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J O Fortrat

Publications and source records attributed to J O Fortrat.

32 records · Page 2Linked to original sources

[Reactivity of "white coat" type is associated with reactivity to mental stress].

This study was aimed to compare the white coat effect and the response to a mental stress. 29 subjects, referred for high blood pressure (BP) were included. Systolic BP (SBP) was recorded beat-to-beat with a Finapres device during 3 periods of at least 5 minutes: 1) rest (alone, in lying position); 2) white coat (5 measurements of BP with a standard mercury sphygmomanometer by the same physician); 3) mental stress (version for computer of the Stroop Word Color Conflict Test). A Coarse-graining spectral analysis was performed to compute the power in the low frequency band (PLF: 0-0.150 Hz) and in the high frequency band (PHF: 0.150-0.500 Hz). SBP was 142 +/- 3.7 during the rest period and increased significantly during the white coat (156.7 +/- 3.9 mmHg) and the mental stress (190.7 +/- 4.8 mmHg) periods. These rises of SBP levels were associated with a rise of PLF, significant only during mental stress (11.3 +/- 1.4, 15.7 +/- 3.7, 17.2 +/- 2.4 mmHg2/Hz, during rest, white coat and mental stress periods, respectively). Moreover, a significant correlation (r = 0.76; p < 0.0001) was found between the white coat effect (PAS "white coat"-PAS "rest") and the response to stress (PAS "stress"-PAS "rest"). This work shows that white coat effect is not a specific response but may rather represent an increased reactivity to stress. As it is associated with an increased power in the LF band like the response to stress, this white coat effect may involve an activation of the sympathetic system.

Blood Pressure↗

Comparison of a 4-day confinement and head-down tilt on endocrine response and cardiovascular variability in humans.

The aim of this study was to determine the effects of a 4-day head-down tilt (HDT; -6 degrees) and 4-day confinement on several indicators that might reflect a state of cardiovascular deconditioning on eight male subjects. Measurements were made of endocrine responses, heart rate variability and spontaneous baroreflex response (SBR) slope before, during and after each intervention. Plasma volume decreased by 10 percent after the 4-day HDT. The concentration of active renin was increased and that of urinary atrial natriuretic peptide decreased during the 4-day experiment in both groups. Plasma arginine vasopressin concentration decreased significantly only after 4-day confinement. After the 4-day HDT, one of the spectrum analysis parameters was statistically changed: the parasympathetic indicator decreased significantly (P <0.05) whereas the sympathetic indicator and the total power spectrum were unaltered. After 4-day confinement spectrum analysis parameters were not statistically altered. A significant decrease of SBR (P <0.05) was noticed only after the 4-day HDT. These data would suggest that exposure to a 4-day HDT was sufficient to induce a cardiovascular deconditioning which may have been induced by confinement and inactivity.

Adult↗

Blood volume regulating hormones response during two space related simulation protocols: four-week confinement and head-down bed-rest.

The volume of regulating hormones (renin, aldosterone, arginine vasopressin and atrial natriuretic factor), electrolytes and creatinine concentrations, and blood pressure were measured in two different four-week experimental protocols: respectively -6 degrees head-down bed-rest (5 subjects) and confinement (6 subjects). We observed a significant increase (P < 0.01 at D2 vs D-5) of systolic blood pressure during confinement and a different level of response for some hormones, especially for arginine vasopressin (300% increase during confinement instead of 50% during bed-rest). The renin-angiotensin-aldosterone system was enhanced during confinement and head-down bed-rest. In both conditions, we obtained a similar pattern of response for blood volume regulating hormones. During confinement, two main factors were inactivity and stress activation of the sympathetic nervous system. In the bed-rest study the response is principally due to the fluid shift and blood volume adaptation but it is not possible to exclude the role of inactivity and stress.

Adult↗

On the fractal nature of heart rate variability in humans: effects of respiratory sinus arrhythmia.

