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Mariani J, Beretta S, Diamanti S, Versace A, Martini B, Viganò M, Castiglioni L, Sironi L, Carone D, Cuccione E, Monza L, Giussani C, Ferrarese C. Head Down Tilt 15° in Acute Ischemic Stroke with Poor Collaterals: A Randomized Preclinical Trial. Neuroscience 2023; 523:1-6. [PMID: 37211082 DOI: 10.1016/j.neuroscience.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 05/23/2023]
Abstract
Cerebral collaterals are recruited after arterial occlusion with a protective effect on tissue outcome in acute ischemic stroke. Head down tilt 15° (HDT15) is a simple, low cost and accessible procedure that could be applied as an emergency treatment, before recanalization therapies, with the aim to increase cerebral collateral flow. Spontaneously hypertensive rats have been shown to display anatomical differences in morphology and function of cerebral collaterals, compared to other rat strains, resulting in an overall poor collateral circulation. We investigate the efficacy and safety of HDT15 in spontaneously hypertensive (SHR) rats, which were considered as an animal stroke model with poor collaterals. Cerebral ischemia was induced by 90 minute endovascular occlusion of the middle cerebral artery (MCA). SHR rats were randomized to HDT15 or flat position (n = 19). HDT15 was applied 30 minutes after occlusion and lasted 60 minutes, until reperfusion. HDT15 application increased cerebral perfusion (+16.6% versus +6.1%; p = 0.0040) and resulted in a small reduction of infarct size (83.6 versus 107.1 mm3; - 21.89%; p = 0.0272), but it was not associated with early neurological improvement, compared to flat position. Our study suggests that the response to HDT15 during MCA occlusion is dependent on baseline collaterals. Nonetheless, HDT15 promoted a mild improvement of cerebral hemodynamics even in subjects with poor collaterals, without safety concerns.
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Affiliation(s)
- Jacopo Mariani
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Milan Center for Neuroscience (NeuroMi), Milano, Italy.
| | - Simone Beretta
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Milan Center for Neuroscience (NeuroMi), Milano, Italy; Department of Neuroscience, San Gerardo Hospital, ASST Monza, Via Pergolesi 33, 20900 Monza (MB), Italy
| | - Susanna Diamanti
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Milan Center for Neuroscience (NeuroMi), Milano, Italy; Department of Neuroscience, San Gerardo Hospital, ASST Monza, Via Pergolesi 33, 20900 Monza (MB), Italy
| | - Alessandro Versace
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Beatrice Martini
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Martina Viganò
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Laura Castiglioni
- Department of Pharmacology, University of Milan, Via Balzaretti 9, 20133 Milano (MI), Italy
| | - Luigi Sironi
- Department of Pharmacology, University of Milan, Via Balzaretti 9, 20133 Milano (MI), Italy
| | - Davide Carone
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Elisa Cuccione
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Laura Monza
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | - Carlo Giussani
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Milan Center for Neuroscience (NeuroMi), Milano, Italy; Department of Neuroscience, San Gerardo Hospital, ASST Monza, Via Pergolesi 33, 20900 Monza (MB), Italy
| | - Carlo Ferrarese
- Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Milan Center for Neuroscience (NeuroMi), Milano, Italy; Department of Neuroscience, San Gerardo Hospital, ASST Monza, Via Pergolesi 33, 20900 Monza (MB), Italy
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2
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Hart DA. Learning From Human Responses to Deconditioning Environments: Improved Understanding of the "Use It or Lose It" Principle. Front Sports Act Living 2021; 3:685845. [PMID: 34927066 PMCID: PMC8677937 DOI: 10.3389/fspor.2021.685845] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/28/2021] [Indexed: 01/25/2023] Open
Abstract
Physical activity, mobility or patterned mobility (i.e., exercise) is intrinsic to the functioning of Homo sapiens, and required for maintenance of health. Thus, systems such as the musculoskeletal and cardiovascular systems appear to require constant reinforcement or conditioning to maintain integrity. Loss of conditioning or development of chronic deconditioning can have multiple consequences. The study of different types of deconditioning and their prevention or reversal can offer a number of clues to the regulation of these systems and point to how deconditioning poses risk for disease development and progression. From the study of deconditioning associated with spaceflight, a condition not predicted by evolution, prolonged bedrest, protracted sedentary behavior, as well as menopause and obesity and their consequences, provide a background to better understand human heterogeneity and how physical fitness may impact the risks for chronic conditions subsequent to the deconditioning. The effectiveness of optimized physical activity and exercise protocols likely depend on the nature of the deconditioning, the sex and genetics of the individual, whether one is addressing prevention of deconditioning-associated disease or disease-associated progression, and whether it is focused on acute or chronic deconditioning associated with different forms of deconditioning. While considerable research effort has gone into preventing deconditioning, the study of the process of deconditioning and its endpoints can provide clues to the regulation of the affected systems and their contributions to human heterogeneity that have been framed by the boundary conditions of Earth during evolution and the "use it or lose it" principle of regulation. Such information regarding heterogeneity that is elaborated by the study of deconditioning environments could enhance the effectiveness of individualized interventions to prevent deconditions or rescue those who have become deconditioned.
