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NASA NTRS2016

Crew Exploration Vehicle (CEV) (Orion) Occupant Protection

Dr. Nancy J. Currie, of the NASA Engineering and Safety Center (NESC), Chief Engineer at Johnson Space Center (JSC), requested an assessment of the Crew Exploration Vehicle (CEV) occupant protection as a result of issues identified by the Constellation Program and Orion Project. The NESC, in collaboration with the Human Research Program (HRP), investigated new methods associated with occupant protection for the Crew Exploration Vehicle (CEV), known as Orion. The primary objective of this assessment was to investigate new methods associated with occupant protection for the CEV, known as Orion, that would ensure the design provided minimal risk to the crew during nominal and contingency landings in an acceptable set of environmental and spacecraft failure conditions. This documents contains the outcome of the NESC assessment. NASA/TM-2013-217380, "Application of the Brinkley Dynamic Response Criterion to Spacecraft Transient Dynamic Events." supercedes this document.

Currie-Gregg, Nancy J.↗

NASA NTRS2015

International Space Station (ISS) Anomalies Trending Study

The NASA Engineering and Safety Center (NESC) set out to utilize data mining and trending techniques to review the anomaly history of the International Space Station (ISS) and provide tools for discipline experts not involved with the ISS Program to search anomaly data to aid in identification of areas that may warrant further investigation. Additionally, the assessment team aimed to develop an approach and skillset for integrating data sets, with the intent of providing an enriched data set for discipline experts to investigate that is easier to navigate, particularly in light of ISS aging and the plan to extend its life into the late 2020s. This report contains the outcome of the NESC Assessment.

Beil, Robert J.↗

NASA NTRS2012

Bringing Together Users and Developers of Forest Biomass Maps

Forests store carbon and thus represent important sinks for atmospheric carbon dioxide. Reducing uncertainty in current estimates of the amount of carbon in standing forests will improve precision of estimates of anthropogenic contributions to carbon dioxide in the atmosphere due to deforestation. Although satellite remote sensing has long been an important tool for mapping land cover, until recently aboveground forest biomass estimates have relied mostly on systematic ground sampling of forests. In alignment with fiscal year 2010 congressional direction, NASA has initiated work toward a carbon monitoring system (CMS) that includes both maps of forest biomass and total carbon flux estimates. A goal of the project is to ensure that the products are useful to a wide community of scientists, managers, and policy makers, as well as to carbon cycle scientists. Understanding the needs and requirements of these data users is helpful not just to the NASA CMS program but also to the entire community working on carbon-related activities. To that end, this meeting brought together a small group of natural resource managers and policy makers who use information on forests in their work with NASA scientists who are working to create aboveground forest biomass maps. These maps, derived from combining remote sensing and ground plots, aim to be more accurate than current inventory approaches when applied at local and regional scales. Meeting participants agreed that users of biomass information will look to the CMS effort not only to provide basic data for carbon or biomass measurements but also to provide data to help serve a broad range of goals, such as forest watershed management for water quality, habitat management for biodiversity and ecosystem services, and potential use for developing payments for ecosystem service projects. Participants also reminded the CMS group that potential users include not only public sector agencies and nongovernmental organizations but also the private sector because much forest acreage in the United States is privately held and needs data for forest management. Additional key outcomes identified by meeting participants include the following: (1) Priority should be given to building into the biomass product ease of use and low costs (including costs of hardware, software, and analysis requirements), (2) CMS products should also be relevant to other biomass measures for forest watershed management, habitat protection for biodiversity, and assessment of markets for ecosystem services, (3) CMS leadership should engage with the Subsidiary Body for Scientific and Technological Advice of the United Nations Framework Convention on Climate Change as they establish measuring, reporting, and verification standards, and (4) CMS leadership should continue to keep sister agencies and other organizations informed as CMS develops, particularly via the agencies active in the U.S. Global Change Research Program Carbon Cycle Interagency Working Group (U.S. Geological Survey, U.S. Department of Agriculture, and National Oceanic and Atmospheric Administration) and nongovernmental organizations.

