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Computer generated cathode ray tube display of diastolic and systolic ventricle shape during gravitational stress
Arterial circulatory system parameter identification from diastolic blood pressure curves by digital filter techniques
Operation of automatic blood pressure data system is described. Analog blood pressure signal is analyzed by three separate circuits, systolic, diastolic, and cycle defect. Digital computer output is displayed on teletype paper tape punch and video screen. Illustration of system is included.
A system is presented which will reduce analog cardiac performance data and convert the results to digital form for direct entry into a commercial time-shared computer. Circuits are discussed which perform the measurement and digital conversion of instantaneous systolic and diastolic parameters from the analog blood pressure waveform. Digital averaging over a selected number of heart cycles is performed on these measurements, as well as those of flow and heart rate. The determination of average cardiac output and peripheral resistance, including trends, is the end result after processing by digital computer.
Standard techniques for monitoring the acceleration-stressed human subject have been augmented by measuring (1) temporal, brachial and/or radial arterial blood flow, and (2) indirect systolic and diastolic blood pressure at 60-sec intervals. Results show that the response of blood pressure to positive accelerations is complex and dependent on an interplay of hydrostatic forces, diminishing venous return, redistribution of blood, and other poorly defined compensatory reflexes.
Exercise response tests were conducted preflight and postflight on Apollo missions 7 to 11. The primary objective of these tests was to detect any changes in the cardiopulmonary response to exercise that were associated with the space flight environment and that could have limited lunar surface activities. A heart-rate-controlled bicycle ergometer was used to produce three heart rate stress levels: 120 beats per minute for 6 minutes; 140 beats per minute for 3 minutes and 160 beats per minute per 3 minutes. Work load, blood pressure and respiratory gas exchange were measured during each stress level. Significant decreases were observed immediately postflight in the following dependent variables at a heart rate of 160 beats per minute: work load, oxygen consumption, systolic blood pressure, and diastolic blood pressure. No changes occurred in work efficiency at 100 watts or the ventilatory equivalent for oxygen at 2.0 liters per minute.
This study reports the design, implementation, and evaluation of a program attempting to reduce job stress by improving person-environment fit with respect to job aspects such as work load, responsibility, and interpersonal relationships. In order to assess the effects of the program, measures of both stress and strain were collected at three points in time--just prior to the program, immediately after the program, and three months after completion of the program. Measures of strain included systolic and diastolic blood pressure, determinations of glucose, cholesterol, and uric acid in the plasma, job satisfaction, and job related self-esteem. The findings were interpreted in light of both program incidents within specific experimental groups and general aspects of the program common to the experimental groups. Additional analyses indicated that both good person-environment fit with respect to participation predicts to good fit with respect to other job aspects over a three month interval and that stress causes strain, rather than the reverse.
Tolerance to positive g accelerations was measured in ten normal male subjects using both standard and advanced techniques. In addition to routine electrocardiogram, heart rate, respiratory rate, and infrared television, monitoring techniques during acceleration exposure included measurement of peripheral vision loss, noninvasive temporal, brachial, and/or radial arterial blood flow, and automatic measurement of indirect systolic and diastolic blood pressure at 60-sec intervals. Although brachial and radial arterial flow measurements reflected significant cardiovascular changes during and after acceleration, they were inconsistent indices of the onset of grayout or blackout. Temporal arterial blood flow, however, showed a high correlation with subjective peripheral light loss.
Self-measurements made by a 55-year-old physician with mild to moderate hypertension of ten years' duration are considered. The physician had been in excellent health until age 45 when sustained elevation of blood pressure up to 180/100 mmHg and a slight aortic diastolic murmur were noted. On the basis of the investigation it is suggested that physical and mental performance measures provide an objective basis for assessing the desirability of a given physiological change. Such studies will have to be complemented by a search for long-term effects.
The crew of the Skylab 4 Mission exhibited physiological changes during their 84-day mission that resembled but in several important areas did not reach the magnitude of changes exhibited in crewmen of the two earlier Skylab flights. At rest all three crewmen showed, in comparison to preflight levels, elevated mean systolic and pulse pressures and decreased mean diastolic and mean arterial pressures. Similar changes were seen in most Skylab 2 and Skylab 3 crewmen. While mean resting heart rates of both the Skylab 3 and Skylab 4 crews were elevated, those of the Skylab 2 crew were, however, lower than during preflight tests. Stressed heart rates followed previous patterns in being consistently elevated over preflight values. Postflight changes in cardiovascular parameters for the most part resembled those seen in previous crewmen of space missions. Their recovery to preflight limits occurred rapidly. In-flight data and subjective impressions of the crewmen confirmed that lower body negative pressure in weightlessness imposed a greater stress upon the cardiovascular system than in earth's gravity.