The purpose of the present study was to investigate the basic fractal nature of the variability in resting heart rate (HRV), relative to that in breathing frequency (BFV) and tidal volume (TVV), and to test the hypothesis that fractal HRV is due to the fractal BFV and/or TVV in humans. In addition, the possible fractal nature of respiratory volume curves (RVC) and HRV was observed. In the first study, eight subjects were tested while they sat quietly in a comfortable chair for 60 min. Beat-to-beat R-R intervals, i.e., HRV, and breath-by-breath BFV and TVV were measured. In the second study, six subjects were tested while they were in the supine position for 20-30 min. The RVC was monitored continuously together with HRV. Coarse-graining spectral analysis (Yamamoto, Y., and R. L. Hughson, Physica D 68: 250-264, 1993) was applied to these signals to evaluate the percentage of random fractal components in the time series (%Fractal) and the spectral exponent (beta), which characterizes irregularity of the signals. The estimates of beta were determined for each variable only over the range normally used to evaluate HRV. Values for %Fractal and beta of both BFV and TVV were significantly (P < 0.05) greater than those for HRV. In addition, there was no significant (P > 0.05) correlation between the beta values of HRV relative to either BFV (r = 0.14) or TVV (r = 0.34). RVC showed a smooth oscillation as compared with HRV; %Fractal for RVC (42.3 +/- 21.7%, mean +/- SD) was significantly (P < 0.05) lower than that for HRV (78.5 +/- 4.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Altered autonomic regulation of cardiac function during head-up tilt after 28-day head-down bed-rest with counter-measures.

The effects of 28 days continuous 6 degrees head-down tilt bed-rest on heart rate variability and the slope of the spontaneous arterial baroreflex were evaluated during supine rest and the first 10 min of 60 degrees head-up tilt. Twelve healthy men were assigned to either a no counter-measure (No-CM), or a counter-measure (CM) group so that there was no difference in maximal oxygen uptake. Counter-measures consisted of short-term, high resistance exercise for 6 days per week from days 7-28, and lower body negative pressure (-28 mmHg) for 15 min on days 16, 18, 20 and 22-28. In spite of balanced between-group fitness, mean RR-interval was different between the No-CM and the CM group prior to bed-rest, but neither this nor any other variables showed significant counter-measure by bed-rest interaction effects. Therefore, all data presented are from the main effects of bed-rest or tilt from the analysis of variance. RR-interval was reduced significantly by bed-rest and by tilt (P < 0.0001). Indicators from spectral analysis of heart-rate variability suggested reduced parasympathetic nervous system activity with bed-rest (P < 0.01) and head-up tilt (P < 0.05), and increased sympathetic nervous system activity after bed-rest (P < 0.01). An indicator of complexity of cardiovascular control mechanisms, taken from the slope (beta) of log spectral power vs. log frequency relationship, suggested reduced complexity with bed-rest (P < 0.05) and head-up tilt (P < 0.01). The spontaneous baroreflex slope was reduced significantly by bed-rest (P < 0.03) and by head-up tilt (P < 0.04). Taken together, these data support the concept of altered autonomic nervous system function in the aetiology of cardiovascular deconditioning with bed-rest or space travel; and it would appear that no benefit is derived from these specific counter-measures.

Adult↗

Reduced spontaneous baroreflex response slope during lower body negative pressure after 28 days of head-down bed rest.

Effects of 28 days of continuous 6 degrees head-down tilt bed rest on spontaneous vagally mediated baroreflex response slope were evaluated from beat-by-beat relationships between R-R interval and systolic arterial blood pressure. Twelve healthy men (age 27-42 yr) were assigned to either countermeasure (CM) or no-countermeasure (no-CM) groups. CM consisted of strenuous short-term exercise once per day 6 days/wk from days 7 to 28 and lower body negative pressure (LBNP) for 15 min on days 16, 18, 20, and 22-28. Spontaneous baroreflex slope was evaluated by application of linear regression to sequences of at least three beats in which systolic blood pressure and R-R interval changed in the same direction. Measurements were made pre-, mid- (day 15), and post-bed rest at rest and during progressive LBNP tests (3 min at each of -20, -30, -40, and -50 mmHg). R-R interval decreased progressively and significantly (P < 0.0001) over duration of bed rest. Spontaneous baroreflex slope at rest in pre-bed rest was 18.5 +/- 2.1 ms/mm Hg for CM and 14.9 +/- 1.6 ms/mmHg for no-CM. There was a significant reduction in baroreflex slope as a function of bed rest, and it was further reduced during LBNP (P < 0.0001). Between CM and no-CM groups differences existed, but these were present pre-bed rest and appeared unaffected by countermeasures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of 28-day head-down bed rest with countermeasures on heart rate variability during LBNP.

