The role of echocardiography in the assessment of cardiac function in weightlessness—Our experience during parabolic flights

Caiani, Enrico G.; Weinert, Lynn; Lang, Roberto M.; Vaïda, P.

doi:10.1016/j.resp.2009.07.007

Cited by 10 publications

(7 citation statements)

References 10 publications

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“…Deformable solids are also subject to gravity, e.g., gels change shape due to gravitational forces [ 59 ]. In the human body, gravitational changes can result in a shift in the position of major organs, and in some cases, there may be a change in organ shape [ 60 , 61 ].…”

Section: Fluid Redistribution In Microgravitymentioning

confidence: 99%

“…In addition to the bulk redistribution imposed by fluid shift, organ shape and position can also respond to microgravity very quickly. In parabolic flight, echocardiography showed that the heart becomes more spherical [ 60 , 61 ]. An independent numerical model validated the modified shape and, by comparing microgravity to lunar, Martian and 1 g simulations, predicted that the stress and strain states of the cardiac tissue at end diastole were a function of gravitational level [ 83 ].…”

Section: Fluid Redistribution In Microgravitymentioning

confidence: 99%

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Microgravity-Induced Fluid Shift and Ophthalmic Changes

Nelson

Mulugeta

Myers

2014

Life

122

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Although changes to visual acuity in spaceflight have been observed in some astronauts since the early days of the space program, the impact to the crew was considered minor. Since that time, missions to the International Space Station have extended the typical duration of time spent in microgravity from a few days or weeks to many months. This has been accompanied by the emergence of a variety of ophthalmic pathologies in a significant proportion of long-duration crewmembers, including globe flattening, choroidal folding, optic disc edema, and optic nerve kinking, among others. The clinical findings of affected astronauts are reminiscent of terrestrial pathologies such as idiopathic intracranial hypertension that are characterized by high intracranial pressure. As a result, NASA has placed an emphasis on determining the relevant factors and their interactions that are responsible for detrimental ophthalmic response to space. This article will describe the Visual Impairment and Intracranial Pressure syndrome, link it to key factors in physiological adaptation to the microgravity environment, particularly a cephalad shifting of bodily fluids, and discuss the implications for ocular biomechanics and physiological function in long-duration spaceflight.

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Section: Fluid Redistribution In Microgravitymentioning

confidence: 99%

Section: Fluid Redistribution In Microgravitymentioning

confidence: 99%

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Nelson

Mulugeta

Myers

2014

Life

122

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“…The different behavior of apical Strain and SR could reflect the relatively load independence of SR, which is more comparable to intrinsic contractility. [29] This LV base-apex gradient was also confirmed by rotation data: compared to control group HTX patients showed a significantly lowered basal rotation with preserved apical rotation. As a consequence LV twist amplitude, which is the net difference in clockwise and counterclockwise rotation of the LV apex and base, was normal.…”

