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At least 145 records · Page 8
All sourcesNASA NTRSDOE OSTI
NASA NTRS1997

Effects of head-down-tilt bed rest on cerebral hemodynamics during orthostatic stress

Our aim was to determine whether the adaptation to simulated microgravity (microG) impairs regulation of cerebral blood flow (CBF) during orthostatic stress and contributes to orthostatic intolerance. Twelve healthy subjects (aged 24 +/- 5 yr) underwent 2 wk of -6 degrees head-down-tilt (HDT) bed rest to simulate hemodynamic changes that occur when humans are exposed to microG. CBF velocity in the middle cerebral artery (transcranial Doppler), blood pressure, cardiac output (acetylene rebreathing), and forearm blood flow were measured at each level of a ramped protocol of lower body negative pressure (LBNP; -15, -30, and -40 mmHg x 5 min, -50 mmHg x 3 min, then -10 mmHg every 3 min to presyncope) before and after bed rest. Orthostatic tolerance was assessed by using the cumulative stress index (CSI; mmHg x minutes) for the LBNP protocol. After bed rest, each individual's orthostatic tolerance was reduced, with the group CSI decreased by 24% associated with greater decreases in cardiac output and greater increases in systemic vascular resistance at each level of LBNP. Before bed rest, mean CBF velocity decreased by 14, 10, and 45% at -40 mmHg, -50 mmHg, and maximal LBNP, respectively. After bed rest, mean velocity decreased by 16% at -30 mmHg and by 21, 35, and 39% at -40 mmHg, -50 mmHg, and maximal LBNP, respectively. Compared with pre-bed rest, post-bed-rest mean velocity was less by 11, 10, and 21% at -30, -40, and -50 mmHg, respectively. However, there was no significant difference at maximal LBNP. We conclude that cerebral autoregulation during orthostatic stress is impaired by adaptation to simulated microG as evidenced by an earlier and greater fall in CBF velocity during LBNP. We speculate that impairment of cerebral autoregulation may contribute to the reduced orthostatic tolerance after bed rest.

NASA Discipline Cardiopulmonary↗
NASA NTRS2012

A Proposed Study Examining Individual Differences in Temporal Profiles of Cardiovascular Responses to Head Down Tilt During Fluid Loading

Susceptibility of healthy astronauts to orthostatic hypotension and presyncope is exacerbated upon return from spaceflight. The effect of altered gravity during space flight and planetary transition on human cardiovascular function is of critical importance to maintenance of astronaut health and safety. Hypovolemia, reduced plasma volume, is suspected to play an important role in cardiovascular deconditioning following exposure to spaceflight, which may lead to increased peripheral resistance, attenuated arterial baroreflex, and changes in cardiac function. A promising countermeasure for post-flight orthostatic intolerance is fluid loading used to restore lost plasma volume by giving crew salt tablets and water prior to re-entry. The main purpose of the proposed study is to define the temporal profile of cardiac responses to simulated 0-G conditions before and following a fluid loading countermeasure. 8 men and 8 women will be tested during 4 hour exposures at 6o head down tilt (HDT). Each subject will be given two exposures to HDT on separate days, one with and one without fluid loading (one liter of 0.9% saline solution). Stand tests (orthostatic stress) will be done before and after each HDT. Cardiac measures will be obtained with both impedance cardiography and echo ultrasound

Cowings, Patricia↗
NASA NTRS2010

Midodrine as a Countermeasure to Orthostatic Hypotension Immediately After Space Shuttle Landing

