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Morris PD, Anderton RA, Marshall-Goebel K, Britton JK, Lee SMC, Smith NP, van de Vosse FN, Ong KM, Newman TA, Taylor DJ, Chico T, Gunn JP, Narracott AJ, Hose DR, Halliday I. Computational modelling of cardiovascular pathophysiology to risk stratify commercial spaceflight. Nat Rev Cardiol 2024:10.1038/s41569-024-01047-5. [PMID: 39030270 DOI: 10.1038/s41569-024-01047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/21/2024]
Abstract
For more than 60 years, humans have travelled into space. Until now, the majority of astronauts have been professional, government agency astronauts selected, in part, for their superlative physical fitness and the absence of disease. Commercial spaceflight is now becoming accessible to members of the public, many of whom would previously have been excluded owing to unsatisfactory fitness or the presence of cardiorespiratory diseases. While data exist on the effects of gravitational and acceleration (G) forces on human physiology, data on the effects of the aerospace environment in unselected members of the public, and particularly in those with clinically significant pathology, are limited. Although short in duration, these high acceleration forces can potentially either impair the experience or, more seriously, pose a risk to health in some individuals. Rather than expose individuals with existing pathology to G forces to collect data, computational modelling might be useful to predict the nature and severity of cardiovascular diseases that are of sufficient risk to restrict access, require modification, or suggest further investigation or training before flight. In this Review, we explore state-of-the-art, zero-dimensional, compartmentalized models of human cardiovascular pathophysiology that can be used to simulate the effects of acceleration forces, homeostatic regulation and ventilation-perfusion matching, using data generated by long-arm centrifuge facilities of the US National Aeronautics and Space Administration and the European Space Agency to risk stratify individuals and help to improve safety in commercial suborbital spaceflight.
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Affiliation(s)
- Paul D Morris
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK.
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | - Ryan A Anderton
- Medical Department, Spaceflight, UK Civil Aviation Authority, Gatwick, UK
| | - Karina Marshall-Goebel
- The National Aeronautics and Space Administration (NASA) Johnson Space Center, Houston, TX, USA
| | - Joseph K Britton
- Aerospace Medicine Specialist Wing, Royal Air Force (RAF) Centre of Aerospace Medicine, Henlow, UK
| | - Stuart M C Lee
- KBR, Human Health Countermeasures Element, NASA Johnson Space Center, Houston, TX, USA
| | - Nicolas P Smith
- Victoria University of Wellington, Wellington, New Zealand
- Auckland Bioengineering Institute, Auckland, New Zealand
| | - Frans N van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Karen M Ong
- Virgin Galactic Medical, Truth or Consequences, NM, USA
| | - Tom A Newman
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Daniel J Taylor
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
| | - Tim Chico
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Julian P Gunn
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Andrew J Narracott
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - D Rod Hose
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - Ian Halliday
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
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2
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Wilson SL, Schulte KM, Steins A, Gruen RL, Tucker EM, van Loon LM. Computational modeling of heart failure in microgravity transitions. Front Physiol 2024; 15:1351985. [PMID: 38974518 PMCID: PMC11224153 DOI: 10.3389/fphys.2024.1351985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/06/2024] [Indexed: 07/09/2024] Open
Abstract
The space tourism industry is growing due to advances in rocket technology. Privatised space travel exposes non-professional astronauts with health profiles comprising underlying conditions to microgravity. Prior research has typically focused on the effects of microgravity on human physiology in healthy astronauts, and little is known how the effects of microgravity may play out in the pathophysiology of underlying medical conditions, such as heart failure. This study used an established, controlled lumped mathematical model of the cardiopulmonary system to simulate the effects of entry into microgravity in the setting of heart failure with both, reduced and preserved ejection fraction. We find that exposure to microgravity eventuates an increased cardiac output, and in patients with heart failure there is an unwanted increase in left atrial pressure, indicating an elevated risk for development of pulmonary oedema. This model gives insight into the risks of space flight for people with heart failure, and the impact this may have on mission success in space tourism.
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Affiliation(s)
| | | | | | | | | | - Lex M. van Loon
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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3
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Munster DW, Lewandowski BE, Nelson ES, Prabhu RK, Myers JG. Modeling the impact of thoracic pressure on intracranial pressure. NPJ Microgravity 2024; 10:46. [PMID: 38600142 PMCID: PMC11006658 DOI: 10.1038/s41526-024-00385-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
A potential contribution to the progression of Spaceflight Associated Neuro-ocular Syndrome is the thoracic-to-spinal dural sac transmural pressure relationship. In this study, we utilize a lumped-parameter computational model of human cerebrospinal fluid (CSF) systems to investigate mechanisms of CSF redistribution. We present two analyses to illustrate potential mechanisms for CSF pressure alterations similar to those observed in microgravity conditions. Our numerical evidence suggests that the compliant relationship between thoracic and CSF compartments is insufficient to solely explain the observed decrease in CSF pressure with respect to the supine position. Our analyses suggest that the interaction between thoracic pressure and the cardiovascular system, particularly the central veins, has greater influence on CSF pressure. These results indicate that future studies should focus on the holistic system, with the impact of cardiovascular changes to the CSF pressure emphasized over the sequestration of fluid in the spine.
