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The CARD Experiment:
Fluid Shifts, Vasodilatation and Ambulatory Blood Pressure Reductionduring Long Duration Spaceflight
1,2Peter Norsk, 2,3Ali Asmar, 4Morten Damgaard and 5Niels Juel Christensen
1USRA/NASA, Johnson Space Center, Houston, Texas, USA;2Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark;3Department of Clinical Physiology & Nuclear Medicine, Bispebjerg University Hospital, Copenhagen, Denmark;4Department of Clinical Physiology & Nuclear Medicine, Koege Hospital, Koege, Denmark;5Department of Internal Medicine and Endocrinology, Herlev University Hospital, Herlev, Denmark.
https://ntrs.nasa.gov/search.jsp?R=20150011045 2020-04-22T22:31:37+00:00Z
Paolo NespoliEuropean Space Agency astronaut
PurposeTo investigate how fluid shifts, blood pressure and systemic vascular resistance adapt to long duration (3-6 months) spaceflight.
Based on results from one week into a shuttle mission(Norsk et al., Hypertension, 47: 69-73,2006)
CardiacOutput(Rebreathing)
Cardiac outputby
rebreathingFreon
BloodPressure(Brachial)
CardiacOutput(Rebreathing)
BloodPressure(Brachial)
CardiacOutput(Rebreathing)
BloodSample(Catechol)
24-h urine(Vol, Na, K, Osm)
Experimental protocolPre-flight: Launch minus 322 – 71 daysIn-flight: Launch plus 85 – 192 days in-flightPost-flight: Landing plus 58 – 209 days_____________________________________________________________________
Time: 12:00 16:00 20:00 24:00 04:00 08:00 12:0014:00 18:00 22:00 02:00 06:00 10:00
_____________________________________________________________________
Blood pressure: X X X X X X X X X X X X X X X X X X X X(Ambulatory)
Cardiac output: X X X X X(Seated)
Blood sampling: X(Seated)
Urine collection: >-----------------------------------------------------------------------< (ambulatory)______________________________________________________________________X: Execution.
Experimental protocolPre-flight: Launch minus 322 – 71 daysIn-flight: Launch plus 85 – 192 days in-flightPost-flight: Landing plus 58 – 209 days_____________________________________________________________________
Time: 12:00 16:00 20:00 24:00 04:00 08:00 12:0014:00 18:00 22:00 02:00 06:00 10:00
_____________________________________________________________________
Blood pressure: X X X X X X X X X X X X X X X X X X X X(Ambulatory)
Cardiac output: X X X X X(Seated)
Blood sampling: X(Seated)
Urine collection: >-----------------------------------------------------------------------< (ambulatory)______________________________________________________________________X: Execution
ResultsN = 8 males:
Age: 49 ± 1 yHeight: 181 ± 2 cm Weight: 85 ± 4 kg
Stroke volume
70
110
150
190
PRE FLIGHT POST
ml
SV
* †
Cardiac output
4
6
8
10
PRE FLIGHT POST
L/m
in
CO
* †
100±6
133±8
92±4
6.2±0.4
8.4±0.3
6.1±0.3
Fluid Shifts
Stroke volume
70
110
150
190
PRE FLIGHT POST
ml
SV
* †
Cardiac output
4
6
8
10
PRE FLIGHT POST
L/m
in
CO
* †
100±6
133±8
92±4
6.2±0.4
8.4±0.3
6.1±0.3
35 ± 10% increase
41 ± 9 % increase
Fluid Shifts
90
100
110
120
130
140
150Pre-flightPost-flightIn-flight
SAP
(mm
Hg)
60
70
80
90
100
110
120
DA
P (m
m H
g)
12 14 16 18 20 22 00 02 04 06 08 10
70
80
90
100
110
120
130
Time (h)
MA
P (m
m H
g)
Blood Pressure(24-h ambulatory brachial)
90
100
110
120
130
140
150Pre-flightPost-flightIn-flight
SAP
(mm
Hg)
60
70
80
90
100
110
120
DA
P (m
m H
g)
12 14 16 18 20 22 00 02 04 06 08 10
70
80
90
100
110
120
130
Time (h)
MA
P (m
m H
g)
Blood Pressure(24-h ambulatory brachial)
Space
Ground
90
100
110
120
130
140
150Pre-flightPost-flightIn-flight
SAP
(mm
Hg)
60
70
80
90
100
110
120
DA
P (m
m H
g)
12 14 16 18 20 22 00 02 04 06 08 10
70
80
90
100
110
120
130
Time (h)
MA
P (m
m H
g)
Blood Pressure(24-h ambulatory brachial)
Space
Ground
• 10 mm Hg decrease
• No change in heart rate
• Nightly dip maintained
5
15
25
PRE FLIGHT POST
mm
Hg
· L-1
· min
TPR
* †
17±111±1
18±1
Systemic Vascular Resistance
5
15
25
PRE FLIGHT POST
mm
Hg
· L-1
· min
TPR
* †
17±111±1
18±1
39 ± 4 % decrease
Systemic Vascular Resistance
5
15
25
PRE FLIGHT POST
mm
Hg
· L-1
· min
TPR
* †
17±111±1
18±1
Plasma noradrenaline (ng/l):730 ± 130 720 ± 90 730 ± 100
39 ± 4 % decrease
Systemic Vascular Resistance
Future challenge (I):
To relate stroke volume and cardiac output to VIIP!