Midodrine prevents post-space flight orthostatic intolerance when testing is conducted in a controlled laboratory setting within 2-4 hours after Space Shuttle landing. It is unknown if midodrine is as effective during re-entry and immediately following landing. METHODS: Cardiovascular responses to 10 minutes of 80 head-up tilt in five male astronauts were compared before and immediately after Space Shuttle missions. Preflight tests were conducted in the Johnson Space Center Cardiovascular Laboratory without midodrine. Post-flight testing was performed in the Crew Transport Vehicle on the Space Shuttle runway within 60 minutes of landing; midodrine was self-administered before re-entry. Survival analysis was performed (Gehan-Breslow test) to compare presyncope rates pre- to post-flight. Cardiovascular responses (last minute standing minus supine) to tilt before and after space flight were compared using paired t-tests. RESULTS: Midodrine did not prevent post-flight orthostatic hypotension in two of the five astronauts, but the rate of presyncope across the group did not increase (p=0.17) from pre- to post-flight. Also, although the change in heart rate from supine to the last minute of standing was not affected by space flight, systolic blood pressure decreased more (p=0.05) and diastolic blood pressure tended to decrease (p=0.08) after space flight. CONCLUSIONS: Accurate interpretation of the current results requires that similar data be collected in control subjects (without midodrine) on the CTV. However, drug interaction concerns with commonly used anti-emetics and potentiation of prolonged QTc intervals observed in long duration astronauts make the routine use of midodrine for immediate post-flight orthostatic hypotension unlikely. 2

Platts, Steven H.↗
NASA NTRS2000

Deconditioning and Reconditioning: Humans in Stressful Environments

Deconditioning is an integrated physiological response of the body to a reduction in metabolic rate; that is, to a reduction in energy use or in exercise level. While it may involve assumption of a horizontal body position, it certainly perturbs bodily homeostasis - at least temporarily. The reduction in physical activity that causes deconditioning is often associated with an increase in the time spent, for whatever reason, in a sitting or horizontal position. As a result, orthostatic factors may also contribute to the deconditioning mechanism. The word decondition may be defined as "1: to cause extinction of (a conditioned response) 2: to cause to lose physical fitness". This definition implies that psychological/emotional factors may accompany physical deconditioning, and it is this interpretation of the word that is used throughout this volume. It is apparent that deconditioning plays a major role in the mechanism of the general adaptive (homeostatic) response that is initiated by exposure to prolonged bed rest (BR). And the total homeostatic response to BR involves more than deconditioning per se. For example, it has been shown that the restoration of plasma volume and maximal work capacity after 4 weeks of BR deconditioning left other bodily functions (submaximal exercise oxygen uptake and cardiac output, leg proprioception and posterior leg muscle thickness and volume, head-up tilt tolerance, and sleep quality) functioning at decreased levels. The precise effect of deconditioning on BR homeostasis is difficult to determine, because the fundamental interactive neuro-endocrine-immune control networks that facilitate conditioning and deconditioning also act to maintain basic wholebody homeostasis. For example, is the mechanism of BR-induced deconditioning independent of the mechanism that provokes concomitant orthostatic intolerance; that is, fainting? Assumption of the recumbent body position for prolonged periods of time, results in a new adaptive-homeostatic state. This state occurs in response to the mutually interactive effects of the change in bodily position (hydrostatic pressure), to the virtual elimination of longitudinal pressure on the bones, to the increased confinement with possible reduction in total daily energy (exercise) expenditure, to the reorientation of stimuli within the vestibular organs, and (often) to altered socio-psychological conditions. The exercise-training (reconditioning) syndrome affects total body homeostasis by facilitating increases in work capacity and endurance, whereas deconditioning decreases physical performance. There are many interrelated factors that influence the control parameters that seek to maintain the adaptive conditioning-deconditioning syndrome. These control parameters can be better elucidated by subjecting otherwise healthy ambulatory people to various stresses, such as exercise training and prolonged spaceflight, bed rest, water immersion, hyperbaria, and isolation and confinement. Changes in control parameters will be manifested in muscle function, orthostatic tolerance, cardiorespiratory responses, musculo-skeletal systems, free-radical processes, and body thermoregulation with overarching effects on the subjects' psycho-sociological states. A discussion of these factors and the control parameters constitutes the substance of this volume. Special emphasis is placed on delineating practical applications of the findings that will be of special interest to physicians, nurses, and other health-care workers.

