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At least 19 records

Cardiovascular Deconditioning in Humans: Alteration in Cardiovascular Regulation and Function During Simulated Microgravity

Alterations in cardiovascular regulation and function that occur during and after space flight have been reported. These alterations are manifested, for example, by reduced orthostatic tolerance upon reentry to the earth's gravity from space. However, the precise physiologic mechanisms responsible for these alterations remain to be fully elucidated. Perhaps, as a result, effective countermeasures have yet to be developed. In this project we apply a powerful, new method - cardiovascular system identification (CSI) - for the study of the effects of space flight on the cardiovascular system so that effective countermeasures can be developed. CSI involves the mathematical analysis of second-to-second fluctuations in non-invasively measured heart rate, arterial blood pressure (ABP), and instantaneous lung volume (ILV - respiratory activity) in order to characterize quantitatively the physiologic mechanisms responsible for the couplings between these signals. Through the characterization of all the physiologic mechanisms coupling these signals, CSI provides a model of the closed-loop cardiovascular regulatory state in an individual subject. The model includes quantitative descriptions of the heart rate baroreflex, autonomic function, as well as other important physiologic mechanisms. We are in the process of incorporating beat-to-beat fluctuations of stroke volume into the CSI technique in order to quantify additional physiologic mechanisms such as those involved in control of peripheral vascular resistance and alterations in cardiac contractility. We apply CSI in conjunction with the two general protocols of the Human Studies Core project. The first protocol involves ground-based, human head down tilt bed rest to simulate microgravity and acute stressors - upright tilt, standing and bicycle exercise - to provide orthostatic and exercise challenges. The second protocol is intended to be the same as the first but with the addition of sleep deprivation to determine whether this contributes to cardiovascular alterations. In these studies, we focus on the basic physiologic mechanisms responsible for the alterations in cardiovascular regulation and function during the simulated microgravity in order to formulate hypotheses regarding what countermeasures are likely to be most effective. Compared to our original proposal, the protocol we are using has been slightly modified to lengthen the bed rest period to 16 days and streamline the data collection. These modifications provide us data on a longer bed rest period and have enabled us to increase our subject throughput. Based on review of our preliminary data we have decided to test a countermeasure which is applied the very end of the bed rest period. We will use the same bed rest protocol to test this countermeasure. We anticipate completing the baseline data collection in our first protocol plus testing of the countermeasure in an additional eight subjects, at which time we plan to initiate the second protocol which includes sleep deprivation. In future studies, we plan to apply CSI to test other potential countermeasures in conjunction with the same bed rest, sleep deprivation and acute stressor models. We also anticipate applying CSI for studying astronauts before and after space flight and ultimately, during space flight. The application of CSI is providing information relevant to the development and evaluation of effective countermeasures allowing humans to adapt appropriately upon re-exposure to a gravity field, and to live and work for longer periods of time in microgravity.

Cohen, Richard↗

Cardiovascular adaptations in weightlessness: The influence of in-flight exercise programs on the cardiovascular adjustments during weightlessness and upon returning to Earth

The effect of in-flight exercise programs on astronauts' cardiovascular adjustments during spaceflight weightlessness and upon return to Earth was studied. Physiological changes in muscle strength and volume, cardiovascular responses during the application of lower body negative pressure, and metabolic activities during pre-flight and flight tests were made on Skylab crewmembers. The successful completion of the Skylab missions showed that man can perform submaximal and maximal aerobic exercise in the weightless enviroment without detrimental trends in any of the physiologic data. Exercise tolerance during flight was unaffected. It was only after return to Earth that a tolerance decrement was noted. The rapid postflight recovery of orthostatic and exercise tolerance following two of the three Skylab missions appeared to be directly related to total in-flight exercise as well as to the graded, regular program of exercise performed during the postflight debriefing period.

Bennett, C. H.↗

Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut Corps

Risk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future.

