Évaluation de la réponse cardiaque lors d’une apnée statique chez les apnéistes expérimentés par rapport aux sujets témoins et analyse du débit cardiaque en temps réel par méthode non invasive : le PhysioFlow®

Abstract : Context: voluntary apnoea induces several physiological adaptations, including bradycardia and redistribution of regional blood flows. PhysioFlow® is a recent tool that uses transthoracic impedance variations to measure cardiac output (CO) non-invasively. Purpose : Analyze with PhysioFlow® cardiac adaptations [CO, heart rate (HR) and stroke volume (SV)] and their kinetics during dry static breath-hold in a group of trained breath-hold divers (BHDs) in comparison to a no divers group (NDs). Methods: prospective cohort study was performed in Bordeaux University Hospital between May 2017 and October 2018 at. We included a group of BHDs (n = 10) and a group of NDs (n = 10). Criteria for inclusion of BHDs were : the participation in regional competitions, and to have a dry apnea record greater than four minutes. Subjects realized a maximum dry static apnea after a training of a twelve minutes. We analyzed the data obtained by the PhysioFlow® using relative variations compared to starting values. The Mann-Whitney U test was used to compare the averages of the two populations. Main objective : Analysis of cardiac adaptations and their kinetics during apnea. Results: both samples were similar, except for resting HR, which was higher in BHDs [70 (± 9) vs 59 (± 11) p = 0.025]. Maximal apnea time was longer in BHDs compared to NDs [292 ± 51 sec vs 128 ± 44 sec, p = 0.0002]. Bradycardia was significantly higher in BHDs than NDs [relative nadir HR = 55.4% vs 77.6%, p = 0.001], and longer during apnea [relative final HR = 64.8% vs. 94.8%, p = 0.001]. They reached nadir HR significantly later in apnea [203 sec vs 51 sec, p = 0.003]. BDs decreased their CO more than NDs [nadir relative CO = 51.2% vs 65.4% p = 0.079; Relative final CO = 64.6% vs. 88.3% p = 0.016]. Conclusion: we found a significant increase in cardiac adaptations in BHDs compared with NDs during dry static apnea in agreement with comparable studies.
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Master Thesis
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Justine Michon. Évaluation de la réponse cardiaque lors d’une apnée statique chez les apnéistes expérimentés par rapport aux sujets témoins et analyse du débit cardiaque en temps réel par méthode non invasive : le PhysioFlow®. Médecine humaine et pathologie. 2018. ⟨dumas-02064963⟩

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