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At least 235 records · Page 13

Angiotensin converting enzyme inhibition and the kidney

Angiotensin II (Ang II) induces a marked reduction in renal blood flow at doses well below those required to induce a pressor response, and as blood flow falls there is a decline in glomerular filtration rate and sodium excretion. This striking sensitivity of the renal blood supply led many workers to consider the possibility that angiotensin functions as a local renal hormone. As angiotensin converting enzyme (ACE) was found in particular abundance in the lung, it seemed reasonable to suspect that most of the conversion occurred there, and that the function of Ang II would be primarily systemic, rather than intrarenal. In this review, I will explore the evidence that has accumulated on these two possibilities, since they have important implications for our current understanding of normal kidney function and derangements of kidney function in disease.

NASA Program Biomedical Research↗

Methods and new approaches to the calculation of physiological parameters by videodensitometry

A complex system featuring a video-camera connected to a video disk, cine (medical motion picture) camera and PDP-9 computer with various input/output facilities has been developed. This system enables the performance of quantitative analysis of various functions recorded in clinical studies. Several studies are described, such as heart chamber volume calculations, left ventricle ejection fraction, blood flow through the lungs and also the possibility of obtaining information about blood flow and constrictions in small cross-section vessels

Kedem, D.↗

Cutaneous microvascular flow in the foot during simulated variable gravities

Our objective was to understand how weight bearing with varying gravitational fields affects blood perfusion in the sole of the foot. Human subjects underwent whole body tilting at four angles: upright [1 gravitational vector from head to foot (Gz)], 22 degrees (0.38 Gz), 10 degrees (0.17 Gz), and supine (0 Gz), simulating the gravitational fields of Earth, Mars, Moon, and microgravity, respectively. Cutaneous capillary blood flow was monitored on the plantar surface of the heel by laser Doppler flowmetry while weight-bearing load was measured. At each tilt angle, subjects increased weight bearing on one foot in graded load increments of 1 kg beginning with zero. The weight bearing at which null flow first occurred was determined as the closing load. Subsequently, the weight bearing was reduced in reverse steps until blood flow returned (opening load). Mean closing loads for simulated Earth gravity, Mars gravity, Moon gravity, and microgravity were 9.1, 4.6, 4.4, and 3.6 kg, respectively. Mean opening loads were 7.9, 4.1, 3.5, and 3.1 kg, respectively. Mean arterial pressures in the foot (MAP(foot)) calculated for each simulated gravitational field were 192, 127, 106, and 87 mmHg, respectively. Closing load and opening load were significantly correlated with MAP(foot) (r =0.70, 0.72, respectively) and were significantly different (P < 0.001) from each other. The data suggest that decreased local arterial pressure in the foot lowers tolerance to external compression. Consequently, the human foot sole may be more prone to cutaneous ischemia during load bearing in microgravity than on Earth.

NASA Discipline Cardiopulmonary↗

Effects of standing on cerebrovascular resistance in patients with idiopathic orthostatic intolerance

PURPOSE: Patients with idiopathic orthostatic intolerance often have debilitating symptoms on standing that are suggestive of cerebral hypoperfusion despite the absence of orthostatic hypotension. SUBJECTS AND METHODS: We evaluated the effects of graded head-up tilt on cerebral blood flow as determined by transcranial Doppler measurements in 10 patients with idiopathic orthostatic intolerance (nine women, one man, 22 to 47 years) and nine age- and sex-matched control subjects. RESULTS: In patients, mean (+/- SD) arterial pressure at 0 degrees head-up tilt was 90 +/- 11 mm Hg and was well maintained at all tilt angles (90 +/- 11 mm Hg at 75 degrees). In controls, mean arterial pressure was 85 +/- 7 mm Hg at 0 degrees and 82 +/- 11 mm Hg at 75 degrees head-up tilt. There was a substantial decrease in peak velocity with increasing tilt angle in patients (28% +/- 10%) but not in controls (10% +/- 10% at 75 degrees, P <0.001). Similarly, mean velocity decreased 26% +/- 13% in patients and 12% +/- 11% in controls (P = 0.01). With increasing head-up tilt, patients had a significantly greater increase in regional cerebrovascular resistance than controls. CONCLUSIONS: In patients with idiopathic orthostatic intolerance, peak and mean middle cerebral artery blood flow velocity decreased in response to head-up tilt despite well sustained arterial blood pressure. These observations indicate that in this group of patients, regulation of cerebrovascular tone may be impaired and might therefore be a target for therapeutic interventions.