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Affiliation(s)
- David A Hart
- Bone and Joint Health Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada.,Department of Surgery, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.,Department of Family Practice, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
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3
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Orter S, Mostl S, Bachler M, Hoffmann F, Kaniusas E, Reisinger M, Wassertheurer S, Tank J, Hametner B. Measuring Arterial Stiffness in a Head-Down Tilt Bed Rest Study: A Multisensor Approach .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2715-2718. [PMID: 33018567 DOI: 10.1109/embc44109.2020.9176275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Arterial stiffness is an important indicator for vascular aging and an independent predictor for cardiovascular diseases. During space flights or simulated space flights by prolonged head-down tilt bed rest, major cardiovascular alterations occur. However, the changes in arterial stiffness are not fully understood yet. Thus, we aimed to develop a setup for the measurement of arterial stiffness during prolonged head-down tilt bed rest, which incorporates several combinations of biosignals and measurement locations for the determination of pulse transit times. By performing measurements using this setup on female and male subjects, we intend to deepen the understanding of changes in arterial stiffness during prolonged head-down tilt bed rest. This work describes and visualizes the complete setup as well as our measurement protocols and algorithms used. The result section shows the successful recording of baseline signals before the bed rest study and visualizes the synchronized recordings of pulse waves measured on different sides of the body. Thus, it is feasible to use the presented setup in bed rest studies.
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4
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Maggioni MA, Castiglioni P, Merati G, Brauns K, Gunga HC, Mendt S, Opatz OS, Rundfeldt LC, Steinach M, Werner A, Stahn AC. High-Intensity Exercise Mitigates Cardiovascular Deconditioning During Long-Duration Bed Rest. Front Physiol 2018; 9:1553. [PMID: 30510516 PMCID: PMC6252355 DOI: 10.3389/fphys.2018.01553] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 10/16/2018] [Indexed: 02/02/2023] Open
Abstract
Head-down-tilt bed rest (HDT) mimics the changes in hemodynamics and autonomic cardiovascular control induced by weightlessness. However, the time course and reciprocal interplay of these adaptations, and the effective exercise protocol as a countermeasure need further clarification. The overarching aim of this work (as part of a European Space Agency sponsored long-term bed rest study) was therefore to evaluate the time course of cardiovascular hemodynamics and autonomic control during prolonged HDT and to assess whether high-intensity, short-duration exercise could mitigate these effects. A total of n = 23 healthy, young, male participants were randomly allocated to two groups: training (TRAIN, n = 12) and non-training (CTRL, n = 11) before undergoing a 60-day HDT. The TRAIN group underwent a resistance training protocol using reactive jumps (5–6 times per week), whereas the CTRL group did not perform countermeasures. Finger blood pressure (BP), heart rate (HR), and stroke volume were collected beat-by-beat for 10 min in both sitting and supine positions 7 days before HDT (BDC−7) and 10 days after HDT (R+10), as well as on the 2nd (HDT2), 28th (HDT28), and 56th (HDT56) day of HDT. We investigated (1) the isolated effects of long-term HDT by comparing all the supine positions (including BDC−7 and R+10 at 0 degrees), and (2) the reactivity of the autonomic response before and after long-term HDT using a specific postural stimulus (i.e., supine vs. sitting). Two-factorial linear mixed models were used to assess the time course of HDT and the effect of the countermeasure. Starting from HDT28 onwards, HR increased (p < 0.02) and parasympathetic tone decreased exclusively in the CTRL group (p < 0.0001). Moreover, after 60-day HDT, CTRL participants showed significant impairments in increasing cardiac sympathovagal balance and controlling BP levels during postural shift (supine to sitting), whereas TRAIN participants did not. Results show that a 10-day recovery did not compensate for the cardiovascular and autonomic deconditioning following 60-day HDT. This has to be considered when designing rehabilitation programs—not only for astronauts but also in general public healthcare. High-intensity, short-duration exercise training effectively minimized these impairments and should therefore deserve consideration as a cardiovascular deconditioning countermeasure for spaceflight.