Halm, M. K.↗

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↗

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.↗

Preliminary Sensorimotor and Cardiovascular Results from the Joint Russian and U.S. Pilot Field Test with Planning for the Full Field Test Beginning with the Year Long Intenational Space Station

Ongoing collaborative research efforts between NASA's Neuroscience and Cardiovascular Laboratories, and the Institute of Biomedical Problems' (IBMP) Sensory-Motor and Countermeasures Laboratories have been measuring functional sensorimotor, cardiovascular and strength responses following bed rest, dry immersion, short duration (Space Shuttle) and long duration (Mir and International Space Station) space flights. While the unloading paradigms associated with dry immersion and bed rest does serve as acceptable flight analogs, testing of crew responses following the long duration flights previously has not been possible until a minimum of 24 hours after landing. As a result, it is not possible to estimate the nonlinear trend of the early (<24 hr) recovery process, nor is it possible to accurately assess the full impact of the decrements associated with long duration flight. To overcome these limitations, both the Russian and U.S. sides have implemented testing at landing site. By joint agreement, this research effort has been identified as the functional Field Test (FT). For practical reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The primary goal of this research is to determine functional abilities in long duration space flight crews beginning as soon after landing as possible (< 2 hr) with one to three immediate follow-up measurements on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessment of hand/eye coordination, ability to egress from a seated position, walk normally without falling, measurement of dynamic visual acuity, ability to discriminate different forces generated with both the hands and legs, recovery from a fall, a coordinated walk involving tandem heel-to-toe placement, and determination of postural ataxia while standing. The cardiovascular portion of the investigation includes blood pressure and heart rate measurements during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data will be acquired at a minimum of one to three more other times within the 24 hr following landing and continue until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a single trial run comprised of jointly agreed upon subset of tests from the full FT and relies heavily on IBMP's Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT was first conducted following the September 2013 landing of the Soyuz spacecraft (34S) and again following the landing of Soyuz 35S in November. Testing included: (1) a sit-tostand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 min while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-to-toe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors and severity of postflight motion sickness were collected for analysis. In summary, the level of functional deficit is expected to be most profound during the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiological data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiological measurements will allow estimation of nonlinear sensorimotor and cardiovascular recovery trends to an accuracy that has not been previously captured in over 50 years of space flight.

Reschke, M. F.↗

Preliminary Sensorimotor and Cardiovascular Results from the Joint Russian/U.S. Pilot Field Test in Preparation for the Full Field Test

Ongoing collaborative research efforts between NASA's Neuroscience and Cardiovascular Laboratories, and the Institute of Biomedical Problems' (IBMP) Sensory-Motor and Countermeasures Laboratories have been measuring functional sensorimotor, cardiovascular and strength responses following bed rest, dry immersion, short-duration (Space Shuttle) and long-duration (Mir and International Space Station [ISS]) space flights. While the unloading paradigms associated with dry immersion and bed rest does serve as acceptable flight analogs, testing of crew responses following the long-duration flights previously has not been possible until a minimum of 24 hours after landing. As a result, it is not possible to estimate the nonlinear trend of the early (<24 hours) recovery process nor is it possible to accurately assess the full impact of the decrements associated with long-duration flight. To overcome these limitations, both the Russian and U.S. programs have implemented testing at the landing site. By joint agreement, this research effort has been identified as the functional Field Test (FT). For practical reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The primary goal of this research is to determine functional abilities in long-duration space-flight crews beginning as soon after landing as possible (< 2 hours) with one to three immediate follow-up measurements on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessing hand/eye coordination, egressing from a seated position, walking normally without falling, measuring of dynamic visual acuity, discriminating different forces generated with both the hands and legs, recovering from a fall, coordinated walking involving tandem heel-to-toe placement, and determining postural ataxia while standing. The cardiovascular portion of the investigation includes measuring blood pressure and heart rate during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during the other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data will be acquired between one and three more other times within the 24 hours after landing and will continue over the subsequent weeks until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a single trial run comprised of a jointly agreed upon subset of tests from the full FT and relies heavily on IBMP's Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT has been collected on several ISS missions. Testing included: (1) a sit-to-stand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 minutes while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-totoe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors, and severity of postflight motion sickness were collected for each test session. In summary, the level of functional deficit is expected to be most profound during the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow estimation of nonlinear sensorimotor and cardiovascular recovery trends that has not been previously captured in over 50 years of space flight.

