The objective of this investigation was to identify the major cardiovascular changes induced by exposure to real or simulated Og (spaceflights: 6, 14, 21 and 25 days, and 6 months; head down tilt, HDT: 10 h, 4, 5, 7, 30 and 42 days), with a minimum of counter-measures. The following cardiovascular data were measured by echocardiography and Doppler ultrasonography: left ventricle end-diastolic volume (LVDV), stroke volume (SV), cardiac output (CO), ejection fraction (EF), middle cerebral artery flow velocity (Qca), femoral artery flow velocity (Qfa), cerebral vascular resistance (Rca), femoral vascular resistance (Rfa), jugular vein cross-sectional area (Ajv), femoral vein cross-sectional area (Afv), heart rate (HR), and mean blood pressure (MBP). LVDV remained decreased compared to pre-HDT or pre-flight levels after 1 week of spaceflight or HDT (-8 to -13%, P<0.05), EF did not change. HR tended to increase (5-10%) during spaceflight and HDT, whereas MBP tended to decrease during flight, but did not change in HDT. These findings are consistent with the existence of a moderate and stable hypovolemia. Qca and Rca fluctuated between +10 and -10% from pre-HDT or pre-flight values, and always showed opposing variations. There was no significant decrease in cerebral perfusion. Lower-limb resistance (Rfa) remained decreased (-5% to -18%, P<0.05) throughout the flights or HDT after week 1. Ajv remained significantly enlarged (+40% P < 0.05) after 1 week in spaceflight or in HDT. Afv was enlarged in spaceflight after week 1 (+15% to +35%, P<0.05), whereas it decreased after 4-5 days of HDT (-20% to -35%, P<0.05). The cardiovascular system reached a new and stable equilibrium during flight and HDT within less than 1 week. With the exception of the femoral vein, there was no significant difference in either the amplitude or the time course of the cardiovascular changes in both situations after 1 week.

The objectives of this investigation were to study the effects of thigh cuffs (bracelets) on cardiovascular adaptation and deconditioning in 0 g. The cardiovascular parameters of six cosmonauts were measured by echocardiography, Doppler, and plethysmography, during three 6-month MIR spaceflights. Measurements were made at rest during preflight (-30 days), inflight (1, 3-4, and 5-5.5 months) without cuffs (morning) and after 5 h with cuffs, and during postflight (+3 and +7 days). Lower-body negative pressure (LBNP) measurements were performed 1 day after each resting session. Inflight values of left ventricle end-diastolic volume and stroke volume measured without the thigh cuffs (-8 to -24% and -10 to -16%, respectively, both P < 0.05) were lower than corresponding preflight values. The jugular and femoral vein cross-sectional areas (Ajv and Afv, respectively) were enlarged (Ajv: by 23-30%, P < 0.001; Afv: by 33-70% P < 0.01). The renal and femoral vascular resistances (Rra and Rfa, respectively) decreased (Rra: by -15 to -16%, P < 0.01; Rfa: by -5 to -11%, P < 0.01). Inflight, the thigh cuffs reduced the Ajv (by -12 to -20%, P < 0.02), but enlarged the Afv (Afv: by 9-20%, P < 0.02) and increased the vascular resistance (Rra: by 8-13%, P < 0.05; Rfa: by 10-16%, P < 0.01) compared to corresponding inflight, without-cuffs values. During LBNP (-45 mmHg, where 1 mmHg = 133.3 N/ m2), Rfa and the ratio between cerebral and femoral blood flow (Qca/Qfa) increased less inflight and postflight (+25% for Rfa and +30% for Qca/Qfa) than during preflight (60% for Rfa and 75% for Qca/Qfa, P < 0.01). This reduced vasoconstrictive response and less efficient flow redistribution toward the brain was associated with orthostatic intolerance during postflight stand tests in all of the cosmonauts. The calf circumference increased less inflight and postflight (6% P < 0.05) than preflight (9% P < 0.05). The vascular response to LBNP remained similarly altered throughout the flight. The thigh cuffs compensated partially for the cardiovascular changes induced by exposure to 0 g, but did not interfere with 0 g deconditioning.

Thigh cuffs, presently named "bracelets," consist of two straps fixed to the upper part of each thigh, applying a pressure of 30 mmHg. The objective was to evaluate the cardiac, arterial, and venous changes in a group of subjects in head-down tilt (HDT) for 7 days by using thigh cuffs during the daytime, and in a control group not using cuffs. The cardiovascular parameters were measured by echography and Doppler. Seven days in HDT reduced stroke volume in both groups (-10%; P < 0.05). Lower limb vascular resistance decreased more in the cuff group than in the control group (-29 vs. -4%; P < 0.05). Cerebral resistance increased in the control group only (+6%; P < 0.05). The jugular vein increased (+45%; P < 0.05) and femoral and popliteal veins decreased in cross-sectional area in both groups (-45 and -8%, respectively; P < 0.05). Carotid diameter tended to decrease (-5%; not significant) in both groups. Heart rate, blood pressure, cardiac output, and total resistance did not change significantly. After 8 h with thigh cuffs, the cardiac and arterial parameters had recovered their pre-HDT level except for blood pressure (+6%; P < 0.05). Jugular vein size decreased from the pre-HDT level (-21%; P < 0.05), and femoral and popliteal vein size increased (+110 and +136%, respectively; P < 0.05). The thigh cuffs had no effect on the development of orthostatic intolerance during the 7 days in HDT.

The first objective of this study was to confirm that 4 days of head-down tilt (HDT) were sufficient to induce orthostatic intolerance, and to check if 4 days of physical confinement may also induce orthostatic intolerance. Evidence of orthostatic intolerance during tilt-up tests was obtained from blood pressure and clinical criteria. The second objective was to quantify the arterial and venous changes associated with orthostatic intolerance and to check whether abnormal responses to the tilt test and lower body negative pressure (LBNP) may occur in the absence of blood pressure or clinical signs of orthostatic intolerance. The cerebral and lower limb arterial blood flow and vascular resistance, the flow redistribution between these two areas, and the femoral vein distension were assessed during tilt-up and LBNP by ultrasound. Eight subjects were given 4 days of HDT and, 1 month later, 4 days of physical confinement. Tilt and LBNP test were performed pre- and post-HDT and confinement. Orthostatic intolerance was significantly more frequent after HDT (63%) than after confinement (25%, P < 0.001). Cerebral haemodynamic responses to tilt-up and LBNP tests were similar pre- and post-HDT or confinement. Conversely, during both tilt and LBNP tests the femoral vascular resistances increased less (P < 0.002), and the femoral blood flow reduced less (P < 0.001) after HDT than before HDT or after confinement. The cerebral to femoral blood flow ratio increased less after HDT than before (P < 0.002) but remained unchanged before and after confinement. This ratio was significantly more disturbed in the subjects who did not complete the tilt test. The femoral superficial vein was more distended during post-HDT LBNP than pre-HDT or after confinement (P < 0.01). In conclusion, 4 days of HDT were enough to alter the lower limb arterial vasoconstriction and venous distensibility during tilt-up and LBNP, which reduced the flow redistribution in favour of the brain in all HDT subjects. Confinement did not alter significantly the haemodynamic responses to orthostatic tests. The cerebral to femoral blood flow ratio measured during LBNP was the best predictor of orthostatic intolerance.

Lack of lower limb vasoconstriction and a lower cerebral-femoral flow ratio during lower body negative pressure in disadapted subjects were associated with orthostatic intolerance. A cerebral flow deficit during lower body negative pressure before disadaptation allowed measurement of the predisposition of the subjects to become intolerant.