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Affiliation(s)
- Martina A Maggioni
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Katharina Brauns
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Stefan Mendt
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Oliver S Opatz
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Lea C Rundfeldt
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Mathias Steinach
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Anika Werner
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.,Université de Normandie, INSERM U 1075 COMETE, Caen, France
| | - Alexander C Stahn
- Charité-Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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5
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Castiglioni P. Commentary: Decomposition of Heart Rate Variability Spectrum into a Power-Law Function and a Residual Spectrum. Front Cardiovasc Med 2018; 5:94. [PMID: 30094240 PMCID: PMC6070638 DOI: 10.3389/fcvm.2018.00094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/26/2018] [Indexed: 11/13/2022] Open
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6
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Beretta S, Versace A, Carone D, Riva M, Dell'Era V, Cuccione E, Cai R, Monza L, Pirovano S, Padovano G, Stiro F, Presotto L, Paternò G, Rossi E, Giussani C, Sganzerla EP, Ferrarese C. Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies. J Cereb Blood Flow Metab 2017; 37:3344-3354. [PMID: 28112023 PMCID: PMC5624388 DOI: 10.1177/0271678x16688705] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion. Compared to untreated animals, treatment with collateral therapeutics was associated with lower infarct volumes (62% relative mean difference; 51.57 mm3 absolute mean difference; p < 0.001) and higher chance of good functional outcome (OR 4.58, p < 0.001). Collateral therapeutics acutely increased cerebral perfusion in the medial (+40.8%; p < 0.001) and lateral (+19.2%; p = 0.016) MCA territory compared to pretreatment during MCA occlusion. Safety indicators were treatment-related mortality and cardiorespiratory effects. The highest efficacy and safety profile was observed for HDT. Our findings suggest that acute modulation of cerebral collaterals is feasible and provides a tissue-saving effect in the hyperacute phase of ischemic stroke prior to recanalization therapy.
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Affiliation(s)
- Simone Beretta
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,2 Milan Center for Neuroscience (NeuroMi), Milano, Italy.,3 Department of Neuroscience, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Alessandro Versace
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Davide Carone
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,2 Milan Center for Neuroscience (NeuroMi), Milano, Italy
| | - Matteo Riva
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Valentina Dell'Era
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Elisa Cuccione
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Ruiyao Cai
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Laura Monza
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Silvia Pirovano
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Giada Padovano
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Fabio Stiro
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Luca Presotto
- 4 In vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS, San Raffaele Scientific Institute, Milano, Italy.,5 Università Vita-Salute San Raffaele, Milano, Italy
| | - Giovanni Paternò
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Emanuela Rossi
- 6 Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Carlo Giussani
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,2 Milan Center for Neuroscience (NeuroMi), Milano, Italy.,3 Department of Neuroscience, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Erik P Sganzerla
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,2 Milan Center for Neuroscience (NeuroMi), Milano, Italy.,3 Department of Neuroscience, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Carlo Ferrarese
- 1 Laboratory of Experimental Stroke Research, School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,2 Milan Center for Neuroscience (NeuroMi), Milano, Italy.,3 Department of Neuroscience, San Gerardo Hospital, ASST Monza, Monza, Italy
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7
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Kitazawa T, Kitazawa K. Prolonged bed rest impairs rapid CPI-17 phosphorylation and contraction in rat mesenteric resistance arteries to cause orthostatic hypotension. Pflugers Arch 2017; 469:1651-1662. [PMID: 28717991 DOI: 10.1007/s00424-017-2031-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/03/2017] [Accepted: 07/09/2017] [Indexed: 02/07/2023]