Reschke, M. F.↗

Instrumentation for Non-Invasive Assessment of Cardiovascular Regulation

It is critically important to be able to assess alterations in cardiovascular regulation during and after space flight. We propose to develop an instrument for the non-invasive assessment of such alterations that can be used on the ground and potentially during space flight. This instrumentation would be used by the Cardiovascular Alterations Team at multiple sites for the study of the effects of space flight on the cardiovascular system and the evaluation of countermeasures. In particular, the Cardiovascular Alterations Team will use this instrumentation in conjunction with ground-based human bed-rest studies and during application of acute stresses e.g., tilt, lower body negative pressure, and exercise. In future studies, the Cardiovascular Alterations Team anticipates using this instrumentation to study astronauts before and after space flight and ultimately, during space flight. The instrumentation may also be used by the Bone Demineralization/Calcium Metabolism Team, the Neurovestibular Team and the Human Performance Factors, Sleep and Chronobiology Team to measure changes in autonomic nervous function. The instrumentation will be based on a powerful new technology - cardiovascular system identification (CSI) - which has been developed in our laboratory. CSI provides a non-invasive approach for the study of alterations in cardiovascular regulation. This approach involves the analysis of second-to-second fluctuations in physiologic signals such as heart rate and non-invasively measured arterial blood pressure in order to characterize quantitatively the physiologic mechanisms responsible for the couplings between these signals. Through the characterization of multiple physiologic mechanisms, CSI provides a closed-loop model of the cardiovascular regulatory state in an individual subject.

Cohen, Richard J.↗

Preliminary Results from the Joint Russian and US Field Test: Measurement of Sensorimotor and Cardiovascular Responses Immediately Following Landing of the Soyuz Spacecraft

Ongoing collaborative research efforts between NASA's Neuroscience and Cardiovascular Laboratories, and the Institute of Biomedical Problems' (IBMP) Sensory-Motor and Countermeasures Laboratories have been measuring functional sensorimotor, cardiovascular and strength responses following bed rest, dry immersion, short duration (Space Shuttle) and long duration (Mir and International Space Station) space flights. While the unloading paradigms associated with dry immersion and bed rest have do serve as acceptable flight analogs, testing of crew responses following the long duration flights does not begin until a minimum of 24 hours after landing. As a result it is not possible to estimate the nonlinear trend of the early (<24 hr) recovery process nor is it possible to accurately assess the full impact of the decrements associated with long duration flight. To overcome these limitations both the Russian and U.S. sides have implemented testing at the time of landing and before the flight crews have left the landing site. By joint agreement this research effort has been identified as the functional Field Test (FT). For practical reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The primary goal of this research is to determine functional abilities in long duration space flight crews beginning as soon after landing as possible (< 2 hr) with one to three immediate follow-up measurements on the day of landing. This goal has both sensorimotor and cardiovascular elements including an evaluation of NASA's new anti-orthostatic compression garment as compared with the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessment of hand/eye coordination, ability to egress from a seated position, walk normally without falling, measurement of dynamic visual acuity, ability to discriminate different forces generated with both the hands and legs, recovery from a fall, a coordinated walk involving tandem heel-to-toe placement and determination of postural ataxia while standing. The cardiovascular portion of the investigation includes blood pressure and heart rate measurements during a timed stand test in conjunction with postural ataxia testing. In addition to the immediate post-landing collection of data for the full FT, postflight data will be acquired at a minimum of one to three more other times within the 24 hr following landing and continue until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a single trial run comprised of jointly agreed tests from the full FT and relies heavily on IBMP's Sensory-Motor and Countermeasures Laboratories for content, and implementation. The PFT is currently scheduled for the September 2013 landing of the Soyuz spacecraft (34S). Testing will include: (1) a sit-to-stand test, (2) recovery from a fall where the crewmember begins in the prone position on the ground and then stands for 3 min while cardiovascular stability is determined and postural ataxia data are acquired, and (3) a tandem heel-to-toe walk to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors and severity of postflight motion sickness will be available for analysis. It is our intent to present, at this celebratory symposium, a summary of these data obtained from two crewmembers. In summary, the level of functional deficit is expected to be most profound during the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiological data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers. Overall, these early functional and related physiological measurements will allow estimation of nonlinear sensorimotor and cardiovascular recovery trends to an accuracy that has not been previously captured in over 50 years of space flight.

