Comprehensive examination of the differences in thermoregulatory and ventilatory responses between humans with and without a PFO under different environmental conditions
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The existence of a patent foramen ovale (PFO) has been known about for nearly 2,000 years. The prevalence of a PFO has been shown to be 25-40% in the general population. Despite the fact that blood flowing through a PFO acts as a shunt, there has been little research looking at the effect a PFO has on physiology in otherwise healthy humans. In Chapter IV, the effect of a PFO on core temperature (Tcore) prior to, and during exercise, was investigated. The design of this experiment included appropriate controls for a thermoregulatory study (i.e. measuring at same time of day, appropriate hydration and food intake, etc.). Results from this study indicate that subjects with a PFO (PFO+) have a Tcore that is ~0.4°C higher at rest and during exercise than subjects without a PFO (PFO–). Additionally, this study showed that PFO– subjects do not increase Tcore to the same extent breathing cold air as they do breathing ambient air during a 10-minute exercise bout, whereas there was no difference in Tcore increase between these two conditions for PFO+ subjects. These findings suggest that the difference in Tcore between PFO+ and PFO– subjects is potentially due to differences in respiratory heat loss. The studies for Chapter V examined differences in thermoregulatory and ventilatory responses during hot water (40°C) and cold water (20°C) immersion. This study found that compared to PFO– subjects, PFO+ subjects 1) increase Tcore at the same rate during hot water immersion and 2) do not cool off as quickly during cold water immersion. Additionally, in subjects who reached a ventilatory threshold, PFO+ subjects had blunted ventilatory responses to increased Tcore compared to PFO– subjects. Finally, in Chapter VI it was shown that PFO+ subjects have blunted ventilatory responses during acute exposure to hyperoxic and normoxic hypercapnia. However, there were no differences in ventilatory responses between PFO+ and PFO– subjects during exposure to either isocapnic or poikilocapnic hypoxia. These findings suggest that PFO+ subjects have a blunted central chemoreflex. This dissertation contains previously, unpublished co-authored material.