Abstract
Prolonged bed rest (PBR) causes orthostatic hypotension (OH). Rapid constriction of splanchnic resistance arteries in response to a sudden increase in sympathetic tone contributes to the recovery of orthostatic arterial pressure upon standing. However, the molecular mechanism of PBR-induced dysfunction in arterial constriction is not fully understood. Previously, we showed that CPI-17, a regulatory protein for myosin phosphatase, mediates α1A-adrenergic receptor-induced rapid contraction of small mesenteric arteries. Here, we tested whether PBR associated with OH affects the α1-adrenergic receptor-induced CPI-17 signaling pathway in mesenteric arteries using rats treated by head-down tail-suspension hindlimb unloading (HDU), an experimental OH model. In normal anesthetized rats, mean arterial pressure (MAP) rapidly reduced upon 90° head-up tilt from supine position and then immediately recovered without change in heart rate, suggesting a rapid arterial constriction. On the other hand, after a 4-week HDU treatment, the fast orthostatic MAP recovery failed for 1 min. Alpha1A subtype-specific antagonist suppressed the orthostatic MAP recovery with a small decrease in basal blood pressure, whereas non-specific α1-antagonist prazosin strongly reduced both basal MAP and orthostatic recovery. The HDU treatment resulted in 68% reduction in contraction in parallel with 83% reduction in CPI-17 phosphorylation in denuded mesenteric arteries 10 s after α1-agonist stimulation. The treatment with either Ca2+-release channel opener or PKC inhibitor mimicked the deficiency in HDU arteries. These results suggest that an impairment of the rapid PKC/CPI-17 signaling pathway downstream of α1A-adrenoceptors in peripheral arterial constriction, as an end organ of orthostatic blood pressure reflex, is associated with OH in prolonged bed rest patients.
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Affiliation(s)
- Toshio Kitazawa
- Boston Biomedical Research Institute, Watertown, MA, 02472, USA. .,Department of Molecular Physiology and Biophysics, Thomas Jefferson University, 1020 Locust Street, Philadelphia, PA, 19107, USA.
| | - Kazuyo Kitazawa
- Boston Biomedical Research Institute, Watertown, MA, 02472, USA
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8
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Kim HA, Yi HA, Lee H. Orthostatic hypotension in acute vestibular neuritis. J Neurol Sci 2015; 358:479-80. [DOI: 10.1016/j.jns.2015.08.1547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 08/12/2015] [Accepted: 08/31/2015] [Indexed: 11/16/2022]
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9
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Effects of gravitational acceleration on cardiovascular autonomic control in resting humans. Eur J Appl Physiol 2015; 115:1417-27. [DOI: 10.1007/s00421-015-3117-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 01/26/2015] [Indexed: 10/24/2022]
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10
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Large artery remodeling and dynamics following simulated microgravity by prolonged head-down tilt bed rest in humans. BIOMED RESEARCH INTERNATIONAL 2015; 2015:342565. [PMID: 25654096 PMCID: PMC4309028 DOI: 10.1155/2015/342565] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 11/19/2022]
Abstract
The effects of simulated microgravity on the static and dynamic properties of large arteries are still mostly unknown. The present study evaluated, using an integrated vascular approach, changes in structure and function of the common carotid and femoral arteries (CCA and CFA) after prolonged head-down tilt bed rest (HDTBR). Ten healthy men were enrolled in a 5-week HDTBR study endorsed by the Italian Space Agency (ASI). Arterial geometry, flow, stiffness, and shear rate were evaluated by ultrasound. Local carotid pulse pressure and wave reflection were studied by applanation tonometry. After five weeks of HDTBR, CFA showed a decrease in lumen diameter without significant changes in wall thickness (IMT), resulting in an inward remodeling. Local carotid pulse pressure decreased and carotid-to-brachial pressure amplification increased. The ratio of systolic-to-diastolic volumetric flow in CFA decreased, whereas in CCA it tended to increase. Indices of arterial stiffness and shear rate did not change during HDTBR, either in CCA or CFA. In summary, prolonged HDTBR has a different impact on CCA and CFA structure and flow, probably depending on the characteristics of the vascular bed perfused.