Reschke, M. F.↗

Astronaut Preflight Cardiovascular Variables Associated with Vascular Compliance are Highly Correlated with Post-Flight Eye Outcome Measures in the Visual Impairment Intracranial Pressure (VIIP) Syndrome Following Long Duration Spaceflight

The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti‐lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post‐flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio‐ each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured

Otto, Christian↗

Computational Models of the Cardiovascular System and Its Response to Microgravity

Computational models of the cardiovascular system are powerful adjuncts to ground-based and in-flight experiments. We will provide NSBRI with a model capable of simulating the short-term effects of gravity on cardiovascular function. The model from this project will: (1) provide a rational framework which quantitatively defines interactions among complex cardiovascular parameters and which supports the critical interpretation of experimental results and testing of hypotheses. (2) permit predictions of the impact of specific countermeasures in the context of various hypothetical cardiovascular abnormalities induced by microgravity. Major progress has been made during the first 18 months of the program: (1) We have developed an operational first-order computer model capable of simulating the cardiovascular response to orthostatic stress. The model consists of a lumped parameter hemodynamic model and a complete reflex control system. The latter includes cardiopulmonary and carotid sinus reflex limbs and interactions between the two. (2) We have modeled the physiologic stress of tilt table experiments and lower body negative pressure procedures (LBNP). We have verified our model's predictions by comparing them with experimental findings from the literature. (3) We have established collaborative efforts with leading investigators interested in experimental studies of orthostatic intolerance, cardiovascular control, and physiologic responses to space flight. (4) We have established a standardized method of transferring data to our laboratory from the ongoing NSBRI bedrest studies. We use this data to estimate input parameters to our model and compare our model predictions to actual data to further verify our model. (5) We are in the process of systematically simulating current hypotheses concerning the mechanism underlying orthostatic intolerance by matching our simulations to stand test data from astronauts pre- and post-flight. (6) We are in the process of developing a JAVA version of the simulator which will be distributed amongst the cardiovascular team members. Future work on this project involves modifications of the model to represent a rodent (rat) model, further evaluation of the bedrest astronaut and animal data, and systematic investigation of specific countermeasures.

Kamm, Roger D.↗

Pilot Sensorimotor and Cardiovascular Results from the Joint Russian/U.S. Field Test

The primary goal of this research is to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible (< 2 hours) with an additional two follow-up measurements sessions on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessing hand/eye coordination, standing from a seated position (sit-to-stand), walking normally without falling, measurement of dynamic visual acuity, discriminating different forces generated with both the hands and legs, recovering from a fall (standing from a prone position), coordinated walking involving tandem heel-to-toe placement, and determining postural ataxia while standing. The cardiovascular portion of the investigation includes measuring blood pressure and heart rate during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during the other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data is being acquired twice more within the 24 hours after landing and will continue over the subsequent weeks until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a initial evaluation of the feasibility of testing in the field, and is comprised of a jointly agreed upon subset of tests from the full FT and relies heavily on Russia's Institute of Biomedical Problems Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT has been collected on several ISS missions. Testing on the U.S. side has included: (1) a sit-to-stand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 minutes while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-to-toe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from bodyworn inertial sensors, and severity of postflight motion sickness were collected during each test session. Our Russian investigators have added measurements associated with: (a) obstacle avoidance, (b) muscle compliance and (c) postural adjustments to perturbations (push) applied to the subject's chest area. The level of functional deficit observed in the crew tested to date is typically beyond what was expected and is clearly triggered by the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow the estimation of nonlinear sensorimotor and cardiovascular recovery trends that have not been previously captured

Reschke, M. F.↗

Space Radiation Induces Long Term Impact on the Cardiovascular System by the Activation of FYN Through Reactive Oxygen Species

