 11 breath-hold divers and eleven matched control subjects. The study was carried out at least 1 month after intense apnea training.

Results

Baseline MSNA frequency was 30 ± 4 bursts/min in control subjects and 31 ± 7 bursts/min in divers (ns). During hypoxia MSNA frequency and total activity increased similarly in both groups (30 and 66% in controls and 27 and 60% in divers, respectively). MSNA remained increased after termination of hypoxia and approached baseline measurements after 20 min. Hypoxia-induced stimulation of minute ventilation was similar in both groups, although in divers it was maintained by higher tidal volumes and lower breathing frequency compared with control subjects. In both groups, hypoxia-induced tachycardia drove an increase in cardiac output whereas total peripheral resistance decreased. Blood pressure remained unchanged.

Interpretation

We conclude that after the end of intensive training/competition periods, apnea divers show normal peripheral chemoreflex regulation of ventilation and sympathetic vasomotor tone. Although voluntary apnea may not lead to sustained changes in sympathetic nervous system regulation, we cannot exclude the possibility that repeated sympathetic activation elicited by voluntary apnea imposes a burden on the cardiovascular system.

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Acknowledgments

This study was supported by the Croatian Ministry of Science, Education and Sports, Grants Nos. 216-2160133-0330 and 216-2160133-0130. K.H., J.T. and J.J. were supported by Deutsche Forschungsgemeinschaft grants. We would like to thank the support staff of the University of Split School of Medicine for facilitating this study and the subjects for their enthusiastic participation.

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Authors and Affiliations

  1. Department of Physiology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia

    Toni Breskovic, Zoran Valic, Vladimir Ivancev & Zeljko Dujic

  2. Department of Neurology, Charité, Campus Virchow, Berlin, Germany

    Axel Lipp

  3. Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany

    Karsten Heusser, Jens Tank & Jens Jordan

  4. Department of Neurology, Clinical Hospital Center, Split, Croatia

    Gordan Dzamonja

  5. Neurovascular Research Laboratory, School of Kinesiology, The University of Western Ontario, London, ON, Canada

    J. Kevin Shoemaker

  6. Department of Biophysics and Scientific Methodology, University of Split School of Medicine, Split, Croatia

    Davor Eterovic

Authors
  1. Toni Breskovic
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  2. Zoran Valic
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  3. Axel Lipp
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  4. Karsten Heusser
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  5. Vladimir Ivancev
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  6. Jens Tank
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  7. Gordan Dzamonja
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  8. Jens Jordan
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  9. J. Kevin Shoemaker
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  10. Davor Eterovic
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  11. Zeljko Dujic
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Correspondence to Zeljko Dujic.

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Breskovic, T., Valic, Z., Lipp, A. et al. Peripheral chemoreflex regulation of sympathetic vasomotor tone in apnea divers. Clin Auton Res 20, 57–63 (2010). https://doi.org/10.1007/s10286-009-0034-1

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  • DOI: https://doi.org/10.1007/s10286-009-0034-1

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