Section: Integrated Ventricular Mechanicsmentioning

confidence: 58%

Integrated Ventricular Mechanics in "Healthy" Heart Transplant Patients

Baldini¹,

Limongelli²,

Amarelli³

et al. 2015

ARC Journal of Cardiology

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Although recently studies using Speckle Tracking Echocardiography (STE) on heart transplant (HTX) recipients have been published, an integrated assessment of myocardial properties is lacking. Thus our aim was to perform, by STE, an integrated study of ventricular mechanics in "healthy" HTX recipients. Standard echo-Doppler and STE study were performed in 50 HTX patients (age 50.4 ± 7.8, M/F = 37/13, follow-up 7.6 ± 5.3 years) without symptoms (NYHA I) and with preserved ejection fraction (EF) (HTX Group). As controls 35 age-, sex-and BSA-matched normal subjects were studied (CTRL Group). Compared to CTRL group our HTX recipients showed: a) impaired left ventricular (LV) longitudinal, circumferential and radial Strain values (p<0.01) with a lesser degree of reduction at the apical segments; b) normal apical longitudinal, circumferential and radial Strain Rate values with reduction in the remaining segments; c) preservation of LV apical rotation and basal impairment (p<0.0001) with normal LV twist; d) delayed untwisting due to prolonged twist (p<0.0001) and thus prolongation of isovolumic relaxation time (p<0.01) in presence of normal E/E' ratio; e) reduced right ventricular TAPSE, S' (p<0.0001) and longitudinal Strain and SR (p<0.0001). "Healthy" HTX patients, even in presence of impaired global biventricular myocardial deformation, show normal amplitude of LV twist and in turn EF. In addition, probably due to regional differences in wall stress, a LV base-apex gradient of these subclinical systolic dysfunction is detectable. Finally an early impaired LV diastolic filling due to delayed untwisting related to prolonged twist is also evident.

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“…In this regard, spaceflight analogs, such as bed rest, head-down tilt at a moderate angle, or water immersion, have been implemented, particularly in scientific settings ( Hargens and Vico, 2016 ). Even so, since a few decades, parabolic flights have equally proven a promising spaceflight analog ( Caiani et al, 2009 ; Petersen et al, 2011 ; Norsk, 2014 ; Shelhamer, 2016 ; Klein et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…So far, scientific works have been focusing on macrocirculatory parameters such as blood pressure, cardiac output, and heart rate during human space missions as well as with spaceflight analogs ( Mukai et al, 1991 ; Fritsch-Yelle et al, 1996 ; Schlegel et al, 1998 ; Norsk et al, 2006 , 2015 ; Caiani et al, 2009 ; Coupé et al, 2009 ). However, in-flight measurements of these cardiovascular parameters are difficult to obtain, and results have been inconsistent ( Fritsch-Yelle et al, 1996 ; Norsk et al, 2006 ; Verheyden et al, 2009 ; Petersen et al, 2011 ; Klein et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Analysis of Macrocirculation and Microcirculation in Microgravity During Parabolic Flights

et al. 2020

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Background Profound knowledge about cardiovascular physiology in the setting of microgravity can help in the course of preparations for human space missions. So far, influences of microgravity on the cardiovascular system have been demonstrated, particularly pertaining to venous fluid shifts. Yet, little is known about the mechanisms of these adaptations on continuous macrocirculatory level and regarding the microcirculation. Methods Twelve healthy volunteers were subjected to alternating microgravity and hypergravity in the course of parabolic flight maneuvers. Under these conditions, as well as in normal gravity, the sublingual microcirculation was assessed by intravital sidestream dark field microscopy. Furthermore, hemodynamic parameters such as heart rate, blood pressure, and cardiac output were recorded by beat-to-beat analysis. In these settings, data acquisition was performed in seated and in supine postures. Results Systolic [median 116 mmHg (102; 129) interquartile range (IQR) vs. 125 mmHg (109; 136) IQR, p = 0.01] as well as diastolic [median 72 mmHg (61; 79) IQR vs. 80 mmHg (69; 89) IQR, p = 0.003] blood pressure was reduced, and cardiac output [median 6.9 l/min (6.5; 8.8) IQR vs. 6.8 l/min (6.2; 8.5) IQR, p = 0.0002] increased in weightlessness compared to normal gravitation phases in the seated but not in the supine posture. However, microcirculation represented by perfused proportion of vessels and by total vessel density was unaffected in acute weightlessness. Conclusion Profound changes of the macrocirculation were found in seated postures, but not in supine postures. However, microcirculation remained stable in all postures.

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The role of echocardiography in the assessment of cardiac function in weightlessness—Our experience during parabolic flights

Cited by 10 publications

References 10 publications

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Integrated Ventricular Mechanics in "Healthy" Heart Transplant Patients

Comprehensive Analysis of Macrocirculation and Microcirculation in Microgravity During Parabolic Flights

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