Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya30863Changes in paradoxical emboly readiness in divers with open oval window of the interatrial septumOnishchenkoEvgeniy Fedorovich-BerezinaNatal'ya Nikolaevna-OnischenkoE FMedical Academy of Postgraduate Education, Moscow-BerezinaN NMedical Academy of Postgraduate Education, Moscow-Medical Academy of Postgraduate Education, Moscow15042011834666910042020Copyright © 2011, Consilium Medicum2011Aim. To study development of paradoxical emboly readiness (PER) in the process of diving.
Material and methods. Examination and observation covered 46 inexperienced divers (beginning divers - BD), 51 experienced divers (diving experience more than 3 years, ED) and 98 healthy individuals not interested in diving. The examinees were follow-up for 20 years. All of them had no organic cardiovascular pathology. PER was detected by the method of imitation modeling of underwater emboly using prolonged infusion contrast echocardiography (PICE) with hydrogen peroxide solution. The intensity of right-left interatrial bypass (RLIAB) was determined by the number of microblebs penetrating in PICE in the left heart. In the BD group PICE was made each 3 years of diving experience, in ED group - each3-5 years of further diving experience.
Results. Diving leads to activation of RLIAB, the number of divers with PER increases. Bypass and PER intensity grows in BD group. In ED group PER increased but RLIAB changed insignificantly.
Conclusion. Our investigation confirms unfavourable effects of diving on RLIAB of blood in persons with open oval window (OOW) enhancing PER. Further investigations should be made on effects of diving on hemodynamic disorders due to OOW.open oval windowparadoxic emboly readinessdivingоткрытое овальное окноготовность к парадоксальной эмболиидайвинг[Langton P. Patent foramen ovale in underwater medicine. Spums J. 1996; 26 (3): 186-191.][Wilmshurst P. T., Byrne J. C., Webb-Peploe M. M. Relation between interatrial shunts and decompression sickness in divers. Lancet 1989; 2 (8675): 1302-1306.][Schwerzmann M., Seiler C. Recreational scuba diving, patent foramen ovale and their associated risks. Swiss Med. Wkly 2001; 131: 365-374.][Torti S. R., Billinger M., Schwerzmann M. et al. Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale. Eur. Heart J. 2004; 25 (12): 1014-1020.][Harrah J. D., O'Boyle P. S., Piantadosi C. A. Underutilization of echocardiography for patent foramen ovale in divers with serious decompression sickness. Undersea Hyperb. Med. 2008; 35 (3): 207-211.][Онищенко Е. Ф., Ильин А. С. Пролонгированная инфузионная контрастная эхокардиография с перекисью водорода. Тер. арх. 1995; 9: 78-81.][Волчков В. А. Краткое практическое руководство по биометрии для врачей. СПб.; 1998.][Лапач С. Н., Чубенко А. В., Бабич П. Н. Статистические методы в медико-биологических исследованиях с использованием Excel. Киев: Морион; 2001.]