Effect of rarefied air in a Mediterranean cave at cardiovascular level in humans

de Yzaguirre y Maura, Ignasi; Grazioli, Gonzalo; Domènech Feira-Carot, Monica; Dulanto Zabala, Diego; Sitges Carreño, Marta; Gutiérrez Rincón, Josep Antoni

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Objective: To investigate the arrhythmogenic capacity of rarefied air and changes the autonomic nervous system (sympathetic and parasympathetic). To establish cutoff levels beyond which preventive measures must be taken. Method: The study included 25 cavers, monitored by ECG Holter and blood pressure measurements in 2 situations at rest, one outside the cave breathing normal air composition (NA), and the other underground, breathing rarefied air of natural origin (RA) in a confined space (O2: 13.38 ± 1.5% and CO2: 2.23 ± 0.31%). Results: Resting heart rate (NA: 81.9 ± 15.1 beats per minute (bpm) vs. RA: 83.8 ± 17.3 bpm; P ≤ .58). Systolic blood pressure (NA: 130.3 ± 17.2 mmHg vs. RA: 140.2 ± 21.3 mmHg; P ≤ .0003). Diastolic blood pressure (NA: 78.2 ± 11.0 mmHg vs. RA: 85.5 ± 11.2 mmHg; P ≤ .0002). Heart rate variability: RMSSD (NA: 25.9 ± 13.8 ms vs. RA: 36.9 ± 17.8 ms; P ≤ .003), NN50 (NA: 49.0 ± 66.2 bpm vs. RA: 111.7 ± 102.8 bpm; P ≤ .003); pNN50 (NA: 11.3% ± 7.5 vs. RA: 15.9 ± 15.8%; P ≤ .0013). Fourier analysis: TP (NA: 1,759.5 ms2 vs. RA: 2,611.5 ms2; P ≤ .04); HF (NA: 301.5 ± 329.4 ms2 vs. RA: 662.3 ± 762.8 ms2; P ≤ .02). An increase in arrhythmic events is detected when comparing the hour that included test 1 (HNA) in normal air with the hour that included test 2 (HRA) with rarefied air. There is a correlation of arrhythmic events in both situations: (ventricular ectopic beats in RA) = 2.9859 × (ventricular ectopic beats NA) + 1.5622; n = 24; r = 0.814; P <.0001. Conclusions: Exposure to RA at rest for 10 minutes causes a pressor response in systolic and diastolic blood pressure compared to normal air (NA). Heart rate variability in a standardised situation and rest shows a parasympathetic response, with increased rMSSD and HF parameters when subjects are subjected to an atmosphere of RA. In RA, the subjects had three times more arrhythmic events when compared to NA. © 2016 Consell Català de l’Esport. Generalitat de Catalunya. Published by Elsevier España, S.L.U. 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Apunts Sports Medicine

ISSN: 2666-5069

Apunts Sports Medicine, a publication by Consell Català de l'Esport (Catalan Sports Council), is a scientific journal dedicated to sports medicine. Apunts is focused, on the one hand, on the impact of high sports performance on men and women and, especially, in the study of team sports and muscle and tendon injuries. On the other hand, on the behaviour to follow while practicing sport or physical activity during illnesses or in certain situations. The journal regularly includes original articles on Applied Research, Clinical Cases, Editorial articles or Comments, Consensus Articles, Reviews and Letters to the Editor. All of which undergo an anonymous external peer review process.

Apunts Sports Medicine has received impact factor for the first time in 2023 (IF 2022: 1.1), and in 2024 it has been assigned a quartile in JCR (IF 2023: 1,1 [Q3]).
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Vol. 51. Issue 190.

Pages 40-7 (April - June 2016)

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Pages 40-7 (April - June 2016)

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Effect of rarefied air in a Mediterranean cave at cardiovascular level in humans

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Ignasi de Yzaguirre y Mauraa, Gonzalo Graziolib, Monica Domènech Feira-Carotc, Diego Dulanto Zabalad, Marta Sitges Carreñob, Josep Antoni Gutiérrez Rincóna

a Medicina Deportiva, Consejo Catalán del Deporte, Gobierno de Cataluña, Barcelona, España

b Servicio de Cardiología, Instituto del Tórax, Hospital Clínico de Barcelona, Barcelona, España

c Unidad de HTA y RCV, Medicina Interna, ICMiD, Hospital Clínico de Barcelona, Barcelona, España

d Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, España

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Introduction: Study of physiological adaptation in people breathing rarefied air in a cave.

Objective: To investigate the arrhythmogenic capacity of rarefied air and changes the autonomic nervous system (sympathetic and parasympathetic). To establish cutoff levels beyond which preventive measures must be taken.

Method: The study included 25 cavers, monitored by ECG Holter and blood pressure measurements in 2 situations at rest, one outside the cave breathing normal air composition (NA), and the other underground, breathing rarefied air of natural origin (RA) in a confined space (O2: 13.38 ± 1.5% and CO2: 2.23 ± 0.31%).

Results: Resting heart rate (NA: 81.9 ± 15.1 beats per minute (bpm) vs. RA: 83.8 ± 17.3 bpm; P ≤ .58). Systolic blood pressure (NA: 130.3 ± 17.2 mmHg vs. RA: 140.2 ± 21.3 mmHg; P ≤ .0003). Diastolic blood pressure (NA: 78.2 ± 11.0 mmHg vs. RA: 85.5 ± 11.2 mmHg; P ≤ .0002). Heart rate variability: RMSSD (NA: 25.9 ± 13.8 ms vs. RA: 36.9 ± 17.8 ms; P ≤ .003), NN50 (NA: 49.0 ± 66.2 bpm vs. RA: 111.7 ± 102.8 bpm; P ≤ .003); pNN50 (NA: 11.3% ± 7.5 vs. RA: 15.9 ± 15.8%; P ≤ .0013). Fourier analysis: TP (NA: 1,759.5 ms2 vs. RA: 2,611.5 ms2; P ≤ .04); HF (NA: 301.5 ± 329.4 ms2 vs. RA: 662.3 ± 762.8 ms2; P ≤ .02). An increase in arrhythmic events is detected when comparing the hour that included test 1 (HNA) in normal air with the hour that included test 2 (HRA) with rarefied air. There is a correlation of arrhythmic events in both situations: (ventricular ectopic beats in RA) = 2.9859 × (ventricular ectopic beats NA) + 1.5622; n = 24; r = 0.814; P <.0001.

Conclusions: Exposure to RA at rest for 10 minutes causes a pressor response in systolic and diastolic blood pressure compared to normal air (NA). Heart rate variability in a standardised situation and rest shows a parasympathetic response, with increased rMSSD and HF parameters when subjects are subjected to an atmosphere of RA. In RA, the subjects had three times more arrhythmic events when compared to NA.

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