Lactate increases oxygen unloading of preconditioned blood from male elite breath‐hold divers
Thomas Kjeld, Egon Godthaab Hansen, Henrik Christian Arendrup, Jens Højberg, Anders Nedergaard, Thomas Krag, John Vissing

TL;DR
Elite breath-hold divers have higher lactate dehydrogenase in their blood, which helps release oxygen more efficiently when lactate is added, similar to diving mammals.
Contribution
This study shows that lactate enhances oxygen unloading in blood from elite breath-hold divers after remote ischemic conditioning.
Findings
BHD had ~30% higher cardiac and erythrocyte LDHa compared to controls.
Lactate added to BHD blood after RIC increased oxygen unloading significantly.
PaO2 decreased ~66% during apnea in BHD.
Abstract
Physical performance can be improved in aerobic athletes and breath‐hold divers (BHD) by limb exposure to repetitive ischemia: remote ischemic conditioning (RIC). RIC protects against cardiac ischemia, and its blood‐borne transferable substrate could be lactate. Accordingly, lactate added to whale blood increases oxygen unloading and adult seals possess higher cardiac lactate dehydrogenase activity (LDHa) than terrestrial mammals. Because BHD and adult diving mammals share adaptations to hypoxia, including lactate metabolization during apnea, we hypothesized that BHD compared to BMI/VO2max‐matched aerobic controls have higher LDHa and lactate added to blood from BHD unloads oxygen more efficiently. Six BHD and six matched aerobic controls underwent RIC: three cycles of 5‐min inflation and 4‐min deflation of a blood pressure cuff on the dominant arm, maximum apnea after three submaximal…
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Taxonomy
TopicsCardiovascular and Diving-Related Complications · Cardiac Ischemia and Reperfusion · Cardiac and Coronary Surgery Techniques
