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      Increased carotid intima-media thickness in scuba divers

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          Abstract

          Background

          Scuba divers work in high pressure conditions which may cause some changes in physiological status to adapt to this situation. In this study, the carotid intima-media thickness (CIMT) was assessed in divers as a risk factor of cerebrovascular and cardiovascular disorders.

          Methods

          This historical cohort study was performed on 16 male professional scuba divers as case group and 30 healthy people as controls with age range of 26-66 years. CIMT of both carotids of supine participants was measured by a 10 MHz linear ultrasonic probe quantitatively. Relationship between experience of diving and carotid IMT was evaluated.

          Results

          All the participants were males (mean age 42.9 ± 10.58. and for the control group was (47.05 ± 12.31 years). The mean right CIMT in divers and control group was 524.31 ± 149.40 and 443.66 ± 59.62 micrometer, respectively. Furthermore, the mean left CIMT in divers and control group was 624.57 ± 116.15 and 458.44 ± 49.56 micrometer, respectively.

          Conclusion

          The findings demonstrated that long-term occupational diving leads to increased intima-media thickness in scuba divers.

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          Most cited references11

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          Impact of breath holding on cardiovascular respiratory and cerebrovascular health.

          Toni Breskovic, Zeljko Dujic (2012)
          Human underwater breath-hold diving is a fascinating example of applied environmental physiology. In combination with swimming, it is one of the most popular forms of summer outdoor physical activities. It is performed by a variety of individuals ranging from elite breath-hold divers, underwater hockey and rugby players, synchronized and sprint swimmers, spear fishermen, sponge harvesters and up to recreational swimmers. Very few data currently exist concerning the influence of regular breath holding on possible health risks such as cerebrovascular, cardiovascular and respiratory diseases. A literature search of the PubMed electronic search engine using keywords 'breath-hold diving' and 'apnoea diving' was performed. This review focuses on recent advances in knowledge regarding possibly harmful physiological changes and/or potential health risks associated with breath-hold diving. Available evidence indicates that deep breath-hold dives can be very dangerous and can cause serious acute health problems such a collapse of the lungs, barotrauma at descent and ascent, pulmonary oedema and alveolar haemorrhage, cardiac arrest, blackouts, nitrogen narcosis, decompression sickness and death. Moreover, even shallow apnoea dives, which are far more frequent, can present a significant health risk. The state of affairs is disturbing as athletes, as well as recreational individuals, practice voluntary apnoea on a regular basis. Long-term health risks of frequent maximal breath holds are at present unknown, but should be addressed in future research. Clearly, further studies are needed to better understand the mechanisms related to the possible development or worsening of different clinical disorders in recreational or competitive breath holding and to determine the potential changes in training/competition regimens in order to prevent these adverse events.
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            Hemodynamic changes induced by recreational scuba diving.

            Daniel Carturan, Alain Boussuges, F. Blanc (2006)
            Cardiac changes induced by scuba diving were investigated using Doppler echocardiography. Ten healthy scuba divers dove to a mean depth of 34.3 +/- 2.7 m of sea water (113 +/- 9 feet) and a mean duration of 25.3 +/- 3.5 min. One hour after the dive, microbubbles could be detected in the right-heart chambers of all subjects. Left atrial and left ventricular (LV) diameters significantly decreased after the dive. Cardiac output, assessed by aortic blood flow, remained unchanged. Heart rate increased and stroke volume (SV) decreased after the dive. LV filling was assessed on transmitral profile. An increase of the contribution of the atrial contraction to LV filling was observed. Right cavity diameters were unchanged, but an increase of the right ventricular/right atrial gradient pressure was found. The diving profile studied promotes a rather important bubble grade in all volunteers. A significantly reduced cardiac diameters and SV was found by our hemodynamic study 1 h after diving. Two factors can explain these results: low volemia secondary to immersion, and venous gas embolism induced by nitrogen desaturation. Consequently, restoration of the water balance of the body should be considered in the recovery process after diving.
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              Carotid intima-media thickness in the Spanish population: reference ranges and association with cardiovascular risk factors.

              María Grau, Isaac Subirana, David Agis … (2012)
              Carotid intima-media thickness as measured with ultrasonography is an inexpensive and noninvasive predictor of cardiovascular events. The objectives of this study were to determine the population reference ranges of carotid intima-media thickness for individuals aged 35-84 years in Spain and to analyze the association of carotid intima-media thickness with cardiovascular risk factors (age, smoking, diabetes, pulse pressure, lipid profile, and body mass index). Population-based cross-sectional study conducted in Gerona (Spain). We described the mean and maximal values of carotid intima-media thickness of the carotid artery and of its 3 segments (common carotid, carotid bulb and internal carotid). We assessed cardiovascular risk factors and analyzed their association with carotid intima-media thickness using adjusted linear regression models. A total of 3161 individuals (54% women) were included, with mean age 58 years. Men showed significantly higher mean common carotid intima-media thickness than did women (0.71 vs 0.67 mm). The strongest predictors of this measure were age (coefficients for 10-year increase: 0.65 and 0.58 for women and men, respectively), smoking in men (coefficient: 0.26), high-density lipoprotein cholesterol in women (coefficient for 10 mg/dL, increase: -0.08) and pulse pressure in both sexes (coefficients for 10 mmHg increase: 0.08 and 0.23 for women and men, respectively). The results were similar for the mean carotid intima-media thickness of all the segments. This population-based study presents the reference ranges for carotid intima-media thickness in the Spanish population. The main determinants of carotid intima-media thickness were age and pulse pressure in both sexes. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Neurol
                Journal ID (iso-abbrev): Iran J Neurol
                Journal ID (publisher-id): IJNL
                Title: Iranian Journal of Neurology
                Publisher: Tehran University of Medical Sciences
                ISSN (Print): 2008-384X
                ISSN (Electronic): 2252-0058
                Publication date (Print): 2014
                Volume: 13
                Issue: 1
                Pages: 45-47
                Affiliations
                [1 ]Department of Neurology, School of Medicine, Iran University of Medical Sciences AND Iranian Center of Neurological Research (ICNR), Tehran University of Medical Sciences, Tehran, Iran
                [2 ]Department of Neurology, School of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
                [3 ]Department of Occupational and Environmental Medicine AND Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding Author: Masoud Mehrpour, Email: m-mehrpour@ 123456tums.ac.ir
                Article
                Publisher ID: IJNL-13-045
                PMC ID: 3968357
                PubMed ID: 24800047
                SO-VID: 65df0455-68b4-4452-8e65-2965fcf5cffb
                Copyright © Copyright © 2014 Iranian Neurological Association, and Tehran University of Medical Sciences
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 25 August 2013
                Date accepted : 27 November 2013
                Categories
                Subject: Short Communication

                Keywords: intima-media thickness,scuba diver,cerebrovascular disease
                Data availability:
                Keywords: intima-media thickness, scuba diver, cerebrovascular disease

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