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11
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Adami A, Pizzinelli P, Bringard A, Capelli C, Malacarne M, Lucini D, Simunič B, Pišot R, Ferretti G. Cardiovascular re-adjustments and baroreflex response during clinical reambulation procedure at the end of 35-day bed rest in humans. Appl Physiol Nutr Metab 2013; 38:673-80. [DOI: 10.1139/apnm-2012-0396] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During the reambulation procedure after 35-day head-down tilt bed rest (HDTBR) for 9 men, we recorded for the first time heart rate (HR; with electrocardiogram) and arterial pressure profiles (fingertip plethysmography) for 5 min in HDTBR and horizontal (SUP) positions, followed by 12 min in standing position, during which 4 subjects fainted (intolerant, INT) and were laid horizontal again (Recovery). We computed: mean arterial pressure (P¯; pressure profiles integral mean), stroke volume (SV; obtained with Modelflow method), and cardiac output (Q̇; SV × HR). All cardiovascular data remained stable in HDTBR and SUP for both groups (EXP). Taking the upright posture, EXP showed a decrease in SV and an increase in HR, becoming significantly different from SUP within 1 min. Further evolution of these parameters kept Q̇ stable in both groups until the second minute of standing. Afterward, in INT, P̄ precipitated without further HR increases: SV stopped being corrected and Q̇ reached 2.9 ± 0.4 L·min−1 at the last 15 s of standing. Sudden drop in P̄ allowed identification of a low-pressure threshold in INT (70.7 ± 12.9 mm Hg), after which syncope occurred within 80 s. During Recovery, baroreflex curves showed a flat phase (P̄ increase, HR stable), followed by a steep phase (P̄ increased, HR decreased, starting when P̄ was 84.5 ± 12.5 mm Hg and Q̇ was 9.6 ± 1.5 L·min−1). INT, in contrast with tolerant subjects, did not sustain standing because HR was unable to correct for the P̄ drop. These results indicate a major role for impaired arterial baroreflexes in the onset of orthostatic intolerance.
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Affiliation(s)
- Alessandra Adami
- Département de Neuroscience Fondamentales, Centre Médical Universitaire, Université de Genève, 1 Rue Michel Servet, CH-1211 Genève 4, Switzerland
| | - Paolo Pizzinelli
- Dipartimento di Scienze Cliniche, Ospedale L. Sacco, Università di Milano, via GB. Grassi 74, Milano, Italia
| | - Aurélien Bringard
- Département de Neuroscience Fondamentales, Centre Médical Universitaire, Université de Genève, 1 Rue Michel Servet, CH-1211 Genève 4, Switzerland
| | - Carlo Capelli
- Dipartimento di Scienze Neurologiche, Neuropsicologiche, Morfologiche e Motorie, Facoltà di Scienze Motorie, Università di Verona, via F. Casorati, 54, 37100 Verona, Italia
| | - Mara Malacarne
- Dipartimento di Scienze Cliniche, Ospedale L. Sacco, Università di Milano, via GB. Grassi 74, Milano, Italia
| | - Daniela Lucini
- Dipartimento di Scienze Cliniche, Ospedale L. Sacco, Università di Milano, via GB. Grassi 74, Milano, Italia
| | - Boštjan Simunič
- Institute of Kinesiology Research, Science and Research Center, University of Primorska, Koper, Garibaldijeva street 1, 6000 Koper, Slovenia
| | - Rado Pišot
- Institute of Kinesiology Research, Science and Research Center, University of Primorska, Koper, Garibaldijeva street 1, 6000 Koper, Slovenia
| | - Guido Ferretti
- Département de Neuroscience Fondamentales, Centre Médical Universitaire, Université de Genève, 1 Rue Michel Servet, CH-1211 Genève 4, Switzerland
- Dipartimento di Scienze Biomediche e Biotecnologie, Facoltà di Medicina, Università di Brescia, Viale Europa 11, 25123 Brescia, Italia
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12
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Fortrat JO, Baum C, Jeanguillaume C, Custaud MA. Noisy fluctuation of heart rate indicates cardiovascular system instability. Eur J Appl Physiol 2013; 113:2253-61. [PMID: 23652709 DOI: 10.1007/s00421-013-2655-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 04/26/2013] [Indexed: 11/28/2022]
Abstract
Heart rate spontaneously fluctuates despite homeostatic regulatory mechanisms to stabilize it. Harmonic and fractal fluctuations have been described. Non-harmonic non-fractal fluctuation has not been studied because it is usually thought that it is caused by apparatus noise. We hypothesized that this fluctuation looking like apparatus noise (that we call "noisy fluctuation") is linked to challenged blood pressure stabilization and not to apparatus noise. We assessed noisy fluctuation by quantifying the small and fastest beat-to-beat fluctuation of RR-interval by means of spectral analysis (Nyquist power of heart rate variability: nyHRV) after filtering out its fractal component. We observed nyHRV in healthy supine subjects and in patients with vasovagal symptoms. We challenged stabilization of blood pressure by upright posture (by means of a head-up tilt table test). Head-up position on the tilt table dramatically decreased nyHRV (0.128 ± 0.063 vs. 0.004 ± 0.002, p < 0.01) in healthy subjects (n = 12). Head-up position also decreased nyHRV in patients without vasovagal symptoms (n = 24; 0.220 ± 0.058 vs. 0.034 ± 0.015, p < 0.05), but not in patients with vasovagal symptoms during a head-up tilt table test (age and sex paired, 0.103 ± 0.041 vs. 0.122 ± 0.069, not significant). Heart rate variability includes a physiological non-harmonic non-fractal noisy fluctuation. This noisy fluctuation indicates low engagement of regulatory mechanisms because it disappears when the cardiovascular system is challenged (upright posture). It also indicates cardiovascular instability because it does not disappear in upright patients before vasovagal syncope, a transient failure of cardiovascular regulation.
