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At least 37 records · Page 2

Characterization of fluid physics effects on cardiovascular response to microgravity (G-572)

The investigation of cardiovascular adaptation to space flight has seen substantial advancement in the last several years. In-flight echocardiographic measurements of astronaut cardiac function on the Space Shuttle have documented an initial increase, followed by a progressive reduction in both left ventricular volume index and stroke volume with a compensatory increase in heart rate to maintain cardiac output. To date, the reduced cardiac size and stroke volume have been presumed to be the consequence of the reduction in circulating fluid volume within a few days after orbital insertion. However, no specific mechanism for the reduced stroke volume has been identified. The following investigation proposes the use of a hydraulic model of the cardiovascular system to examine the possibility that the observed reduction in stroke volume may, in part, be related to fluid physics effects on heart function. The automated model is being prepared to fly as a Get Away Special (GAS) payload within the next year.

Pantalos, George M.↗

The role of nuclear medicine in assessments of cardiac dyssynchrony

Radionuclide imaging has an advantage for quantitative analyses of the tracer concentration and its temporal changes. Myocardial perfusion and function have been adapted for synchrony analyses. Extracted parameters have been demonstrated to measure ventricular synchrony and even to predict CRT outcomes. ERNA has the advantages of higher temporal resolution, greater reproducibility, and the volumetric analysis of both ventricles that can be applied for analyses of intraventricular synchrony and interventricular synchrony. Several software packages such as Quantitative Gated SPECT, the Emory Cardiac Toolbox, cardioREPO, and Heart Function View are available to assess the LV dyssynchrony parameters from GSPECT. A count-based method is applied to extract the amplitude and phase from each of the reconstructed GSPECT short-axis datasets throughout the cardiac cycle and then subjected to a Fourier analysis, the results of which are displayed on a polar map and histogram. Some of the parameters such as the bandwidth (expressed as the 95% width of the phase histogram) and the standard deviation of the phase are obtained by the phase histogram to assess the intraventricular synchrony. This review paper focuses on the application of the LV dyssynchrony parameters estimated by cardiac SPECT in patients with a heart disease.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Cardiovascular Responses to Simulated Spaceflight: Molecular Signatures and Surrogate Outputs to Measure CVD Risk

During extended space missions beyond low Earth orbit, astronauts will encounter prolonged periods of weightlessness and low dose space radiation. Previous studies have shown that exposure to small doses of high LET radiation (< 50 cGy) can lead to both short-term and long-term alterations in heart function, structure and underlying molecular mechanisms. In this study, we aim to identify the molecular signature associated with the cardiovascular response to simulated galactic cosmic radiation (5-ion GCR) alone or in combination with simulated weightlessness at time intervals relevant to mission length and recovery. Additionally, we aim to determine whether sex impacts cardiovascular responses to these spaceflight factors. Our overarching goal is to enhance our understanding of the cardiovascular risks associated with extended space missions and the clinical endpoints they suggest. We hypothesize that exposure to simulated space radiation leads to enduring alterations in the transcriptome, redox signaling and cytokine environment of cardiovascular tissue, some which have known links with reduced cardiovascular performance, aging, and increased risk of cardiovascular disease (CVD). Furthermore, we posit that simulated space radiation exposure in combination with simulated microgravity exacerbates cardiovascular deficits compared to single factor exposure. Female and male C57BL/6J mice, aged 23-24 weeks, were exposed to a single dose of 5, 15, or 50 cGy of 5-ion GCR, or sham-treated (0 cGy). Euthanasia was performed at 14 days and ~4 months post-irradiation. Hearts, aorta and blood plasma were collected shortly thereafter. RNA-sequencing of left ventricles at ~4 months post-GCR exposure revealed sex differences in the heart transcriptome with a few genes showing radiation-dependent changes in expression levels. Notably, some of the differentially expressed genes in 15 and 50 cGy GCR groups are known to play roles in the development of CVD. Analysis of protein levels of a subset of inflammatory cytokines in the heart indicated sex differences but no differences between sham and 50 cGy groups. Results also showed correlations among differentially expressed genes and a subset of inflammatory cytokines, with some correlations altered by GCR exposure. These findings suggest that GCR exposure can modify protein and gene networks linked to inflammation and CVD progression. In the aorta, telomere lengths were comparable across treatment groups sexes. Mitochondrial copy number is a biomarker for mitochondrial function with decreased copy numbers associated with cardiometabolic disease traits. Mitochondrial copy numbers of aorta also showed no sex nor dose differences. In a second study, mice underwent one week of simulated microgravity by hindlimb unloading (HU) and then exposed to a single dose of 15 cGy of 5-ion GCR. HU was conducted for an additional two weeks following GCR exposure. Single factor exposure groups (HU or GCR only) also were included in the study. Euthanasia was then performed and the same tissues were collected. Protein levels of select inflammatory cytokines in the heart showed sex-dependent differences in expression. In the aorta, telomere lengths and mitochondrial copy number also showed sex differences. In summary, our results indicate differences between sexes in biomarkers related to cardiovascular health. Exposure to 5-ion GCR or HU, alone or in combination, did not result in changes in most of the cardiovascular biomarkers that were examined. However, in the heart, simulated space radiation at doses of 15 and 50 cGy led to long-term alterations in the expression levels of a small group of genes known to be associated with the progression of CVD. The long-term transcriptomic changes resulting from exposure to simulated space radiation should be carefully investigated to mitigate adverse cardiovascular events during and after deep space missions. Our results also highlight the importance of sex-specific strategies in monitoring and maintaining cardiovascular health during and after deep space missions.

