{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:09:00Z","timestamp":1791958140280,"version":"4.3.4"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Physical performance can be improved in aerobic athletes and breath\u2010hold divers (BHD) by limb exposure to repetitive ischemia: remote ischemic conditioning (RIC). RIC protects against cardiac ischemia, and its blood\u2010borne 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\/VO\n                    <jats:sub>2<\/jats:sub>\n                    max\u2010matched 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\u2010min inflation and 4\u2010min deflation of a blood pressure cuff on the dominant arm, maximum apnea after three submaximal apneas (BHD only), and a VO\n                    <jats:sub>2<\/jats:sub>\n                    max\u2010test. Blood\u2010samples were collected from the nondominant radial artery and the vena basilica of the dominant arm at rest, before termination of the three interventions, and for LDHa. Blood gases were compared to samples added lactate or placebo suspension. BHD had \u205330% higher cardiac\/erythrocyte LDHa compared to controls (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Lactate added to arterial blood from BHD after RIC increased oxygen unloading (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). PaO\n                    <jats:sub>2<\/jats:sub>\n                    decreased \u205366% during apnea (375+\/\u221249\u2009s;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001; BHD only). We conclude that 1 (erythrocyte\u2010 and cardiac\u2010\n                    <jats:styled-content style=\"fixed-case\">LDHa<\/jats:styled-content>\n                    is higher in\n                    <jats:styled-content style=\"fixed-case\">BHD<\/jats:styled-content>\n                    compared to matched controls, and 2) lactate facilitates oxygen\u2010unloading in blood from\n                    <jats:styled-content style=\"fixed-case\">BHD<\/jats:styled-content>\n                    after\n                    <jats:styled-content style=\"fixed-case\">RIC<\/jats:styled-content>\n                    , similar to diving mammals.\n                  <\/jats:p>","DOI":"10.14814\/phy2.70698","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T18:07:01Z","timestamp":1767809221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lactate increases oxygen unloading of preconditioned blood from male elite breath\u2010hold divers"],"prefix":"10.14814","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-9857","authenticated-orcid":false,"given":"Thomas","family":"Kjeld","sequence":"first","affiliation":[{"name":"Copenhagen Neuromuscular Center Rigshospitalet, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egon Godthaab","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Herlev Hospital, Herlev, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik Christian","family":"Arendrup","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"H\u00f8jberg","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Anesthesiology Rigshospitalet, Copenhagen, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Nedergaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Krag","sequence":"additional","affiliation":[{"name":"Copenhagen Neuromuscular Center Rigshospitalet, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vissing","sequence":"additional","affiliation":[{"name":"Copenhagen Neuromuscular Center Rigshospitalet, University of Copenhagen  Copenhagen 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