70
110
150
190
PRE FLIGHT POST
ml
SV
* †
4
6
8
10
PRE FLIGHT POST
L/m
in
CO
* †
35 ± 10 %
41 ± 9 %
Future challenge (II):
To identify the spaceflight vasodilatation mechanism
BP
SNA
39 ± 4 %
Acknowledgements: Co-authors
Niels J. Christensen (Herlev Univ. Hosp., Herlev, Denmark)Ali Asmar (Bispebjerg Univ. Hosp., CPH, Denmark)Morten Damgaard (Koege Hosp., Koege, Denmark).
Laboratory technical assistance
Jakob Utzon-Frank (Univ. CPH, Denmark)Inge H. Petersen (Univ. CPH, Denmark)
ESA assistance
Poul Knudsen (Danish Aerospace Company, Odense, Denmark)Thomas A. E. Andersen (Danish Aerospace Company, Odense, Denmark)
Allain Maillet (Cadmos, CNES, Toulouse France)Stephanie Herr (Cadmos, CNES, Toulouse, France)
Simone Thomas (ESA-ESTEC)Jennifer Ngo-Anh (ESA-ESTEC)Patrik Sundblad (ESA-ESTEC)Astronauts (ESA-EAC)
NASA assistance
Suzanne McCollum and Kathleen McMonigal (NASA-JSC)Astronauts (NASA-JSC)
Thank you
Thank you!Norsk et al. J. Physiol. 593: 573-584, 2015.
SVR SNA
BP
(+)
Arterial baro-receptors(+)
SpaceflightVasodilatationMechanism(s)?
Myogenic,Vascular
Constriction
Headward fluid shift
1-G seated
0 G
Cardiac distension
Vasodilatory(Natriuretic)
Peptides
SVR SNA
BP
(+)
Arterial baro-receptors(+)
SpaceflightVasodilatationMechanism(s)?
Myogenic,Vascular
Constriction
Headward fluid shift
1-G seated
0 G
Cardiac distension
Vasodilatory(Natriuretic)
Peptides
SVR SNA
BP
(+)
(-)
Arterial baro-receptors(+)
SpaceflightVasodilatationMechanism(s)?
Myogenic,Vascular
Constriction
CNS effects:•Vestibular disturbance•Intracranial pressure•Operational stress
Headward fluid shift
1-G seated
0 G
Cardiac distension
Vasodilatory(Natriuretic)
Peptides
SVR SNA
BP
(+)
(+)(-)
Arterial baro-receptors(+)
SpaceflightVasodilatationMechanism(s)?
Myogenic,Vascular
Constriction
CNS effects:•Vestibular disturbance•Intracranial pressure•Operational stress
Headward fluid shift
1-G seated
0 G
Cardiac distension
Vasodilatory(Natriuretic)
Peptides
SVR SNA
BP
(+)
(+)(-)
Arterial baro-receptors(+)
SpaceflightVasodilatationMechanism(s)?
CO2