Greenleaf, John E.↗
NASA NTRS1999

Cardiovascular Deconditioning

Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

Charles, John B.↗
NASA NTRS2002

Human muscle sympathetic neural and haemodynamic responses to tilt following spaceflight

Orthostatic intolerance is common when astronauts return to Earth: after brief spaceflight, up to two-thirds are unable to remain standing for 10 min. Previous research suggests that susceptible individuals are unable to increase their systemic vascular resistance and plasma noradrenaline concentrations above pre-flight upright levels. In this study, we tested the hypothesis that adaptation to the microgravity of space impairs sympathetic neural responses to upright posture on Earth. We studied six astronauts approximately 72 and 23 days before and on landing day after the 16 day Neurolab space shuttle mission. We measured heart rate, arterial pressure and cardiac output, and calculated stroke volume and total peripheral resistance, during supine rest and 10 min of 60 deg upright tilt. Muscle sympathetic nerve activity was recorded in five subjects, as a direct measure of sympathetic nervous system responses. As in previous studies, mean (+/- S.E.M.) stroke volume was lower (46 +/- 5 vs. 76 +/- 3 ml, P = 0.017) and heart rate was higher (93 +/- 1 vs. 74 +/- 4 beats min(-1), P = 0.002) during tilt after spaceflight than before spaceflight. Total peripheral resistance during tilt post flight was higher in some, but not all astronauts (1674 +/- 256 vs. 1372 +/- 62 dynes s cm(-5), P = 0.32). No crew member exhibited orthostatic hypotension or presyncopal symptoms during the 10 min of postflight tilting. Muscle sympathetic nerve activity was higher post flight in all subjects, in supine (27 +/- 4 vs. 17 +/- 2 bursts min(-1), P = 0.04) and tilted (46 +/- 4 vs. 38 +/- 3 bursts min(-1), P = 0.01) positions. A strong (r(2) = 0.91-1.00) linear correlation between left ventricular stroke volume and muscle sympathetic nerve activity suggested that sympathetic responses were appropriate for the haemodynamic challenge of upright tilt and were unaffected by spaceflight. We conclude that after 16 days of spaceflight, muscle sympathetic nerve responses to upright tilt are normal.

Non-NASA Center↗
NASA NTRS2002

Impaired pulmonary artery contractile responses in a rat model of microgravity: role of nitric oxide

Vascular contractile hyporesponsiveness is an important mechanism underlying orthostatic intolerance after microgravity. Baroreceptor reflexes can modulate both pulmonary resistance and capacitance function and thus cardiac output. We hypothesized, therefore, that pulmonary vasoreactivity is impaired in the hindlimb-unweighted (HLU) rat model of microgravity. Pulmonary artery (PA) contractile responses to phenylephrine (PE) and U-46619 (U4) were significantly decreased in the PAs from HLU vs. control (C) animals. N(G)-nitro-L-arginine methyl ester (10(-5) M) enhanced the contractile responses in the PA rings from both C and HLU animals and completely abolished the differential responses to PE and U4 in HLU vs. C animals. Vasorelaxant responses to ACh were significantly enhanced in PA rings from HLU rats compared with C. Moreover, vasorelaxant responses to sodium nitroprusside were also significantly enhanced. Endothelial nitric oxide synthase (eNOS) and soluble guanlyl cyclase expression were significantly enhanced in PA and lung tissue from HLU rats. In marked contrast, the expression of inducible nitric oxide synthase was unchanged in lung tissue. These data support the hypothesis that vascular contractile responsiveness is attenuated in PAs from HLU rats and that this hyporesponsiveness is due at least in part to increased nitric oxide synthase activity resulting from enhanced eNOS expression. These findings may have important implications for blood volume distribution and attenuated stroke volume responses to orthostatic stress after microgravity exposure.

