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Meck, Janice V.

Publications and source records attributed to Meck, Janice V..

24 records · Page 2

Long-Duration Space Flight Provokes Pathologic Q-Tc Interval Prolongation

Space flight has a profound influence on the cardiovascular and autonomic nervous systems. Alterations in baroreflex function, plasma catecholamine concentrations, and arterial pressure regulation have been observed. Changes in autonomic regulation of cardiac function may lead to serious rhythm disturbances. In fact, ventricular tachycardia has been reported during long-duration space flight. The study aim was to determine the effects of space flight on cardiac conduction. Methods and Results: Electrocardiograms (ECGs) and serum electrolytes were obtained before and after short-duration (SD) (4-16 days) and long-duration (LD) (4-6 months) missions. Holter recordings were obtained from 3 different subjects before, during and after a 4-month mission. P-R, R-R, and Q-T intervals were measured manually in a random, blinded fashion and Bazzet's formula used to correct the Q-T interval (Q-Tc). Space flight had no clinically significant effect on electrolyte concentrations. P-R and RR intervals were decreased after SD flight (p<0.05) and recovered 3 days after landing. In the same subjects, P-R and Q-Tc intervals were prolonged after LD flight (p<0.01). Clinically significant Q-Tc prolongation (>0.44 sec) occurred during the first month of flight and persisted until 3 days after landing (p<0.01). Conclusions - Space flight alters cardiac conduction with more ominous changes seen with LD missions. Alterations in autonomic tone may explain ECG changes associated with space flight. Primary cardiac changes may also contribute to the conduction changes with LD flight. Q-Tc prolongation may predispose astronauts to ventricular arrhythmias during and after long-duration space flight.

D'Aunno, DOminick S.↗

Postspaceflight orthostatic hypotension occurs mostly in women and is predicted by low vascular resistance

About 20% of astronauts suffer postspaceflight presyncope. We studied pre- to postflight (5- to 16-day missions) cardiovascular responses to standing in 35 astronauts to determine differences between 1) men and women and 2) presyncopal and nonpresyncopal groups. The groups were presyncopal women, presyncopal men, and nonpresyncopal men based on their ability to stand for 10 min postflight. Preflight, women and presyncopal men had low vascular resistance, with the women having the lowest. Postflight, women experienced higher rates of presyncope (100 vs. 20%; P = 0.001) and greater losses of plasma volume (20 vs. 7%; P < 0.05) than men. Also, presyncopal subjects had lower standing mean arterial pressure (P < or = 0.001) and vascular resistance (P < 0.05), smaller increases in norepinephrine (P < or = 0.058) and greater increases in epinephrine (P < or = 0.058) than nonpresyncopal subjects. Presyncopal subjects had a strong dependence on plasma volume to maintain standing stroke volume. These findings suggest that postflight presyncope is greatest in women, and this can be ascribed to a combination of inherently low-resistance responses, a strong dependence on volume status, and relative hypoadrenergic responses. Conversely, high vascular resistance and postflight hyperadrenergic responses prevent presyncope.

Flight Experiment↗

Protective Effects of the Launch/Entry Suit (LES) and the Liquid Cooling Garment(LCG) During Re-entry and Landing After Spaceflight

Heart rate and arterial pressure were measured during shuttle re-entry, landing and initial standing in crewmembers with and without inflated anti-g suits and with and without liquid cooling garments (LCG). Preflight, three measurements were obtained seated, then standing. Prior to and during re-entry, arterial pressure and heart rate were measured every five minutes until wheels stop (WS). Then crewmembers initiated three seated and three standing measurements. In subjects without inflated anti-g suits, SBP and DBP were significantly lower during preflight standing (P = 0.006; P = 0.001 respectively) and at touchdown (TD) (P = 0.001; P = 0.003 respectively); standing SBP was significantly lower after WS. on-LeG users developed significantly higher heart rates during re-entry (P = 0.029, maxG; P = 0.05, TD; P = 0.02, post-WS seated; P = 0.01, post-WS standing) than LCG users. Our data suggest that the anti-g suit is effective, but the combined anti-g suit with LCG is more effective.

Perez, Sondra A.↗

Temazepam, But Not Zolpidem, Causes Orthostatic Hypotension in Astronauts After Spaceflight

Many astronauts do not sleep well due to the difficult environment in space. Hypnotics such as temazepam or zolpidem are often taken while in space and/or the night prior to returning to Earth. Until now, no data have illustrated the effect of these sleeping medications on postflight hemodynamic responses. The purpose of this study was to determine if the use of different hypnotics during flight has any effect on cardiovascular responses to standing in astronauts upon returning to Earth's gravity.

Shi, Shang-Jin↗

Post-Spaceflight Orthostatic Hypotension Occurs Mostly in Women and is Predicted by Low Vascular Resistance

About 20% of astronauts suffer post-spaceflight presyncope, but the underlying etiology remains elusive. We studied responses to standing in 36 astronauts before and after spaceflight (5- 16 days). Individuals were separated into presyncopal women, presyncopal men, and non-presyncopal men based on their ability to stand for 10 min postflight. Preflight, presyncopal women and presyncopal men had low vascular resistance, with the women having the lowest. Postflight, women experienced significantly higher rates of presyncope (P<0.01) and significantly greater losses of plasma volume than the men (P<0.05). Both presyncopal women and men had lower standing arterial pressure (P<=0.001) and vascular resistance (P<0.05), smaller increases in norepinephrine (P<=0.058) and greater increases in epinephrine (P<=0.058) than nonpresyncopal men. Both presyncopal groups had a strong dependence (P<=0.05) on plasma volume to maintain standing stroke volume. These findings suggest that postflight presyncope is ascribed to a combination of inherently low resistance responses, a strong dependence on volume status, and spaceflight-induced hypoadrenergic responses. In contrast, high vascular resistance and spaceflight-induced hyperadrenergic responses prevent presyncope.

Waters, Wendy W.↗

Spaceflight Did Not Impair Cardiovascular Responses to Upright Posture in an Elderly Astronaut

Some of the cardiovascular changes associated with spaceflight have similarities to those associated with aging. We studied the neuroendocrine and hemodynamic responses to upright posture in a 77 year old astronaut before and after spaceflight and compared them to those of a group of 20 younger (41 plus or minus 1 years) astronauts. While arterial pressure responses to standing were similar between the young and old astronauts, hemodynamic profiles were quite different. The elderly astronaut achieved adequate standing arterial pressure primarily by maintaining stroke volume and thus cardiac output. In spite of very high norepinephrine release, he had very little increase in heart rate or total peripheral resistance. This pattern persisted on all test occasions. These responses suggest high sympathetic responses, down-regulated adrenergic receptors and decreased venous compliance typical of aging. In contrast, younger astronauts did not maintain stroke volume or cardiac output with standing, but had significant increases in heart rate and resistance. These results suggest that this elderly subject had cardiovascular responses to standing that are expected in an aged person. These responses were not deleteriously affected by spaceflight. We suggest that healthy, fit elderly individuals are able to withstand the stresses of extreme environments and are not necessarily limited in their activities simply due to their chronological age.

Rossum, Alfred C.↗