Non-NASA Center↗

Cutaneous interstitial nitric oxide concentration does not increase during heat stress in humans

Inhibition of cutaneous nitric oxide (NO) synthase reduces the magnitude of cutaneous vasodilation during whole body heating in humans. However, this observation is insufficient to conclude that NO concentration increases in the skin during a heat stress. This study was designed to test the hypothesis that whole body heating increases cutaneous interstitial NO concentration. This was accomplished by placing 2 microdialysis membranes in the forearm dermal space of 12 subjects. Both membranes were perfused with lactated Ringer solutions at a rate of 2 microl/min. In both normothermia and during whole body heating via a water perfused suit, dialysate from these membranes were obtained and analyzed for NO using the chemiluminescence technique. In six of these subjects, after the heat stress, the membranes were perfused with a 1 M solution of acetylcholine to stimulate NO release. Dialysate from these trials was also assayed to quantify cutaneous interstitial NO concentration. Whole body heating increased skin temperature from 34.6 +/- 0.2 to 38.8 +/- 0.2 degrees C (P < 0.05), which increased sublingual temperature (36.4 +/- 0.1 to 37.6 +/- 0.1 degrees C; P < 0.05), heart rate (63 +/- 5 to 93 +/- 5 beats/min; P < 0.05), and skin blood flow over the membranes (21 +/- 4 to 88 +/- 10 perfusion units; P < 0.05). NO concentration in the dialysate did not increase significantly during of the heat stress (7.6 +/- 0.7 to 8.6 +/- 0.8 microM; P > 0.05). After the heat stress, administration of acetylcholine in the perfusate significantly increased skin blood flow (128 +/- 6 perfusion units) relative to both normothermic and heat stress values and significantly increased NO concentration in the dialysate (15.8 +/- 2.4 microM). These data suggest that whole body heating does not increase cutaneous interstitial NO concentration in forearm skin. Rather, NO may serve in a permissive role in facilitating the effects of an unknown neurotransmitter, leading to cutaneous vasodilation during a heat stress.

Non-NASA Center↗

Muscle metaboreceptor modulation of cutaneous active vasodilation

PURPOSE: Isometric handgrip exercise in hyperthermia has been shown to reduce cutaneous vascular conductance (CVC) by inhibiting the cutaneous active vasodilator system. METHODS: To identify whether this response was initiated by muscle metaboreceptors, in seven subjects two 3-min bouts of isometric handgrip exercise in hyperthermia were performed, followed by 2 min of postexercise ischemia (PEI). An index of forearm skin blood flow (laser-Doppler flowmetry) was measured on the contralateral arm at an unblocked site and at a site at which adrenergic vasoconstrictor function was blocked via bretylium iontophoresis to reveal active cutaneous vasodilator function unambiguously. Sweat rate was measured via capacitance hygrometry, CVC was indexed from the ratio of skin blood flow to mean arterial pressure and was expressed as a percentage of maximal CVC at that site. In normothermia, neither isometric exercise nor PEI affected CVC (P > 0.05). RESULTS: The first bout of isometric handgrip exercise in hyperthermia reduced CVC at control sites and this reduction persisted through PEI (pre-exercise: 59.8 +/- 5.4, exercise: 49.8 +/- 4.9, PEI: 49.7 +/- 5.3% of maximum; both P < 0.05), whereas there were no significant changes in CVC at the bretylium treated sites. The succeeding bout of isometric exercise in hyperthermia significantly reduced CVC at both untreated (pre-exercise: 59.0 +/- 4.8, exercise: 47.3 +/- 4.0, PEI: 50.1 +/- 4.1% of maximum; both P < 0.05) and bretylium treated sites (pre-exercise: 61.4 +/- 7.3, exercise: 50.6 +/- 5.1, PEI: 53.9 +/- 6.0% of maximum, both P < 0.05). At both sites, CVC during PEI was lower than during the pre-exercise period (P < 0.05). Sweat rate rose significantly during both bouts of isometric exercise and remained elevated during PEI. CONCLUSIONS: These data suggest that the reduction in CVC during isometric exercise in hyperthermia, including the inhibition of the active vasodilator system, is primarily mediated by muscle metaboreceptors, whereas central command or muscle mechanoreceptors have less influence.