Forest↗

NASA NTRS2011

Cable Tester Box

Cables are very important electrical devices that carry power and signals across multiple instruments. Any fault in a cable can easily result in a catastrophic outcome. Therefore, verifying that all cables are built to spec is a very important part of Electrical Integration Procedures. Currently, there are two methods used in lab for verifying cable connectivity. (1) Using a Break-Out Box and an ohmmeter this method is time-consuming but effective for custom cables and (2) Commercial Automated Cable Tester Boxes this method is fast, but to test custom cables often requires pre-programmed configuration files, and cables used on spacecraft are often uniquely designed for specific purposes. The idea is to develop a semi-automatic continuity tester that reduces human effort in cable testing, speeds up the electrical integration process, and ensures system safety. The JPL-Cable Tester Box is developed to check every single possible electrical connection in a cable in parallel. This system indicates connectivity through LED (light emitting diode) circuits. Users can choose to test any pin/shell (test node) with a single push of a button, and any other nodes that are shorted to the test node, even if they are in the same connector, will light up with the test node. The JPL-Cable Tester Boxes offers the following advantages: 1. Easy to use: The architecture is simple enough that it only takes 5 minutes for anyone to learn how operate the Cable Tester Box. No pre-programming and calibration are required, since this box only checks continuity. 2. Fast: The cable tester box checks all the possible electrical connections in parallel at a push of a button. If a cable normally takes half an hour to test, using the Cable Tester Box will improve the speed to as little as 60 seconds to complete. 3. Versatile: Multiple cable tester boxes can be used together. As long as all the boxes share the same electrical potential, any number of connectors can be tested together.

Lee, Jason H.↗

NASA NTRS2009

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Kerstman, Eric↗

NASA NTRS1991

Space physics strategy: Implementation study. Volume 2: Program plan

In June, 1989, the Space Science and Applications Advisory Committee (SSAAC) authorized its Space Physics Subcommittee (SPS) to prepare a plan specifying the future missions, launch sequence, and encompassing themes of the Space Physics Division. The plan, now complete, is the product of a year-long study comprising two week-long workshops - in January and June 1990 - assisted by pre-workshop, inter-workshop, and post-workshop preparation and assessment activities. The workshops engaged about seventy participants, drawn equally from the Division's four science disciplines: cosmic and heliospheric physics, solar physics, magnetosphere physics, and ionosphere-thermosphere-mesospheric physics. An earlier report records the outcome of the first workshop; this is the report of the final workshop.

Source record↗

NASA NTRS2016

ROS Hexapod

As an intern project for NASA Johnson Space Center (JSC), my job was to familiarize myself and operate a Robotics Operating System (ROS). The project outcome will convert existing software assets into ROS using nodes, enabling a robotic Hexapod to communicate and to be functional and controlled by an existing PlayStation 3 (PS3) controller. Existing control algorithms and current libraries have no ROS capabilities within the Hexapod C++ source code. Conversion of C++ codes to ROS will enable existing code to be compatible with ROS, and will be controlled using existing PS3 controller. Furthermore, my job description is to design ROS messages and script programs which will enable assets to participate in the ROS ecosystem. In addition, an open source software (IDE) Arduino board will be integrated in the ecosystem with designing circuitry on a breadboard to add additional behavior with push buttons, potentiometers and other simple elements in the electrical circuitry. Other projects with the Arduino will be a GPS module digital clock that will run off 22 satellites to show accurate real time using a GPS signal and internal patch antenna to communicate with satellites.

Davis, Kirsch↗

NASA NTRS2001

Evaluation of NCAR Icing/SLD Forecasts, Tools and Techniques Used During The 1998 NASA SLD Flight Season