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Affiliation(s)
- Jacques-Olivier Fortrat
- Faculté de Médecine d'Angers, UMR CNRS 6214 Inserm 1083 (Biologie Neurovasculaire et Mitochondriale Intégrée), Rue Haute de Reculée, 49045 Angers Cedex, France.
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Lin DC, Sharif A. Common multifractality in the heart rate variability and brain activity of healthy humans. CHAOS (WOODBURY, N.Y.) 2010; 20:023121. [PMID: 20590317 DOI: 10.1063/1.3427639] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The influence from the central nervous system on the human multifractal heart rate variability (HRV) is examined under the autonomic nervous system perturbation induced by the head-up-tilt body maneuver. We conducted the multifractal factorization analysis to factor out the common multifractal factor in the joint fluctuation of the beat-to-beat heart rate and electroencephalography data. Evidence of a central link in the multifractal HRV was found, where the transition towards increased (decreased) HRV multifractal complexity is associated with a stronger (weaker) multifractal correlation between the central and autonomic nervous systems.
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Affiliation(s)
- D C Lin
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Ontario M5B 2K3, Canada.
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Pavy-Le Traon A, Heer M, Narici MV, Rittweger J, Vernikos J. From space to Earth: advances in human physiology from 20 years of bed rest studies (1986-2006). Eur J Appl Physiol 2007; 101:143-94. [PMID: 17661073 DOI: 10.1007/s00421-007-0474-z] [Citation(s) in RCA: 375] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2007] [Indexed: 01/11/2023]
Abstract
Bed rest studies of the past 20 years are reviewed. Head-down bed rest (HDBR) has proved its usefulness as a reliable simulation model for the most physiological effects of spaceflight. As well as continuing to search for better understanding of the physiological changes induced, these studies focused mostly on identifying effective countermeasures with encouraging but limited success. HDBR is characterised by immobilization, inactivity, confinement and elimination of Gz gravitational stimuli, such as posture change and direction, which affect body sensors and responses. These induce upward fluid shift, unloading the body's upright weight, absence of work against gravity, reduced energy requirements and reduction in overall sensory stimulation. The upward fluid shift by acting on central volume receptors induces a 10-15% reduction in plasma volume which leads to a now well-documented set of cardiovascular changes including changes in cardiac performance and baroreflex sensitivity that are identical to those in space. Calcium excretion is increased from the beginning of bed rest leading to a sustained negative calcium balance. Calcium absorption is reduced. Body weight, muscle mass, muscle strength is reduced, as is the resistance of muscle to insulin. Bone density, stiffness of bones of the lower limbs and spinal cord and bone architecture are altered. Circadian rhythms may shift and are dampened. Ways to improve the process of evaluating countermeasures--exercise (aerobic, resistive, vibration), nutritional and pharmacological--are proposed. Artificial gravity requires systematic evaluation. This review points to clinical applications of BR research revealing the crucial role of gravity to health.
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Affiliation(s)
- A Pavy-Le Traon
- Service D'explorations Fonctionnelles Respiratoires Et d'analyses Physiologiques, Hopital La Cavale Blanche, University Hospital of Brest, 29609, Brest Cedex, France.