Non-NASA Center↗

Cardiovascular responses of semi-arboreal snakes to chronic, intermittent hypergravity

Cardiovascular functions were studied in semi-arboreal rat snakes (Elaphe obsoleta) following long-term, intermittent exposure to +1.5 Gz (head-to-tail acceleration) on a centrifuge. Snakes were held in a nearly straight position within horizontal plastic tubes during periods of centrifugation. Centrifugal acceleration, therefore, subjected snakes to a linear force gradient with the maximal force being experienced at the tail. Compared to non-centrifuged controls, Gz-acclimated snakes showed greater increases of heart rate during head-up tilt or acceleration, greater sensitivity of arterial pressure to circulating catecholamines, higher blood levels of corticosterone, and higher blood ratios of prostaglandin F 2 alpha/prostaglandin E2. Cardiovascular tolerance to increased gravity during graded Gz acceleration was measured as the maximum (caudal) acceleration force at which carotid arterial blood flow became null. When such tolerances were adjusted for effects of body size and other continuous variables incorporated into an analysis of covariance, the difference between the adjusted mean values of control and acclimated snakes (2.37 and 2.84 Gz, respectively) corresponded closely to the 0.5 G difference between the acclimation G (1.5) and Earth gravity (1.0). As in other vertebrates, cardiovascular tolerance to Gz stress tended to be increased by acclimation, short body length, high arterial pressure, and comparatively large blood volume. Voluntary body movements were important for promoting carotid blood flow at the higher levels of Gz stress.

NASA Discipline Cardiopulmonary↗

Doppler instrumentation for measuring blood velocity and flow

Doppler ultrasonic blood flowmeters are reviewed in detail. The importance of measurement accuracy for transcutaneous flowmeters and their clinical application is stressed. Doppler imaging was combined with conventional pulse echo imaging, and diagnostic information was extracted from flow signals. The range and extent of applications of Doppler instruments was also presented.

Gill, R. W.↗

Head-down-tilt bed rest alters forearm vasodilator and vasoconstrictor responses

To test the hypothesis that head-down-tilt bed rest (HDBR) for 14 days alters vascular reactivity to vasodilatory and vasoconstrictor stimuli, the reactive hyperemic forearm blood flow (RHBF, measured by venous occlusion plethysmography) and mean arterial pressure (MAP, measured by Finapres) responses after 10 min of circulatory arrest were measured in a control trial (n = 20) and when sympathetic discharge was increased by a cold pressor test (RHBF + cold pressor test; n = 10). Vascular conductance (VC) was calculated (VC = RHBF/MAP). In the control trial, peak RHBF at 5 s after circulatory arrest (34.1 +/- 2.5 vs. 48.9 +/- 4.3 ml . 100 ml-1 . min-1) and VC (0.34 +/- 0.02 vs. 0.53 +/- 0.05 ml . 100 ml-1 . min-1 . mmHg-1) were reduced in the post- compared with the pre-HDBR tests (P < 0. 05). Total excess RHBF over 3 min was diminished in the post- compared with the pre-HDBR trial (84.8 vs. 117 ml/100 ml, P < 0.002). The ability of the cold pressor test to lower forearm blood flow was less in the post- than in the pre-HDBR test (P < 0.05), despite similar increases in MAP. These data suggest that regulation of vascular dilation and the interaction between dilatory and constrictor influences were altered with bed rest.

NASA Discipline Musculoskeletal↗

Multichannel implantable telemetry system

Multiplexed biotelemetry system for animal research combines several power-saving features. Implantable sensor measures up to eight parameters simultaneously, including blood flow. Microamp transistors, switching circuits, and CMOS technology are used to lower power requirements. However, when blood flow is monitored, these measures are insufficient to reduce power enough for long-term operation from implantable primary battery.

Fryer, T. B.↗

The endocrine system in space flight

A trial natriuretic factor (ANF), a hormone recently shown to regulate sodium and water excretion, has been measured in blood specimens obtained during flight. After 30 or 42 h of weightlessness, mean ANF was elevated. After 175 or 180 h, ANF has increased by 59 percent, and it changed little between that time and soon after landing. There is probably an increase in ANF early inflight associated with the fluid shift, followed by a compensatory decrease in blood volume. Increased renal blood flow may cause the later ANF decrease. Erythropoietin (Ep), a hormone involved in the control of red blood cell proudction, was measured in blood samples taken during the first Spacelab mission and was significantly decreased on the second day of flight, suggesting also an increase in renal blood flow. Spacelab-2 investigators report that the active vitamin D metabolite 1 alpha, 25-dihydroxyvitamin D-3 increased early in the flight, indicating that a stimulus for increased bone resorption occurs by 30 h after launch.

Leach, C. S.↗

A multichannel electromagnetic flowmeter telemetry system.