Decreased cardiothoracic transverse diameter ratios following Mercury, Gemini and Apollo space flights have been reported previously. To evaluate further changes in cardiac size, standard posteroanterior chest films in systole and diastole were obtained before flight and within a few hours after recovery on each of the Skylab astronauts. Postflight chest X-rays were visually compared to the preflight roentgenograms for possible changes in pulmonary vasculature, lung parenchyma, bony or soft tissue structures. From these roentgenograms the following measurements were obtained: cardiac and thoracic transverse diameters, cardiothoracic transverse diameter ratio, cardiac area from the product of both diagonal diameters, cardiac silhouette area by planimetry, thoracic cage area and cardiothoracic area ratio. The postflight frontal cardiac silhouette sizes were significantly decreased when compared with the respective preflight values (P0.05 or 0.01). The observed changes are thought to be related to postflight decrease in the intracardiac chamber volume.
Submaximal exercise stress tests were conducted preflight and postflight on the Apollo 14-17 crewmen. A bicycle ergometer was utilized to evoke target heart rates up to 160 beats/min while respiratory gas exchange, blood pressure, and cardiac output were measured. Three preflight tests were conducted during the month prior to flight to establish baseline values for postflight comparisons. Tachycardia was evidenced at rest and during exercise immediately postflight. This transitory tachycardia compensated for reduced stroke volume. Systolic blood pressure was reduced during exercise stress, but no consistent changes were observed in diastolic blood pressure. With the exception of the Apollo 15 crewmen, all crewmen had returned to preflight response levels by the day following recovery. No changes were observed in mechanical or respiratory efficiency immediately postflight.
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.
In the technique of arterio-arterial pumping, a volume of fluid is withdrawn from the aorta during systole and reinjected during diastole, thereby reducing the systolic pressure of the heart and adding energy to the systemic circulation. It is found that an upper bound for the effectiveness of such devices is given by a formula that considers stroke output of the unaided heart and the increment caused by the pump with a stroke. The division of effort of the pump between the reduction of pressure and the increase of flow depends on the physiological mechanical impedance of the heart. The total effect is, however, independent of the impedance.
An overview is given of basic features of biological rhythms. The classification of periodic behavior of physical and psychological characteristics as circadian, circannual, diurnal, and ultradian is discussed, and the notion of relativistic time as it applies in biology is examined. Special attention is given to circadian rhythms which are dependent on the adrenocortical cycle. The need for adequate understanding of circadian variations in the basic physiological indicators of an individual (heart rate, body temperature, systolic and diastolic blood pressure, etc.) to ensure the effectiveness of prophylactic and therapeutic measures is stressed.
The relationships between two behavioral patterns, cardiac risk factors, and coronary heart disease are investigated. Risk factors used in the analysis were family history of coronary disease, smoking, cholesterol, obesity, systotic blood pressure, diastolic blood pressure, blood sugar, uric acid, erythrocyte sedimentation rate, and white blood unit. It was found that conventional, non-behavioral pattern risk factors alone were not significantly related to coronary heart disease.
By taking advantage of the capabilities of echocardiography to measure noninvasively left ventricular volume, stroke volume, and ejection fraction, and of the fact that the astronauts were routinely subjected to lower body negative pressure (whereby cardiac filling is progressively decreased), it was possible to construct classic ventricular function curves noninvasively, thereby obviating the difficulties encountered in comparing cardiac function at different end-diastolic volumes preflight and postflight. In this manner, the effect of an 84-day period of weightlessness on cardiac structure and function was evaluated in the Skylab 4 astronauts.
The paper describes an angiographic analysis system which uses a video disk for recording and playback, a light-pen for data input, minicomputer processing, and an electrostatic printer/plotter for hardcopy output. The method is applied to quantitative analysis of ventricular volumes, sequential ventriculography for assessment of physiologic and pharmacologic interventions, analysis of instantaneous time sequence of ventricular systolic and diastolic events, and quantitation of segmental abnormalities. The system is shown to provide the capability for computation of ventricular volumes and other measurements from operator-defined margins by greatly reducing the tedium and errors associated with manual planimetry.