Supercooled Large Droplet (SLD) icing conditions were implicated in at least one recent aircraft crash, and have been associated with other aircraft incidents. Inflight encounters with SLD can result in ice accreting on unprotected areas of the wing where it can not be removed. Because this ice can adversely affect flight characteristics of some aircraft, there has been concern about flight safety in these conditions. The FAA held a conference on in-flight icing in 1996 where the state of knowledge concerning SLD was explored. One outcome of these meetings was an identified need to acquire SLD flight research data, particularly in the Great Lakes Region. The flight research data was needed by the FAA to develop a better understanding of the meteorological characteristics associated with SLD and facilitate an assessment of existing aircraft icing certification regulations with respect to SLD. In response to this need, NASA, the Federal Aviation Administration (FAA), and the National Center for Atmospheric Research (NCAR) conducted a cooperative icing flight research program to acquire SLD flight research data. The NASA Glenn Research Center's Twin Otter icing research aircraft was flown throughout the Great Lakes region during the winters of 1996-97 and 1997-98 to acquire SLD icing and meteorological data. The NASA Twin Otter was instrumented to measure cloud microphysical properties (particle size, LWC (Liquid Water Content), temperature, etc.), capture images of wing and tail ice accretion, and then record the resultant effect on aircraft performance due to the ice accretion. A satellite telephone link enabled the researchers onboard the Twin Otter to communicate with NCAR meteorologists. who provided real-time guidance into SLD icing conditions. NCAR meteorologists also provided preflight SLD weather forecasts that were used to plan the research flights, and served as on-board researchers. This document contains an evaluation of the tools and techniques NCAR forecasters used to predict the location of SLD icing conditions during the winter of 1997-1998. The objectives of this report are to: (1) assess the tools used to forecast in-flight icing. (2) assess the success/failure rate of the forecasts, and (3) discuss suggested changes to forecast techniques.

Bernstein, Ben C.↗

NASA NTRS2005

Evaluation of radioisotope electric propulsion for selected interplanetary science missions

This study assessed the benefits and applicability of REP to missions relevant to the In-Space Propulsion Program (ISPP) using first and second generation RPS with specific powers of 4 We/kg and 8 We/kg, respectively. Three missions representing small body targets, medium outer planet class, and main belt asteroids and comets were evaluated. Those missions were a Trojan Asteroid Orbiter, Comet Surface Sample Return (CSSR), and Jupiter Polar Orbiter with Probes (JPOP). For each mission, REP cost and performance was compared with solar electric propulsion system (SEPS) and SOA chemical propulsion system (SCPS) cost and performance. The outcome of the analysis would be a determinant for potential inclusion in the ISPP investment portfolio.

trojan asteroid↗

NASA NTRS2019

Large Male Anthropomorphic Test Device (ATD) Finite Element Model (FEM) Correlation Improvement

As part of an activity for the Commercial Crew Program (CCP), a NASA Engineering and Safety Center (NESC) team conducted tests of small female, medium male, and large male Hybrid III anthropomorphic test device (ATD) head-neck complexes. The results were compared to simulation results from ATD finite element model (FEM) predictions to determine the validity and fidelity of ATD models for use in certifying CCP vehicles. The NESC was requested to help improve the large male ATD FEM to better represent physical responses. This report contains the outcome of the NESC assessment.

Kelly, Michael J.↗

NASA NTRSDate not supplied

Sensitivity Analysis of the Human Research Program’s Impact 1.0 Model

Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Leave One Out (LOO) are methods of conducting sensitivity analysis on non-linear simulation models like the IMPACT Model. The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The “partial” part is due to the adjustments made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. LOO removes a medical condition from test suite and calculates the change in the outcome. This is used to identify the influence of the condition input in the model The inputs to the sensitivity procedures include the number of occurrences of each of the one hundred plus IMPACT medical conditions generated over the simulations, and the IMPACT outputs from the MEDPRAT mathematical model. The outputs total task time lost (TTL), number of return to definitive care (RTDC), and number of loss of crew lives (LOCL). The IMPACT team will report the results of using PRCC and LOO on IMPACT 1.0. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty, and input values could drive changes in overall model output uncertainty. These efforts are an integral part of the overall verification, validation, and credibility review of IMPACT 1.0.

Sensitivity Anaylsis↗

NASA NTRS2012

Performance Data Report: Space Medicine Division, Human Research Program, Behavioural Health and Performance Research Element

This report is the result of a collaborative effort between NASA?s Behavioral Health & Performance (BHP) Research and Operations Group to investigate and determine the availability of data pertaining to behavioral performance (and other pertinent variables) that have been collected by the laboratories at NASA?s Johnson Space Center. BHP?s Operations and Research groups collaborated to systematically identify what types of performance data are needed in relevant BHP performance domains and also to conduct structured interviews with NASA personnel to identify which data do or do not exist currently (and for instances where such data exist, to evaluate the type, quality, accessibility, and confidentiality of those data). The authors defined outcome categories of performance that encapsulate BHP performance domains, mapped BHP Research Risks and Gaps onto those performance outcome categories, and identified and prioritized indicators for each outcome category. The team identified key points of contact (subject matter experts [SMEs]) as potential interviewees, created a template for structured interview questions about sources and accessibility of performance data, and coordinated and conducted structured interviews with the SMEs. The methodology, results, and implications of this effort, as well as forward work needed, are discussed in this report.