cardiovascular↗

Absence of NUCKS augments paracrine effects of mesenchymal stem cells-mediated cardiac protection

Bone marrow-derived mesenchymal stem cells (BM-MSCs) contribute to myocardial repair after myocardial infarction (MI) by secreting a panel of growth factors and cytokines. This study was to investigate the potential mechanisms of the nuclear casein kinase and cyclin-dependent kinase substrate 1 (NUCKS) in regulation of the profiles of BM-MSCs secretion and compare the therapeutic efficacy of NUCKS{sup -/-} and wide type-BM-MSCs (WT-BM-MSCs) on MI. The secretion profiles between NUCKS{sup -/-} and WT-BM-MSCs under hypoxia (1%O{sub 2}) were analyzed. Gene function analysis showed that compared with WT-BM-MSCs-conditioned medium (CdM), some genes over-presented in NUCKS{sup -/-}BM-MSCs-CdM were closely associated with inflammatory response, regulation of cell proliferation, death, migration and secretion. Notably, VEGFa in NUCKS{sup -/-}BM-MSCs-CdM was higher than that of WT-BM-MSCs-CdM. WT-BM-MSCs and NUCKS{sup -/-}BM-MSCs were transplanted into the peri-infarct region in mice of MI. At 4 weeks after cell transplantation, NUCKS{sup -/-} or WT-BM-MSCs group significantly improved heart function and vessels density and reduced infarction size and apoptosis of cardiomyocytes. Furthermore, NUCKS{sup -/-}BM-MSCs provided better cardioprotective effects than WT-BM-MSCs against MI. Our study demonstrates that depletion of NUCKS enhances the therapeutic efficacy of BM-MSCs for MI via regulating the secretion. - Highlights: • Absence of NUCKS alters the secretion of BM-MSCs and enhances VEGFa level. • Absence of NUCKS in BM-MSCs exerts a better therapeutic effect for myocardial infarction than WT-BM-MSCs. • The enhanced cardioprotection of NUCKS{sup -/-}BM-MSCs is attributed to the increased capacity of angiogenesis and anti-apoptosis post transplantation.

60 APPLIED LIFE SCIENCES↗

Myocardial wall-thickness transducer

Device consists of highly compliant circular beam attached to piezoresistive strain gage and barbed needle. Radial deflection of myocardium is measured with minimal disturbance of normal heart functions.

Feldstein, C.↗

Altitude acclimatization. Citations from the International Aerospace Abstracts data base

This bibliography of citations to the international literature covers aspects of altitude acclimatization. Included are articles concerning high altitude environments, hypoxia, heart function and hemodynamic responses, physical exercise, human tolerances and reactions, physiological responses, and oxygen consumption. This updated bibliography contains 164 citations, 35 of which are new entries to the previous edition.

Mauk, S. C.↗

Transducers For Heat Research

Series of transducers with seven different configurations enable measurement of forces and displacements in heart wall. New transducers small, cause minimal perturbation of heart function and attached and detached without causing excessive tissue damage. All units implanted or removed during single heartbeat, permitting rapid relocation for detail mapping.

Feldstein, C.↗

Cardiac Monitor

Under contract to Johnson Space Center, the University of Minnesota developed the concept of impedance cardiography as an alternative to thermodilution to access astronaut heart function in flight. NASA then contracted Space Labs, Inc. to construct miniature space units based on this technology. Several companies then launched their own impedance cardiography, including Renaissance Technologies, which manufactures the IQ System. The IQ System is 5 to 17 times cheaper than thermodilution, and features the signal processing technology called TFD (Time Frequency Distribution). TFD provides three- dimensional distribution of the blood circulation force signals, allowing visualization of changes in power, frequency and time.