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Affiliation(s)
- Drayton W Munster
- NASA Glenn Research Center, 21000 Brookpark Road, Cleveland, OH, 44135, USA.
| | - Beth E Lewandowski
- NASA Glenn Research Center, 21000 Brookpark Road, Cleveland, OH, 44135, USA
| | - Emily S Nelson
- NASA Glenn Research Center, 21000 Brookpark Road, Cleveland, OH, 44135, USA
| | - R K Prabhu
- Universities Space Research Association, 21000 Brookpark Road, Cleveland, OH, 44135, USA
| | - Jerry G Myers
- NASA Glenn Research Center, 21000 Brookpark Road, Cleveland, OH, 44135, USA
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Fois M, Diaz-Artiles A, Zaman SY, Ridolfi L, Scarsoglio S. Linking cerebral hemodynamics and ocular microgravity-induced alterations through an in silico-in vivo head-down tilt framework. NPJ Microgravity 2024; 10:22. [PMID: 38413627 PMCID: PMC10899661 DOI: 10.1038/s41526-024-00366-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
Head-down tilt (HDT) has been widely proposed as a terrestrial analog of microgravity and used also to investigate the occurrence of spaceflight-associated neuro-ocular syndrome (SANS), which is currently considered one of the major health risks for human spaceflight. We propose here an in vivo validated numerical framework to simulate the acute ocular-cerebrovascular response to 6° HDT, to explore the etiology and pathophysiology of SANS. The model links cerebral and ocular posture-induced hemodynamics, simulating the response of the main cerebrovascular mechanisms, as well as the relationship between intracranial and intraocular pressure to HDT. Our results from short-term (10 min) 6° HDT show increased hemodynamic pulsatility in the proximal-to-distal/capillary-venous cerebral direction, a marked decrease (-43%) in ocular translaminar pressure, and an increase (+31%) in ocular perfusion pressure, suggesting a plausible explanation of the underlying mechanisms at the onset of ocular globe deformation and edema formation over longer time scales.
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Affiliation(s)
- Matteo Fois
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, Turin, 10129, Italy.
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, 3141 TAMU, College Station, TX, 77843-3141, USA
- Department of Kinesiology and Sport Management, Texas A&M University, 2929 Research Pkwy, College Station, TX, 77845, USA
| | - Syeda Yasmin Zaman
- Department of Aerospace Engineering, Texas A&M University, 3141 TAMU, College Station, TX, 77843-3141, USA
| | - Luca Ridolfi
- Department of Environmental, Land and Infrastructure Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, Turin, 10129, Italy
- PolitoBioMed Lab, Politecnico di Torino, Corso Duca degli Abruzzi 24, Turin, 10129, Italy
| | - Stefania Scarsoglio
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, Turin, 10129, Italy
- PolitoBioMed Lab, Politecnico di Torino, Corso Duca degli Abruzzi 24, Turin, 10129, Italy
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Caddy HT, Kelsey LJ, Parker LP, Green DJ, Doyle BJ. Modelling large scale artery haemodynamics from the heart to the eye in response to simulated microgravity. NPJ Microgravity 2024; 10:7. [PMID: 38218868 PMCID: PMC10787773 DOI: 10.1038/s41526-024-00348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024] Open
Abstract
We investigated variations in haemodynamics in response to simulated microgravity across a semi-subject-specific three-dimensional (3D) continuous arterial network connecting the heart to the eye using computational fluid dynamics (CFD) simulations. Using this model we simulated pulsatile blood flow in an upright Earth gravity case and a simulated microgravity case. Under simulated microgravity, regional time-averaged wall shear stress (TAWSS) increased and oscillatory shear index (OSI) decreased in upper body arteries, whilst the opposite was observed in the lower body. Between cases, uniform changes in TAWSS and OSI were found in the retina across diameters. This work demonstrates that 3D CFD simulations can be performed across continuously connected networks of small and large arteries. Simulated results exhibited similarities to low dimensional spaceflight simulations and measured data-specifically that blood flow and shear stress decrease towards the lower limbs and increase towards the cerebrovasculature and eyes in response to simulated microgravity, relative to an upright position in Earth gravity.