Shea, Camille↗

NASA NTRS1992

The adult literacy evaluator: An intelligent computer-aided training system for diagnosing adult illiterates

An important part of NASA's mission involves the secondary application of its technologies in the public and private sectors. One current application being developed is The Adult Literacy Evaluator, a simulation-based diagnostic tool designed to assess the operant literacy abilities of adults having difficulties in learning to read and write. Using ICAT system technology in addition to speech recognition, closed-captioned television (CCTV), live video and other state-of-the art graphics and storage capabilities, this project attempts to overcome the negative effects of adult literacy assessment by allowing the client to interact with an intelligent computer system which simulates real-life literacy activities and materials and which measures literacy performance in the actual context of its use. The specific objectives of the project are as follows: (1) To develop a simulation-based diagnostic tool to assess adults' prior knowledge about reading and writing processes in actual contexts of application; (2) to provide a profile of readers' strengths and weaknesses; and (3) to suggest instructional strategies and materials which can be used as a beginning point for remediation. In the first and developmental phase of the project, descriptions of literacy events and environments are being written and functional literacy documents analyzed for their components. Examples of literacy events and situations being considered included interactions with environmental print (e.g., billboards, street signs, commercial marquees, storefront logos, etc.), functional literacy materials (e.g., newspapers, magazines, telephone books, bills, receipts, etc.) and employment related communication (i.e., job descriptions, application forms, technical manuals, memorandums, newsletters, etc.). Each of these situations and materials is being analyzed for its literacy requirements in terms of written display (i.e., knowledge of printed forms and conventions), meaning demands (i.e., comprehension and word knowledge) and social situation. From these descriptions, scripts are being generated which define the interaction between the student, an on-screen guide and the simulated literacy environment. The proposed outcome of the Evaluator is a diagnostic profile which will present broad classifications of literacy behaviors across the major areas of metacognitive abilities, word recognition, vocabulary knowledge, comprehension and writing. From these classifications, suggestions for materials and strategies for instruction with which to begin corrective action will be made. The focus of the Literacy Evaluator will be essentially to provide an expert diagnosis and an interpretation of that assessment which then can be used by a human tutor to further design and individualize a remedial program as needed through the use of an authoring system.

Yaden, David B., Jr.↗

NASA NTRS2006

What Happened, and Why: Toward an Understanding of Human Error Based on Automated Analyses of Incident Reports

The objective of the Aviation System Monitoring and Modeling project of NASA's Aviation Safety and Security Program was to develop technologies to enable proactive management of safety risk, which entails identifying the precursor events and conditions that foreshadow most accidents. Information about what happened can be extracted from quantitative data sources, but the experiential account of the incident reporter is the best available source of information about why an incident happened. In Volume I, the concept of the Scenario was introduced as a pragmatic guide for identifying similarities of what happened based on the objective parameters that define the Context and the Outcome of a Scenario. In this Volume II, that study continues into the analyses of the free narratives to gain understanding as to why the incident occurred from the reporter s perspective. While this is just the first experiment, the results of our approach are encouraging and indicate that it will be possible to design an automated analysis process guided by the structure of the Scenario that can achieve the level of consistency and reliability of human analysis of narrative reports.

Ferryman, Thomas A.↗

NASA NTRS2014

Scalable Asset Discovery, Vulnerability Scanning, and Penetration Testing for Remote Sites and Wireless Spectrums Utilizing an Embedded Linux Plug - PwniPlug and the Raspberry Pi B+ as a Sample Pen Test

