Abstract
Introduction: Scuba diving represents stressful event for cardiovascular system. Breathing with compressed air, hyperbaric environment and microbubbles formation are the main factors are the most influencing factors for pulmonary circulation. Hypothesis: The aim of the study was to evaluate the change in morphology and function of the right heart after scuba dive with compressed air. Methods: Ten healthy sport divers (2 woman, 8 men, average age 42.1 ± 4.1 yrs., 21-52yrs) performed one scuba dive with compressed air (the depth was 20 meters, bottom tine 20 minutes, one safety stop at 3 m, water temperature 15°C). Echocardiography was performed just before and immediately after the dive, and every 60 minutes after surfacing with the aim to evaluate the presence of microbubbles (iVivid, GE). Results: After the dive, left atrium, right ventricle and inferior vena cava diameters significantly decreased (LA: 30.4±2.1 vs. 27.1±1.2 mm, p<0.05; RV: 27.8±2.1 vs. 25.2±1.1mm, p<0.05; IVC: 19.3±1.1 vs. 17.6±0.9 mm, p<0.05). LV ejection fraction, fractional shortening and myocardial performance index remained unchanged (LVEF: 65.7±7.1 vs. 62.2±10, p ns; FS: 40.9±6.1 vs.38.9±9.9, p ns; LV MPI: 0.50±0.15 vs. 0.48±0.14, p ns). We found significant decrease in mitral E/A (E/A 1.37±0.18 vs. 1.19±0.15 m/s, p<0.05). Right ventricle functional parameters decreased (TAPSE: 29.9±2.1 vs. 26.1±2.2 mm, p<0.05; RV MPI: 0.58±0.18 vs. 0.43±0.16mm, p<0.05). Analysis of the pulsed tissue Doppler velocities of the tricuspid annulus showed significant decrease in S’ parameter (S’lat 16.1±1.1 vs. 13.9±2.3, p<0.05). In 8 divers (80%), microbubbles were detected in right heart. They were detectable in pulmonary circulation for 3 hours. Due to this fact, the Doppler estimates of pulmonary artery pressure were not possible. Conclusions: Scuba dive with compressed air is associated with decrease of the both ventricle and atria diameters. It is associated with the decreased diastolic LV function and global RV function. These changes can be associated with the presence of microbubbles in lung circulation. This study showed echocardiography is able to detect changes of the circulation which are associated with the recreational dive.
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