Source record↗

Cardiovascular and Cerebrovascular Control on Return from ISS

Cardiovascular and Cerebrovascular Control on Return from ISS (CCISS) will study the effects of long-duration spaceflight on crew members' heart functions and their blood vessels that supply the brain. Learning more about the cardiovascular and cerebrovascular systems could lead to specific countermeasures that might better protect future space travelers. This experiment is collaborative with the Canadian Space Agency.

Hughson, Richard Lee↗

Examining Individual Differences in Temporal Profiles of Cardiovascular Responses to the Head Down Tilt during Fluid Loading

Upon returning to Earth after an extended exposure to micro-gravity in space many astronauts have experienced symptoms of light headedness and fainting associated with post-flight orthostatic intolerance (low blood pressure). The main reason for this condition is the reduced fluid volume in the body while in space. A preventative treatment was proposed to prevent this condition by fluid loading to restore lost plasma volume by giving crew members salt tablets and water prior to re-entry. In order to simulate micro-gravity effects on earth test subjects are placed in a supine position with their head below the level of their heart (6 head down tilt-HDT). The purpose of the present study is to define individual differences in the time course of cardiac stroke volume responses to HDT (6 hours) and the effectiveness of fluid loading for mitigating orthostatic intolerance when standing . Echocardiography and impedance cardiography data will be collected on 8 men and 8 women to examine heart function to HDT. A second objective is to determine if the effects of fluid loading vary due to individual differences (e.g., age, gender, height, weight, physical fitness, etc.).

orthostatic intolerance↗

Exploring Heart and Lung Function in Space: ARMS Experiments

The Advanced Respiratory Monitoring System (ARMS) is a suite of monitoring instruments and supplies used to study the heart, lungs, and metabolism. Many experiments sponsored by the European Space Agency (ESA) will be conducted using ARMS during STS-107. The near-weightless environment of space causes the body to undergo many physiological adaptations, and the regulation of blood pressure is no exception. Astronauts also experience a decrease in blood volume as an adaptation to microgravity. Reduced blood volume may not provide enough blood pressure to the head during entry or landing. As a result, astronauts often experience light-headedness, and sometimes even fainting, when they stand shortly after returning to Earth. To help regulate blood pressure and heart rate, baroreceptors, sensors located in artery walls in the neck and near the heart, control blood pressure by sending information to the brain and ensuring blood flow to organs. These mechanisms work properly in Earth's gravity but must adapt in the microgravity environment of space. However, upon return to Earth during entry and landing, the cardiovascular system must readjust itself to gravity, which can cause fluctuation in the control of blood pressure and heart rate. Although the system recovers in hours or days, these occurrences are not easily predicted or understood - a puzzle investigators will study with the ARMS equipment. In space, researchers can focus on aspects of the cardiovascular system normally masked by gravity. The STS-107 experiments using ARMS will provide data on how the heart and lungs function in space, as well as how the nervous system controls them. Exercise will also be combined with breath holding and straining (the Valsalva maneuver) to test how heart rate and blood pressure react to different stresses. This understanding will improve astronauts' cardiopulmonary function after return to Earth, and may well help Earthbound patients who experience similar effects after long-term bed rest.

Andre Kuipers↗

ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease

This document is the second of 2 companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. The first document (J Am Coll Cardiol 2017;70:1647-1672) addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas this document addresses this topic with regard to structural (nonvalvular) heart disease. While dealing with different subjects, the 2 documents do share a common structure and feature some clinical overlap. The goal of the companion AUC documents is to provide a comprehensive resource for multimodality imaging in the context of structural and valvular heart disease, encompassing multiple imaging modalities. Using standardized methodology, the clinical scenarios (indications) were developed by a diverse writing group to represent patient presentations encountered in everyday practice and included common applications and anticipated uses. Where appropriate, the scenarios were developed on the basis of the most current American College of Cardiology/American Heart Association Clinical Practice Guidelines. A separate, independent rating panel scored the 102 clinical scenarios in this document on a scale of 1 to 9. Scores of 7 to 9 indicate that a modality is considered appropriate for the clinical scenario presented. Midrange scores of 4 to 6 indicate that a modality may be appropriate for the clinical scenario, and scores of 1 to 3 indicate that a modality is considered rarely appropriate for the clinical scenario. The primary objective of the AUC is to provide a framework for the assessment of these scenarios by practices that will improve and standardize physician decision making. AUC publications reflect an ongoing effort by the American College of Cardiology to critically and systematically create, review, and categorize clinical situations in which diagnostic tests and procedures are utilized by physicians caring for patients with cardiovascular diseases. The process is based on the current understanding of the technical capabilities of the imaging modalities examined.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Early therapeutic effects of adaptive servo-ventilation on cardiac sympathetic nervous function in patients with heart failure evaluated using a combination of {sup 11}C-HED PET and {sup 123}I-MIBG SPECT