All devices attached to the NASA KSC network are subject to security vulnerability scanning and/or penetration testing. In today's changing environment, vulnerable and/or unprotected systems can easily be overlooked. Systems that are not properly managed can become a potential threat to the operational integrity of our systems and networks. This includes all NASA (internal and external) information systems within NASA KSC Internet Protocol (IP) address space, and NASA KSC facilities. The Office of the Chief Information Officer (OCIO) recommends that all NASA Centers and information systems be subject to penetration testing on a regular interval in accordance with the guidelines identified by the National Institute of Standards and Technology (NIST). (ITS-HBK-2810.04-02A) Protecting information and equipment at NASA is an area of increasing concern. In addition to the CPU's on the network; Supervisory, Control and Data Acquisition (SCADA) systems are especially vulnerable because these systems have lacked standards, use embedded controllers with little computational power and informal software, are connected to physical processes, have few operators, and are increasingly also being connected to corporate networks. The scope of work is comprised of several individual components which together build upon previous work by Drew Branch, NASA KSC Intern. The Pwn Plug is the selected COTS (Commercial-Off-The-Shelf) device chosen to test simplification of mandatory IT Security tasks. The device will be utilized to provide services to NASA KSC and enable an assessment of infrastructure soundness and regulatory compliance in an efficient, economical, and business responsive manner. The Pwn Plug is designed as a pen testing appliance which provides a hardware platform that can support commercial penetration testing efforts at significantly reduced costs. The expected outcomes are: 1) External Penetration Testing, 2) Social Engineering, 3) Procedural Documentation, 4) Recommended Remediation Action Plan, 5) System Retest & Remediation Attestation and 6) Final Reports, out briefing and Presentation. Due to physical and material constraints beyond intern and mentor control, the project was redefined as a working pen-test scenario. Limitations of lab availability and tools dictated an academic exercise. This report was developed within the scenario guidelines suggested by the project mentor. The guidelines were to be creative in developing a Pen Test program for a client.

Penetration Testing↗

NASA NTRSDate not supplied

Functional Task Tests in Partial Gravity During Parabolic Flight

BACKGROUND Critical mission tasks required by crews immediately after landing on a planetary surface include walking, jumping, and egressing from a seat. Understanding how these functional tasks are performed in partial gravity such as on the moon or Mars is necessary to define effective and comprehensive countermeasure strategies for preserving crew performance during exploration-class missions. We propose to study the performance of these tasks during the partial gravity phases of parabolic flight. These tasks will be performed using the same equipment and procedures as those used with astronauts returning from spaceflight and with ground-based subjects after prolonged axial body unloading during bed rest (sensorimotor standard measures). HYPOTHESIS We hypothesize that partial gravity during parabolic flight will cause acute changes in vestibular, proprioceptive, and sensorimotor functions, and these changes will impact the performance of mission critical tasks such as standing, walking, and jumping. The largest changes in performance are expected at the lowest gravity level (0.25g) because subjects will no longer be able to use the gravitational reference for the perception of upright. Ultimately, this information could be used to assess performance risks and inform the design of countermeasures for NASA exploration-class human missions. METHODS Twelve subjects will be tested during three flights of 30 parabolas, including 10 parabolas at 0.25g, 10 parabolas at 0.5g, and 10 parabolas at 0.75g. Subjects also will perform tests in 1g between parabolas. The tasks will be the same as those tested on astronauts returning from spaceflight: sit-to-stand with obstacle walk, tandem rail balance, jump down, and recovery from fall. Measurements will include: (a) time to test completion (sit-to-stand with obstacle walk, recovery from fall); (b) time elapsed between the start of motion and the stabilization of upright posture (recovery from fall, jump down); (c) mean sway speed during quiet standing (recovery from fall, jump down); (d) changes in heart rate and blood pressure (recovery from fall); (e) balance time and torso accelerations (tandem rail balance); (f) cone of stability (jump down); and (g) severity of motion sickness symptoms. RELEVANCE Although gravitational dose-response curves have been obtained for some biochemical systems in animals, these dose-responses are unknown for most human physiologic systems. Our study will compare the outcomes of four functional task tests in 0.25g, 0.5g, 0.75g, and 1g with those previously obtained in ground-based subjects after prolonged axial body unloading and in astronauts immediately after spaceflight. These comparisons will help us understand the true extent of functional task performance deficits in partial gravity. The dose-response relationship between gravity level and task performance decrement also will help determining the gravity threshold for these functional tasks. ACKNOWLEDGEMENT This work is supported by the NASA’s Human Research Program Human Health Countermeasures Element.