Non-NASA Center↗
NASA NTRS1966

Cardiovascular conditioning

Pulsatile leg cuffs effectiveness in lessening postflight orthostatic intolerance and blood pooling in lower extremities of Gemini 5 and 7 astronauts

Dietlein, L. F.↗
NASA NTRS1973

The development of an elastic reverse gradient garment to be used as a countermeasure for cardiovascular deconditioning

Using a new Nomex-Lycra elastic fabric and individualized garment engineering techniques, reverse gradient garments (RGG's) were designed, constructed, and tested for effectiveness as a countermeasure against cardiovascular deconditioning. By combining torso-compensated positive pressure breathing with a distally diminishing gradient of counterpressure supplied by the elastic fabric on the limbs, the RGG acts to pool blood in the extremities of recumbent persons much as though they were standing erect in 1 g. It was theorized that through the use of a dynamic pressurization scheme, the RGG would stress the vasculature in a fashion similar to that experienced by the noramlly active man, hence preventing or limiting the development of post-weightlessness orthostatic intolerance and related conditions. Four male, college-age subjects received daily treatments with the RGG during a 15-day bedrest study. Four additional subjects also underwent the bedrest, but received no treatments; they served as controls. The design and construction of the garments are described, and results of the treatment related measurements are given.

Annis, J. F.↗
NASA NTRS1974

The metabolic and hemodynamic effects of prolonged bed rest in normal subjects

Investigation in six normal subjects of the effects of chronic bed rest on the interrelationships between cardiovascular hemodynamics, catecholamine metabolism, vascular reactivity, renin and aldosterone activity, and electrolyte and fluid balance. Negative sodium and potassium balances and reductions in plasma volume were observed in all subjects, but plasma renin activity and aldosterone secretory rate showed no significant change. Other findings included the observation that major decreases in sodium balance and plasma volume occurred in the early bed rest period and did not correlate closely with the degree of orthostatic intolerance.

Chobanian, A. V.↗
NASA NTRS1975

Skylab experiment M-092 - Results of the first manned mission

Blood pressure, heart rate, and percentage increase in leg volume were continuously recorded for the Inflight Lower Body Negative Pressure (LBNP) experiment conducted during the first manned Skylab mission. Data were collected over a 5-month preflight period as well as at approximately 3-day intervals throughout the mission. Individual variations in cardiovascular responses to LBNP during the preflight period continued to be demonstrated inflight, and measurements of the calf showed that a large volume of fluid was shifted out of the legs early in the flight. A much greater increase in leg volume occurred during inflight LBNP than in preflight tests. Resting heart rates tended to be low early in the flight and to increase slightly as it progressed, while resting blood pressure varied. The LBNP protocol was a greater stress inflight, and the tests had to be stopped early on three occasions due to impending syncopal reactions. Inflight LBNP responses seemed to predict the degree of postflight orthostatic intolerance. Postflight responses to LBNP during the first 48 hours were characterized by marked elevations in heart rate, instability in blood pressure, and considerably elevated systolic and diastolic pressures both at rest and during stress.

Johnson, R. L.↗
NASA NTRS1976

Report of 14-day bedrest simulation of Skylab

Part one of a two-phase bedrest project in which the physiological effects of weightlessness were simulated is presented. The project was designed to approximate the medical testing and dietary control of Skylab. The test period included a three week pre-flight period, a two week bedrest period and a two week post-flight period. The test subjects ate measured amounts of the Skylab diet and drank deionized water to recreate the metabolic balance studies of Skylab. The medical testing program, pre- and postbedrest, was similar to that of Skylab including: lower body negative pressure testing the orthostatic intolerance noted after both spaceflights and bedrest, bicycle ergometry testing the cardiovascular response to graded exercise, postural equilibrium, vestibular studies and electromyograms. Fluid and electrolyte shifts and balance were documented with intake and output records and radionuclide studies. The subjects were observed by a psychiatrist who watched for signs of mental stress in the test environment and changes in mental status.