An eight-channel biomedical telemetry system provides four channels of blood flow measurements in addition to blood-pressure and EKG data. Emphasis is placed on the amplifiers and signal conditioning circuitry required for interfacing of the electromagnetic flow transducers with the transmission and modulation subsystems. The large number of data channels permits measurement of flow distribution as well as total cardiac output. The batteries and electronics for four channels (blood flow) weigh about 500 g and have a volume of 250 cu cm.

Fryer, T. B.↗

Validation of Spectral Analysis as a Noninvasive Tool to Assess Autonomic Regulation of Cardiovascular Function

A major focus of our program has been to develop a sensitive noninvasive procedure to quantify early weightlessness-induced changes in cardiovascular function or potential dysfunction. Forty studies of healthy young volunteers (10 men and 10 women, each studied twice) were conducted to determine changes in the sympatho-vagal balance of autonomic control of cardiovascular regulation during graded headward and footward blood volume shifts. Changes in sympatho-vagal balance were classified by changes in the mean levels and spectral content of cardiovascular variables and verified by changes in circulating levels of catecholamines and pancreatic polypeptide. Possible shifts in intra/extravascular fluid were assessed from changes in hematocrit and plasma mass density while changes in the stimulus to regulate plasma volume were determined from Plasma Renin Activity (PRA). Autonomic blockade was used to unmask the relative contribution of sympathetic and parasympathetic efferent influences in response to 10 min each of 0, 20 and 40 mmHg Lower Body Negative Pressure (LBNP) and 15 and 30 mmHg Positive Pressure (LBPP). The combination of muscarinic blockade with graded LBNP and LBPP was used to evoke graded increases and decreases in sympathetic activity without parasympathetic contributions. The combination of beta blockade with graded LBNP and LBPP was used to produce graded increases and decreases in parasympathetic activity without beta sympathetic contributions. Finally, a combination of both beta and muscarinic blockades with LBNP and LBPP was used to determine the contribution from other, primarily alpha adrenergic, sources. Mean values, spectral analyses and time frequency analysis of R-R interval (HR), Arterial Pressure (AP), peripheral blood flow (RF), Stroke Volume (SV) and peripheral resistance (TPR) were performed for all phases of the study. Skin blood Flow (SF) was also measured in other studies and similarly analyzed. Spectra were examined for changes in three frequency regions (low 0.006 - 0.005 Hz (LF), mid 0.05 - 0.15 Hz (W), and high 0.15 - 0.45 Hz (EF)). The primary objective of the study was to indicate which changes in the mean values and/or spectra of cardiovascular variables consistently correlated with changes in sympatho-vagal balance in response to headward and footward fluid shifts. A secondaey objective was to quantify the vascular and extravascular fluid shifts evoked by LBNP and LBPP. The principal hypothesis being tested was that headward fluid shifts would evoke an increase in parasympathetic activity and footward fluid shifts would evoke an increase in sympathetic activity both of which would be detected by spectral analysis and verified by circulating hormones. Hematocrit (HCT), plasma mass density and plasma renin activity increased with muscarinic blockade and with LBNP, a response indicative of a plasma shift to extravascular spaces. Beta blockade alone or after muscarinic blockade had no effect on HCT or plasma mass density. With respect to intravascular fluid volume distribution, LBNP and LBPP produced sufficient upper body vascular fluid shifts to evoke appropriate autonomic regulatory responses.

Knapp, Charles F.↗

Development of A Directed Acyclic Graph for Venous Thromboembolism During Spaceflight

Introduction: Recent studies have reported the development of venous blood flow stasis in astronauts and an occlusive venous thrombosis during spaceflight. Subsequent investigations revealed approximately one quarter of surveilled crew members had some degree of blood flow stasis in the left internal jugular vein. Therefore, NASA’s Human System Risk Board now formally tracks venous thromboembolism (VTE) as a “concern” for human spaceflight. To investigate potential mechanisms by which exposures concomitant with spaceflight (e.g., microgravity, radiation) may contribute to VTE, we developed a causal diagram in the form of a directed acyclic graph (DAG). Methods: The mechanisms by which spaceflight exposures may elevate the risk of VTE and the downstream effects on mission outcomes were critically analyzed, taking into account scientific literature and subject matter expertise consultation, and a DAG was generated. A Level-of-Evidence score for each causal relationship was assigned based on assessing the literature against a set of criteria derived from the A. Bradford Hill Causal Guidelines. Results: The set of three main factors that predispose people to VTE (hypercoagulability, endothelial damage, and blood stasis) is known as Virchow’s Triad. In constructing the DAG for VTE we articulated various mechanisms by which the principal spaceflight hazards (microgravity, radiation, closed hostile environment, isolation and confinement, distance from Earth) are thought to interact with or cause the components in Virchow’s triad. We found sufficient evidence to at least speculate that fluid shifts from microgravity, compensatory alterations in hematologic indices, spaceflight atmospheric conditions, and oxidative stress/inflammation from radiation may be potential contributors to VTE development. Discussion: Developing the DAG entailed a systematic and repeatable approach for visualizing relationships between contributing factors that may lead to VTE in spaceflight. Articulating pathways linking spaceflight exposures to VTE risk factors and possible VTE development enables subject matter experts from different domains to construct a shared mental model. Assignment of levels of evidence scores to the relationships helps identify knowledge and capability gaps that should be considered for further investigation. Furthermore, the DAG highlights modifiable variables and may therefore facilitate the development of new VTE risk mitigation strategies.

