Vascular Responses to Simulated Breath-Hold Diving Involving Multiple Reflexes
Breath-hold diving evokes a complex cardiovascular response. The degrees of hypertension induced by the diving reflex are substantial and accentuated by the underwater swimming. This condition provides a circulatory challenge to properly buffer and cushion cardiac pulsations. We determined hemodynamic changes during the diving maneuver. A total of 20 healthy young adults were studied. Hemodynamics were measured during exercise on a cycle ergometer, apnea, face immersion in cold water (trigeminal stimulation), and simulated breath-hold diving. Dynamic arterial compliance (measured by changes in carotid artery diameter via ultrasound divided by changes in carotid blood pressure as assessed by arterial tonometry) increased with simulated diving compared with rest (p=0.007) and was elevated compared with exercise and apnea alone (p<0.01). A significant increase in heart rate was observed with exercise, apnea, and facial immersion when compared with rest (p<0.001). However, simulated diving brought the heart rate down to resting levels. Cardiac output increased with all conditions (p<0.001), with an attenuated response during simulated diving compared with exercise and facial immersion (p<0.05). Mean blood pressure was elevated during all conditions (p<0.001), with a further elevation observed during simulated diving compared with exercise (p<0.001), apnea (p=0.016), and facial immersion (p<0.001). Total peripheral resistance was decreased during exercise and facial immersion compared with rest (p<0.001) but was increased during simulated diving compared with exercise (p<0.001), apnea (p=0.008), and facial immersion (p=0.003). We concluded that central artery compliance is augmented during simulated breath-hold diving to help buffer cardiac pulsations.