Johnson, P. C.↗
NASA NTRS1977

Evaluation of the electromechanical properties of the cardiovascular system after prolonged weightlessness

Devices and techniques for measuring and analyzing systolic time intervals and quantitative phonocardiograms were initiated during Apollo 17. The data show that the systolic time interval from Apollo 17 crewmen remained elevated longer postflight than the response criteria of heart rate, blood pressure, and percent change in leg volume all of which had returned to preflight levels by the second day postflight. Although the systolic time interval values were only slightly outside the preflight fiducial limits, this finding suggested that: the analysis of systolic time intervals may help to identify the mechanisms of postflight orthostatic intolerance by virtue of measuring ventricular function more directly and, the noninvasive technique may prove useful in determining the extent and duration of cardiovascular instability after long duration space flight. The systolic time intervals obtained on the Apollo 17 crewmen during lower body negative pressure were similar to those noted in patients with significant heart disease.

Bergman, S. A., Jr.↗
NASA NTRS1975

Study report on combining diagnostic and therapeutic considerations with subsystem and whole-body simulation

Current applications of simulation models for clinical research described included tilt model simulation of orthostatic intolerance with hemorrhage, and modeling long term circulatory circulation. Current capabilities include: (1) simulation of analogous pathological states and effects of abnormal environmental stressors by the manipulation of system variables and changing inputs in various sequences; (2) simulation of time courses of responses of controlled variables by the altered inputs and their relationships; (3) simulation of physiological responses of treatment such as isotonic saline transfusion; (4) simulation of the effectiveness of a treatment as well as the effects of complication superimposed on an existing pathological state; and (5) comparison of the effectiveness of various treatments/countermeasures for a given pathological state. The feasibility of applying simulation models to diagnostic and therapeutic research problems is assessed.

Furukawa, S.↗
NASA NTRS1979

Cardiovascular regulatory response to lower body negative pressure following blood volume loss

An attempt is made to explain the cardiovascular regulatory responses to lower body negative pressure (LBNP) stress, both in the absence of and following blood or plasma volume loss, the latter being factors regularly observed with short- or long-term recumbency or weightlessness and associated with resulting cardiovascular deconditioning. Analytical expressions are derived for the responses of mean venous pressure and blood volume pooled in the lower body due to LBNP. An analysis is presented for determining the HR change due to LBNP stress following blood volume loss. It is concluded that the reduced orthostatic tolerance following long-term space flight or recumbency can be mainly attributed to blood volume loss, and that the associated cardiovascular responses characterizing this orthostatic intolerance is elicited by the associated central venous pressure response.

Shimizu, M.↗
NASA NTRS1980

The development of an elastic reverse gradient garment to be used as a countermeasure for cardiovascular deconditioning

Using a new nomex lycra elastic fabric and individualized garment engineering techniques, reverse gradient garments (RGG's) were designed, constructed, and tested for effectiveness as a countermeasure against cardiovascular deconditioning. By combining torso compensated positive pressure breathing with a distally diminishing gradient of counterpressure supplied by the elastic fabric on the limbs, the RGG acts to pool blood in the extremities of recumbent persons much as though they were standing erect in 1 g. The RGG stresses the vasculature in a fashion similar to that experienced by the normally active man, hence preventing or limiting the development of post weightlessness orthostatic intolerance and related conditions. Four male, college age subjects received daily treatments with the RGG during a 15 day bedrest study. Four additional subjects also underwent the bedrest, but received no treatments; they served as controls. The preliminary indication was that the RGG was somewhat effective in limiting the deconditioning process.

Annis, J. F.↗
NASA NTRS1982

Cardiovascular responses to weightlessness and ground-based simulations

Mission experience, from NASA and Soviet programs, on human cardiovascular responses to weightlessness, and the ability of bed rest studies to simulate these are discussed. In-flight effects include fluid shift to the upper body, decreased heart size, bone demineralization, orthostatic intolerance, and loss of exercise tolerance. All the cardiovascular changes that occur with weightlessness also occur with prolonged bed rest. They are most manifest when subjects stand suddenly, or undergo tilting or lower body negative pressure. The mechanisms which control these responses, e.g., the role of the central nervous system, are unclear.

Sandler, H.↗