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Grenon SM, Hurwitz S, Sheynberg N, Xiao X, Ramsdell CD, Mai CL, Kim C, Cohen RJ, Williams GH. Role of individual predisposition in orthostatic intolerance before and after simulated microgravity. J Appl Physiol (1985) 2004; 96:1714-22. [PMID: 15075309 DOI: 10.1152/japplphysiol.01274.2003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Orthostatic intolerance (OI) is a major problem after spaceflight. Its etiology remains uncertain, but reports have pointed toward an individual susceptibility to OI. We hypothesized that individual predisposition plays an important role in post-bed rest OI. Twenty-four healthy male subjects were equilibrated on a constant diet, after which they underwent tilt-stand test (pre-TST). They then completed 14-16 days of head-down-tilt bed rest, and 14 of the subjects underwent repeat tilt-stand test (post-TST). During various phases, the following were performed: 24-h urine collections and hormonal measurements, plethysmography, and cardiovascular system identification (a noninvasive method to assess autonomic function and separately quantify parasympathetic and sympathetic responsiveness). Development of presyncope or syncope defined OI. During pre-TST, 11 subjects were intolerant and 13 were tolerant. At baseline, intolerant subjects had lower serum aldosterone (P < 0.01), higher excretion of potassium (P = 0.01), lower leg venous compliance (P = 0.03), higher supine parasympathetic responsiveness (P = 0.02), and lower standing sympathetic responsiveness (P = 0.048). Of the 14 subjects who completed post-TST, 9 were intolerant and 5 were tolerant. Intolerant subjects had lower baseline serum cortisol (P = 0.03) and a higher sodium level (P = 0.02) compared with tolerant subjects. Thus several physiological characteristics were associated with increased susceptibility to OI. We propose a new model for OI, whereby individuals with greater leg venous compliance recruit compensatory mechanisms (activation of the renin-angiotensin-aldosterone system and sympathetic nervous system, and withdrawal of the parasympathetic nervous system) in the face of daily postural challenges, which places them at an advantage to face orthostatic stress. With head-down-tilt bed rest, the stimulus to recruit compensatory mechanisms disappears, and differences between the two subgroups attenuate.
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Affiliation(s)
- S M Grenon
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Boston, MA 02115, USA
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Lin DC. Robustness and perturbation in the modeled cascade heart rate variability. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2003; 67:031914. [PMID: 12689108 DOI: 10.1103/physreve.67.031914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2002] [Revised: 11/08/2002] [Indexed: 05/24/2023]
Abstract
In this study, numerical experiments are conducted to examine the robustness of using cascade to describe the multifractal heart rate variability (HRV) by perturbing the hierarchical time scale structure and the multiplicative rule of the cascade. It is shown that a rigid structure of the multiple time scales is not essential for the multifractal scaling in healthy HRV. So long as there exists a tree structure for the multiplication to take place, a multifractal HRV and related properties can be captured by using the cascade. But the perturbation of the multiplicative rule can lead to a qualitative change. In particular, a multifractal to monofractal HRV transition can result after the product law is perturbed to an additive one at the fast time scale. We suggest that this explains the similar HRV scaling transition in the parasympathetic nervous system blockade.
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Affiliation(s)
- D C Lin
- Department of Mechanical, Aerospace and Industrial Engineering, Ryerson University, Toronto, Ontario, Canada M5B 2K3
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Maillet A, Beaufrere B, Di Nardo P, Elia M, Pichard C. Weightlessness as an accelerated model of nutritional disturbances. Curr Opin Clin Nutr Metab Care 2001; 4:301-6. [PMID: 11458025 DOI: 10.1097/00075197-200107000-00010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Food intake and eating patterns, body functions and composition are significantly altered by short-duration space flight. Prolonged missions lasting weeks or months further aggravate these changes, and are responsible for acute or chronic physical impairments at return to ground conditions. Current projects of missions to Mars, resulting in 2 years of microgravity conditions, stress the critical need for the development of optimal nutritional programs and physical countermeasures to prevent body mass and function alterations. This review outlines ground models of microgravity simulation, summarizes the major effects of weightlessness on body composition, protein metabolism, hormonal pattern, and muscle function, and addresses contradictory findings related to the oxidative stress secondary to space flight. Potential countermeasures, such as nutrient intake and physical conditioning, as well as areas of interest for future research both in ground and space medicine, are discussed.
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Affiliation(s)
- A Maillet
- Biotechnology Topical Team about Nutrition of the European Space Agency, Clinique Spatiale, MEDES, CHU Rangueil, Toulouse Cedex 4, France
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