Rationale: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. Methods: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57.3 ± 17.3 years old, left ventricular ejection fraction (LVEF) 36.1 ± 16.7%]. We performed echocardiography, polysomnography, biomarkers, {sup 11}C-hydroxyephedrine (HED) PET as a presynaptic function marker and planar {sup 123}I-metaiodobenzylguanidine (MIBG) to evaluate washout rate. Results: ASV therapy reduced apnea-hypopnea index (AHI) and improved plasma brain natriuretic peptide (BNP) concentration. In {sup 123}I-MIBG imaging, the early heart/mediastinum (H/M) ratio increased after ASV therapy (2.19 ± 0.58 to 2.40 ± 0.67; P = 0.045). Washout rate did not change (23.8 ± 7.3% to 23.8 ± 8.8%; P = 0.122). Global {sup 11}C-HED retention index (RI) improved from 0.068 ± 0.033/s to 0.075 ± 0.034/s (P = 0.029). Conclusions: ASV reduced AHI and improved BNP. ASV might initially improve presynaptic cardiac sympathetic nervous function in HF patients after 6 months of treatment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Predicting fatigue from heart rate signatures using functional logistic regression

Physical fatigue can have adverse effects on humans in extreme environments. Therefore, being able to predict fatigue using easy to measure metrics such as heart rate (HR) signatures has potential to have an impact in real-life scenarios. We apply a functional logistic regression model that uses HR signatures to predict physical fatigue, where physical fatigue is defined in a data-driven manner. Data were collected using commercially available wearable devices on 47 participants hiking the 20.7-mile Grand Canyon rim-to-rim trail in a single day. Fitted model provides good predictions and interpretable parameters for real-life application.

60 APPLIED LIFE SCIENCES↗

Real-time three-dimensional echocardiographic study of left ventricular function after infarct exclusion surgery for ischemic cardiomyopathy

BACKGROUND: Infarct exclusion (IE) surgery, a technique of left ventricular (LV) reconstruction for dyskinetic or akinetic LV segments in patients with ischemic cardiomyopathy, requires accurate volume quantification to determine the impact of surgery due to complicated geometric changes. METHODS AND RESULTS: Thirty patients who underwent IE (mean age 61+/-8 years, 73% men) had epicardial real-time 3-dimensional echocardiographic (RT3DE) studies performed before and after IE. RT3DE follow-up was performed transthoracically 42+/-67 days after surgery in 22 patients. Repeated measures ANOVA was used to compare the values before and after IE surgery and at follow-up. Significant decreases in LV end-diastolic (EDVI) and end-systolic (ESVI) volume indices were apparent immediately after IE and in follow-up (EDVI 99+/-40, 67+/-26, and 71+/-31 mL/m(2), respectively; ESVI 72+/-37, 40+/-21, and 42+/-22 mL/m(2), respectively; P:<0.05). LV ejection fraction increased significantly and remained higher (0.29+/-0.11, 0.43+/-0.13, and 0.42+/-0.09, respectively, P:<0.05). Forward stroke volume in 16 patients with preoperative mitral regurgitation significantly improved after IE and in follow-up (22+/-12, 53+/-24, and 58+/-21 mL, respectively, P:<0.005). New York Heart Association functional class at an average 285+/-144 days of clinical follow-up significantly improved from 3.0+/-0.8 to 1.8+/-0.8 (P:<0.0001). Smaller end-diastolic and end-systolic volumes measured with RT3DE immediately after IE were closely related to improvement in New York Heart Association functional class at clinical follow-up (Spearman's rho=0.58 and 0.60, respectively). CONCLUSIONS: RT3DE can be used to quantitatively assess changes in LV volume and function after complicated LV reconstruction. Decreased LV volume and increased ejection fraction imply a reduction in LV wall stress after IE surgery and are predictive of symptomatic improvement.

Non-NASA Center↗