Alexander Svoronos↗

Sympathetic discharge and vascular resistance after bed rest

The effect of -6 degrees head-down-tilt bed rest (HDBR) for 14 days on supine sympathetic discharge and cardiovascular hemodynamics at rest was assessed. Mean arterial pressure, heart rate (n = 25), muscle sympathetic nerve activity (MSNA; n = 16) burst frequency, and forearm blood flow (n = 14) were measured, and forearm vascular resistance (FVR) was calculated. Stroke distance, our index of stroke volume, was derived from measurements of aortic mean blood velocity (Doppler) and R-R interval (n = 7). With these data, an index of total peripheral resistance was determined. Heart rate at rest was greater in the post (71 +/- 2 beats/min)- compared with the pre-HDBR test (66 +/- 2 beats/min; P < 0.003), but mean arterial pressure was unchanged. Aortic stroke distance during post-HDBR (15.5 +/- 1.1 cm/beat) was reduced from pre-HDBR levels (20.0 +/- 1.5 cm/beat) (P < 0.03). Also, MSNA burst frequency was reduced in the post (16.7 +/- 2.8 beats/min)- compared with the pre (25.2 +/- 2.6 beats/min)-HDBR condition (P < 0.01). Bed rest did not alter forearm blood flow, FVR, or total peripheral resistance. Thus reductions in MSNA with HDBR were not associated with a decrease in FVR.

NASA Discipline Musculoskeletal↗

Limb neurovascular control during altered otolithic input in humans

Head-down rotation (HDR), which activates the vestibulosympathetic reflex, increases leg muscle sympathetic nerve activity (MSNA) and produces calf vasoconstriction with no change in either cardiac output or arterial blood pressure. Based on animal studies, it was hypothesized that differential control of arm and leg MSNA explains why HDR does not alter arterial blood pressure. Fifteen healthy subjects were studied. Heart rate, arterial blood pressure, forearm and calf blood flow, and leg MSNA responses were measured during HDR in these subjects. Simultaneous recordings of arm and leg MSNA were obtained from five of the subjects. Forearm and calf blood flow, vascular conductances, and vascular resistances were similar before HDR, as were arm and leg MSNA. HDR elicited similar significant increases in leg (Delta 6 +/- 1 bursts min(-1); 59 +/- 16 % from baseline) and arm MSNA (Delta 5 +/- 1 bursts min(-1); 80 +/- 28 % from baseline). HDR significantly decreased calf (-19 +/- 2 %) and forearm vascular conductance (-12 +/- 2 %) and significantly increased calf (25 +/- 4 %) and forearm vascular resistance (15 +/- 2 %), with ~60 % greater vasoconstriction in the calf than in the forearm. Arterial blood pressure and heart rate were not altered by HDR. These results indicate that there is no differential control of MSNA in the arm and leg during altered feedback from the otolith organs in humans, but that greater vasoconstriction occurs in the calf than in the forearm. These findings indicate that vasodilatation occurs in other vascular bed(s) to account for the lack of increase in arterial blood pressure during HDR.

Non-NASA Center↗

Objective measurement of human tolerance to +G sub z acceleration stress

The efficacy of a new objective technique using a transcutaneous Doppler flowmeter to monitor superficial temporal artery blood flow velocity during acceleration was investigated. The results were correlated with current objective and subjective G tolerance end points. In over 1300 centrifuge runs, retrograde eye level blood flow leading to total flow cessation was consistently recorded and preceded visual field deterioration leading to blackout by 3 to 23 seconds. The new method was successfully applied as an objective indication of tolerance in a variety of test situations including evaluation of g-suits, straining maneuvers, and 13 deg, 45 deg and 65 deg set back angles.

Rositano, S. A.↗