Impacte en humans, a nivell cardiovascular, de l’aire enrarit d’una cova mediterrània
Effect of rarefied air in a Mediterranean cave at cardiovascular level in humans
Ignasi de Yzaguirre i Mauraa, Gonzalo Graziolib, Mònica Domènech Feira-Carotc, Diego Dulanto Zabalad, Marta Sitges Carreñob, Josep Antoni Gutiérrez Rincóna
a Medicina de l’Esport, Consell Català de l’Esport, Generalitat de Catalunya, Barcelona, Espanya
b Servei de Cardiologia, Institut Clínic del Tòrax, Hospital Clínic de Barcelona, Barcelona, Espanya
c Unitat d’HTA i RCV, Medicina Interna, ICMiD, Hospital Clínic de Barcelona, Barcelona, Espanya
d Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Espanya
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Establir uns nivells de tall més enllà dels quals cal prendre mesures preventives.</p> <p class="elsevierStylePara"> Mètode: Vint-i-cinc espeleòlegs, 6 dels quals pertanyien a cossos professionals de rescat, foren  sotmesos a controls en repòs a l’exterior, respirant aire de composició normal (AN), a un control subterrani, també en repòs, respirant aire enrarit d’origen natural (AE) en un espai confinat (O<span class="elsevierStyleInf">2</span>: 13,38 ± 1,5% i CO<span class="elsevierStyleInf">2</span>: 2,23 ± 0,31%). Monitorats mitjançant control Holter cardíac i pressió arterial.</p> <p class="elsevierStylePara"> Resultats: Pols cardíac en repòs (AN: 81,9 ± 15,1 batecs vs. AE: 83,8 ± 17,3 batecs en AE; p ≤ 0,58). Pressió arterial sistòlica (AN: 130,3 ± 17,2 mmHg vs. AE: 140,2 ± 21,3 mmHg; p ≤ 0,0003). Pressió arterial diastòlica (AN: 78,2 ± 11,0 mmHg vs. AE: 85,5 ± 11,2 mmHg; p ≤ 0,0002). Variabilitat cardíaca: RMSSD (AN: 25,9 ± 13,8 ms vs. AE: 36,9 ± 17,8 ms; p ≤ 0,003); NN50 (AN: 49,0 ± 66,2 batecs vs. AE: 111,7 ± 102,8 batecs; p ≤ 0,003); pNN50 (7,5 ± 11,3% en AN vs. 15,9 ± 15,8% en AE; p ≤ 0,0013). Anàlisi de Fourier: TP (AN: 1.759,5 ms<span class="elsevierStyleSup">2</span> vs. AE: 2.611,5 ms<span class="elsevierStyleSup">2</span>; p < 0,04); HF (AN: 301,5 ± 329,4 ms<span class="elsevierStyleSup">2</span> vs. AE: 662,3 ± 762,8 ms<span class="elsevierStyleSup">2</span>; p ≤ 0,02). Es detecta un increment d’esdeveniments arítmics en comparar l’hora que inclou la prova 1 (H<span class="elsevierStyleInf">AN</span>) amb aire de proporcions normals versus l’hora que inclou la prova 2 (H<span class="elsevierStyleInf">AE</span>) amb aire enrarit. Hi ha clara correlació estadística d’esdeveniments arítmics en ambdues situacions: (batecs ectòpics en AE) = 2,9859 × (batecs ectòpics en AN) + 1,5622; n = 24; r = 0,814; p < 0,0001.</p> <p class="elsevierStylePara"> Conclusions: L’exposició a l’aire enrarit en repòs de només 10 min provoca una resposta pressora de la pressió arterial sistòlica i diastòlica, comparada amb l’aire normal. La variabilitat cardíaca, en situació de repòs estandarditzada, mostra una resposta de tipus parasimpàtic, amb augment dels paràmetres rMSSD i HF quan els subjectes estan sotmesos a una atmosfera d’aire enrarit. En aquest cas, compost per un 13% d’O<span class="elsevierStyleInf">2</span> i un 2,5% de CO<span class="elsevierStyleInf">2</span>. En l’aire enrarit, com en el de l’avenc estudiat, els subjectes presentaven el triple de fenòmens arítmics que quan feien una tasca amb una càrrega similar en aire estàndard.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStylePara"> Introduction: Study of physiological adaptation in people breathing rarefied air in a cave.</p> <p class="elsevierStylePara"> 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.</p> <p class="elsevierStylePara"> 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 (O<span class="elsevierStyleInf">2</span>: 13.38 ± 1.5% and CO<span class="elsevierStyleInf">2</span>: 2.23 ± 0.31%).</p> <p class="elsevierStylePara"> 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 ms<span class="elsevierStyleSup">2</span> vs. RA: 2,611.5 ms<span class="elsevierStyleSup">2</span>; P ≤ .04); HF (NA: 301.5 ± 329.4 ms<span class="elsevierStyleSup">2</span> vs. RA: 662.3 ± 762.8 ms<span class="elsevierStyleSup">2</span>; 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.</p> <p class="elsevierStylePara"> 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 standardized 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.</p>" ] ] ] "idiomaDefecto" => "ct" "url" => "/X8866581/0000005100000190/v0_201801081358/XX886658116544821/v0_201801081358/ct/main.assets" "Apartado" => array:4 [ "identificador" => "71856" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Treballs originals" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/X8866581/0000005100000190/v0_201801081358/XX886658116544821/v0_201801081358/ct/278v51n190a90454482pdf001.pdf?idApp=UINPBA00004N&text.app=https://apunts.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/XX886658116544821?idApp=UINPBA00004N" ]
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ISSN: X8866581Original language: Català
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