Space radiation can damage the cardiovascular system and thus is an important health risk factor for astronauts during long-term space missions. We utilized publicly available transcriptomic data through NASA's GeneLab platform (genelab.nasa.gov) to determine cardiovascular system response to space radiation. GeneLab is an open repository that houses all NASA related omics experiments including on the International Space Station (ISS) and related radiation ground studies. We analyzed 3 datasets from GeneLab: GLDS-117 and GLDS-109, which are ground studies of cardiomyocytes followed-up for 28 days after exposure to 90cGy of proton at 1GeV and 15cGy of 56Fe at 1GeV; and GLDS-52, human endothelial cells (HUVECs) that were cultured for 10 days on the ISS. The ground studies were designed to characterize the long-term impact following space irradiation on cardiomyocytes for 5 different time points up to 28 days after irradiation. Our analysis was guided by the hypothesis that there are common persistent molecules affecting the cardiovascular system due to radiation effects during spaceflight. Endothelial cells are known to directly regulate the development and activity of cardiomyocytes, and thus their response to spaceflight should be highly correlated with cardiomyocytes. To investigate our hypothesis, we identified the molecular pathways that were modified for all time points compared across both radiation on the ground and the pathways found in HUVECs flown in the ISS. We found the following key results related to the cardiovascular systems: 1) space radiation downregulate ROS functions; and 2) the key/driving genes: FYN, LCK, AKT1 are upregulated and LYN and FOS are downregulated with FYN being the central driver/hub for the cardiovascular response to space radiation. It is worth noting the activation of FYN is a key event which prevents cardiac cell death and ROS production. From our study we thus hypothesize that a feedback loop occurs from the oxidative stress caused by space radiation that upregulates FYN which in turn reduces ROS levels and thus ROS pathways, preventing cardiomyocyte and endothelial cell death and thus protecting the cardiovascular systems. We believe that this is a novel mechanism for space radiation induced cardiovascular risk directly linking radiation ground studies to spaceflight

Beheshti, Afshin↗

Orthostatic stress is necessary to maintain the dynamic range of cardiovascular control in space

In the upright position, gravity fills the low-pressure systems of human circulation with blood and interstitial fluid in the sections below the diaphragm. Without gravity one pressure component in the vessels disappears and the relationship between hydrostatic pressure and oncotic pressure, which regulates fluid passage across the capillary endothelium in the terminal vascular bed, shifts constantly. The visible consequences of this are a puffy face and "bird" legs. The plasma volume shrinks in space and the range of cardiovascular control is reduced. When they stand up for the first time after landing, 30-50% of astronauts suffer from orthostatic intolerance. It remains unclear whether microgravity impairs cardiovascular reflexes, or whether it is the altered volume status that causes the cardiovascular instability following space flight. Lower body negative pressure was used in several space missions to stimulate the cardiovascular reflexes before, during and after a space flight. The results show that cardiovascular reflexes are maintained in microgravity. However, the astronauts' volume status changed in space, towards a volume-retracted state, as measurements of fluid-regulating hormones have shown. It can be hypothesized that the control of circulation and body fluid homeostasis in humans is adapted to their upright posture in the Earth's gravitational field. Autonomic control regulates fluid distribution to maintain the blood pressure in that posture, which most of us have to cope with for two-thirds of the day. A determined amount of interstitial volume is necessary to maintain the dynamic range of cardiovascular control in the upright posture; otherwise orthostatic intolerance may occur more often.

manned↗

Beat to beat variability in cardiovascular variables: noise or music?

Cardiovascular variables such as heart rate, arterial blood pressure, stroke volume and the shape of electrocardiographic complexes all fluctuate on a beat to beat basis. These fluctuations have traditionally been ignored or, at best, treated as noise to be averaged out. The variability in cardiovascular signals reflects the homeodynamic interplay between perturbations to cardiovascular function and the dynamic response of the cardiovascular regulatory systems. Modern signal processing techniques provide a means of analyzing beat to beat fluctuations in cardiovascular signals, so as to permit a quantitative, noninvasive or minimally invasive method of assessing closed loop hemodynamic regulation and cardiac electrical stability. This method promises to provide a new approach to the clinical diagnosis and management of alterations in cardiovascular regulation and stability.