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Affiliation(s)
- Harrison T Caddy
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, Queen Elizabeth II Medical Centre, Nedlands, Australia and the UWA Centre for Medical Research, The University of Western Australia, Perth, WA, Australia
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, WA, Australia
| | - Lachlan J Kelsey
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, Queen Elizabeth II Medical Centre, Nedlands, Australia and the UWA Centre for Medical Research, The University of Western Australia, Perth, WA, Australia
- School of Engineering, The University of Western Australia, Perth, WA, Australia
| | - Louis P Parker
- FLOW, Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, WA, Australia
| | - Barry J Doyle
- Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, Queen Elizabeth II Medical Centre, Nedlands, Australia and the UWA Centre for Medical Research, The University of Western Australia, Perth, WA, Australia.
- School of Engineering, The University of Western Australia, Perth, WA, Australia.
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Murali A, Sarkar RR. Mechano-immunology in microgravity. LIFE SCIENCES IN SPACE RESEARCH 2023; 37:50-64. [PMID: 37087179 DOI: 10.1016/j.lssr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/16/2023] [Accepted: 03/05/2023] [Indexed: 05/03/2023]
Abstract
Life on Earth has evolved to thrive in the Earth's natural gravitational field; however, as space technology advances, we must revisit and investigate the effects of unnatural conditions on human health, such as gravitational change. Studies have shown that microgravity has a negative impact on various systemic parts of humans, with the effects being more severe in the human immune system. Increasing costs, limited experimental time, and sample handling issues hampered our understanding of this field. To address the existing knowledge gap and provide confidence in modelling the phenomena, in this review, we highlight experimental works in mechano-immunology under microgravity and different computational modelling approaches that can be used to address the existing problems.
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Affiliation(s)
- Anirudh Murali
- Chemical Engineering and Process Development, CSIR - National Chemical Laboratory, Pune, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Ram Rup Sarkar
- Chemical Engineering and Process Development, CSIR - National Chemical Laboratory, Pune, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Coccarelli A, Nelson MD. Modeling Reactive Hyperemia to Better Understand and Assess Microvascular Function: A Review of Techniques. Ann Biomed Eng 2023; 51:479-492. [PMID: 36709231 PMCID: PMC9928923 DOI: 10.1007/s10439-022-03134-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/25/2022] [Indexed: 01/30/2023]
Abstract
Reactive hyperemia is a well-established technique for the non-invasive evaluation of the peripheral microcirculatory function, measured as the magnitude of limb re-perfusion after a brief period of ischemia. Despite widespread adoption by researchers and clinicians alike, many uncertainties remain surrounding interpretation, compounded by patient-specific confounding factors (such as blood pressure or the metabolic rate of the ischemic limb). Mathematical modeling can accelerate our understanding of the physiology underlying the reactive hyperemia response and guide in the estimation of quantities which are difficult to measure experimentally. In this work, we aim to provide a comprehensive guide for mathematical modeling techniques that can be used for describing the key phenomena involved in the reactive hyperemia response, alongside their limitations and advantages. The reported methodologies can be used for investigating specific reactive hyperemia aspects alone, or can be combined into a computational framework to be used in (pre-)clinical settings.
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Affiliation(s)
- Alberto Coccarelli
- Zienkiewicz Centre for Computational Engineering, Faculty of Science and Engineering, Swansea University, Swansea, UK.
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
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Computational modeling of orthostatic intolerance for travel to Mars. NPJ Microgravity 2022; 8:34. [PMID: 35945233 PMCID: PMC9363491 DOI: 10.1038/s41526-022-00219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/15/2022] [Indexed: 11/12/2022] Open
Abstract
Astronauts in a microgravity environment will experience significant changes in their cardiopulmonary system. Up until now, there has always been the reassurance that they have real-time contact with experts on Earth. Mars crew however will have gaps in their communication of 20 min or more. In silico experiments are therefore needed to assess fitness to fly for those on future space flights to Mars. In this study, we present an open-source controlled lumped mathematical model of the cardiopulmonary system that is able simulate the short-term adaptations of key hemodynamic parameters to an active stand test after being exposed to microgravity. The presented model is capable of adequately simulating key cardiovascular hemodynamic changes—over a short time frame—during a stand test after prolonged spaceflight under different gravitational conditions and fluid loading conditions. This model can form the basis for further exploration of the ability of the human cardiovascular system to withstand long-duration space flight and life on Mars.
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Baselli G, Laganà MM. The intracranial Windkessel implies arteriovenous pulsatile coupling increased by venous resistances. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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