T. R. Macaulay↗

NASA NTRSDate not supplied

Functional Task Tests in Partial Gravity During Parabolic Flight

BACKGROUND Critical mission tasks that are required by crews immediately after landing on a planetary surface are seat egress, jump, and walk. To be able to define an effective and comprehensive countermeasure strategy for preserving crew performance during exploration-class missions, there is a need to understand how these functional tasks are actually performed in partial gravity such as on the Moon or Mars. We propose to study the performance in the execution of these tasks during the partial gravity and hypergravity phases of parabolic flight. These tasks will be completed using the same equipment and procedures as the Standard Measures Sensorimotor protocol, which is performed by astronauts returning from spaceflight and by ground-based subjects after prolonged axial body unloading during bed rest. HYPOTHESIS We hypothesize that partial gravity during parabolic flight will cause acute changes in vestibular, proprioceptive, and sensorimotor functions, and these changes will impact the performance of mission critical tasks such as standing, walking, and jumping. The largest changes in performance are expected at the lowest gravity level (0.25g) because subjects will no longer be able to use the gravitational reference for the perception of vertical. Ultimately, this information could be used to assess performance risks and inform the design of countermeasures for NASA exploration-class human missions. METHODS Twelve subjects will be tested during three flights of 30 parabolas, including 10 parabolas at 0.25g, 10 parabolas at 0.5g and 10 parabolas at 0.75g. Subject also will perform tests in 1g between parabolas and in hypergravity (1.8g) during the pull-out phases. Subjects will perform the same tasks as those tested on astronauts returning from spaceflight: sit-to-stand and obstacle walk, tandem walk, jump down, and recovery from fall. Measurements will include: (a) the time for the subject to complete the test (sit-to-stand and obstacle walk, recovery from fall); (b) the time elapsed between the start of motion and the stabilization of upright posture (recovery from fall, jump down); (c) the mean sway speed during quiet standing (recovery from fall, jump down); (d) changes in heart rate and blood pressure (recovery from fall); (e) the percentage of correct steps and torso acceleration (tandem walk); and (f) the severity of motion sickness symptoms. RELEVANCE Although gravitational dose-response curves have been obtained for some biochemical systems in animals, these dose-responses are unknown for most human physiologic systems. Our study will compare the outcomes of 5 functional task tests in 0.25g, 0.5g, 0.75g, 1g, and 1.8g with those previously obtained in ground-based subjects after prolonged axial body unloading and in astronauts immediately after spaceflight. This comparison will help understanding the true extent of functional task performance deficits in partial gravity. The dose-response relationship between gravity level and task performance decrement also will help determining the gravity threshold for these functional tasks. ACKNOWLEDGEMENT This work is supported by the NASA’s Human Research Program Human Health Countermeasures Element

Gilles Clement↗

NASA NTRS2003

Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction

We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical myectomy. Echocardiograms were then analyzed in 19 patients at baseline and after ESR. Pulsed Doppler data through the mitral valve and pulmonary venous flow were obtained. CMM was used to obtain the flow propagation velocity (Vp) and to calculate IVPG off-line. Left atrial pressure was estimated with the use of previously validated Doppler equations. Data were compared before and after ESR. CMM-derived IVPG correlated well with invasive measurements obtained before and after surgical myectomy [r = 0.8, P < 0.01, Delta(CMM - invasive IVPG) = 0.09 +/- 0.45 mmHg]. ESR resulted in a decrease of resting LVOT systolic gradient from 62 +/- 10 to 29 +/- 5 mmHg (P < 0.001). There was a significant increase in the Vp and IVPG (from 48 +/- 5to 74 +/- 7 cm/s and from 1.5 +/- 0.2 to 2.6 +/- 0.3 mmHg, respectively, P < 0.001 for both). Estimated left atrial pressure decreased from 16.2 +/- 1.1 to 11.5 +/- 0.9 mmHg (P < 0.001). The increase in IVPG correlated with the reduction in the LVOT gradient (r = 0.6, P < 0.01). Reduction of LVOT obstruction after ESR is associated with an improvement in diastolic suction force. Noninvasive measurements of IVPG may be used as an indicator of diastolic function improvement in HOCM.

NASA Program Biomedical Research and Countermeasur↗