Non-NASA Center↗

Cardiovascular Deconditioning in Humans: Human Studies Core

Major cardiovascular problems, secondary to cardiovascular deconditioning, may occur on extended space missions. While it is generally assumed that the microgravity state is the primary cause of cardiovascular deconditioning, sleep deprivation and disruption of diurnal rhythms may also play an important role. Factors that could be modified by either or both of these perturbations include: autonomic function and short-term cardiovascular reflexes, vasoreactivity, circadian rhythm of cardiovascular hormones (specifically the renin-angiotensin system) and renal sodium handling and hormonal influences on that process, venous compliance, cardiac mass, and cardiac conduction processes. The purpose of the Human Studies Core is to provide the infrastructure to conduct human experiments which will allow for the assessment of the likely role of such factors in the space travel associated cardiovascular deconditioning process and to develop appropriate countermeasures. The Core takes advantage of a newly-created Intensive Physiologic Monitoring (IPM) Unit at the Brigham and Women's Hospital, Boston, MA, to perform these studies. The Core includes two general experimental protocols. The first protocol involves a head down tilt bed-rest study to simulate microgravity. The second protocol includes the addition of a disruption of circadian rhythms to the simulated microgravity environment. Before and after each of these environmental manipulations, the subjects will undergo acute stressors simulating changes in volume and/or stress, which could occur in space and on return to Earth. The subjects are maintained in a rigidly controlled environment with fixed light/dark cycles, activity pattern, and dietary intake of nutrients, fluids, ions and calories.

Williams, Gordon↗

Alterations in Cardiovascular Regulation and Function During Long-Term Simulated Microgravity

The Cardiovascular Alterations Team is conducting studies of hemodynamic regulation and susceptibility to arrhythmias resulting from sixteen days of simulated microgravity exposure. In these studies very intensive measurements are made during a short duration of bed rest. In this collaborative effort are making many of the same measurements, however much less frequently, on subjects who are exposed to a much longer duration of simulated microgravity. Alterations in cardiovascular regulation and function that occur during and after space flight have been reported. These alterations are manifested, for example, by reduced orthostatic tolerance upon reentry to the earth's gravity from space. However, the precise physiologic mechanisms responsible for these alterations remain to be fully elucidated. Perhaps, as a result, effective countermeasures have yet to be developed. In addition, numerous reports from the past 30 years suggest that the incidence of ventricular arrhythmias among astronauts is increased during space flight. However, the effects of space flight and the associated physiologic stresses on cardiac conduction processes are not known, and an increase in cardiac susceptibility to arrhythmias has never been quantified. In this project we are applying the most powerful technologies available to determine, in a ground-based study of long duration space flight, the mechanisms by which space flight affects cardiovascular function, and then on the basis of an understanding of these mechanisms to develop rational and specific countermeasures. To this end we are conducting a collaborative project with the Bone Demineralization/Calcium Metabolism Team of the National Space Biomedical Research Institute (NSBRI). The Bone Team is conducting bed rest studies in human subjects lasting 17 weeks, which provides a unique opportunity to study the effects of long duration microgravity exposure on the human cardiovascular system. We are applying a number of powerful new methods to these long term bed rest subjects, including cardiovascular system identification (CSI), microvolt level T wave alternans analysis, and cardiac magnetic resonance imaging to assess non-invasively the effects of simulated long duration space flight on the cardiovascular system.

Cohen, Richard J.↗

Effects of lesions of the caudal cerebellar vermis on cardiovascular regulation in awake cats

The vestibular system is known to participate in cardiovascular regulation during movement and postural alterations. The present study considered whether lesions of two regions of the posterior cerebellar vermis (the nodulus and uvula) that provide inputs to vestibular nucleus regions that affect control of blood pressure would alter cardiovascular responses during changes in posture. Blood pressure and heart rate were monitored in awake cats during nose-up tilts up to 60 degrees in amplitude before and following aspiration lesions of the nodulus or uvula; in most animals, cardiovascular responses were also recorded following the subsequent removal of vestibular inputs. Lesions of the nodulus or uvula did not affect baseline blood pressure or heart rate, although cardiovascular responses during nose-up tilts were altered. Increases in heart rate that typically occurred during 60 degrees nose-up tilt were attenuated in all three animals with lesions affecting both dorsal and ventral portions of the uvula; in contrast, the heart rate responses were augmented in the two animals with lesions mainly confined to the nodulus. Furthermore, following subsequent removal of vestibular inputs, uvulectomized animals, but not those with nodulus lesions, experienced more severe orthostatic hypotension than has previously been reported in cerebellum-intact animals with bilateral labyrinthectomies. These data suggest that the cerebellar nodulus and uvula modulate vestibulo-cardiovascular responses, although the two regions play different roles in cardiovascular regulation.

NASA Discipline Neuroscience↗