The effect of exercise and LBNP countermeasures on the cardiovascular deconditioning response have been evaluated by the study of heart rate variability during progressive LBNP tests before, during (day 15), and after 28 d continuous 6 degrees head-down tilt bed rest. Twelve healthy men (age 27-42 years) were studied in two groups. Six were assigned to a countermeasure regime (CM) consisting of strenuous short-term resistance exercise once per day, 6 days per week from day 7 to day 28, combined with lower body negative pressure (LBNP, -28 mm Hg) for 15 min on days 16, 18, 20, and 22-28. Results were compared with data from six subjects, matched on the basis of maximum oxygen uptake, who received no countermeasures (No-CM). The main effects of bed rest were seen in reductions in RR-interval, and in total spectral power. The results of spectral analysis showed a significant reduction in an index of parasympathetic activity with a nonsignificant increase in a sympathetic indicator. The fractal component of heart rate variability was reduced also, suggesting a change in cardiovascular control mechanisms. Although there were significant differences between CM and No-CM for a number of variables, there were no bed rest by countermeasure interaction effects in the statistical analysis. These results suggested that this particular series of countermeasures was ineffective in preventing at least certain changes indicative of cardiovascular deconditioning with 28 d head-down tilt bed rest.

Adult↗

European isolation and confinement study. Blood pressure, volume-regulating hormones, and electrolytes.

In the ISEMSI confinement experiment we observed three main reactions concerning blood volume regulation: first, a stress activation produced by the high workload that the subjects had to accomplish, both before the isolation period and during the two first weeks of isolation; second, a typical defense reaction to the environment occurred, at least during the two initial days of isolation and later perhaps between crew members themselves; and third, a change in blood volume regulating hormone levels may have been the result of the increase of sympathetic system activity and of dehydration. Confinement is certainly a good and valid method to simulate space station life (with the absence of weightlessness). So, it is interesting to use these confinement studies to perform biological and physiological experiments to obtain greater knowledge, but also to prepare and validate new scientific protocols or new scientific equipment suitable for spaceflights. Even more so, confinement is a good way to prepare and train crew members for long-term space missions. It would seem desirable to confirm the scientific results obtained during the ISEMSI campaign, and especially those for the regulation of the blood volume. This will be done during the next confinement experiment, called EXEMSI, in which four subjects will be subjected to 60 days of confinement.

Adult↗

Effects of 28-day isolation (ESA-ISEMSI'90) on blood pressure and blood volume regulating hormones.

The aim of this study was to determine what effects social isolation and confinement stress had on the volume regulating hormones. In six healthy male subjects, during a 28-d isolation and confinement study (ESA-ISEMSI'90), hematocrit, blood pressure and resting heart rate, plasma cortisol, renin, aldosterone, arginine vasopressin levels besides the electrolyte (Na+, K+) balance and plasma creatinine were measured. During the confinement, an elevated systolic blood pressure (p < 0.01) was observed together with an increase in MHPG corresponding to an elevated mental work load. The pattern displayed by volume regulating hormones (increased values for renin, aldosterone (p < 0.05) and arginine vasopressin) was not only characteristic of confinement stress but also reflected changes in the water and electrolyte metabolism. The increased creatinine levels seen throughout the study were regarded as consequences of hypohydration, and an enhanced muscular catabolism due to reduced physical activity. A similar pattern of hormone modifications was obtained in a head down tilt of the same duration, indicating that some of the described modifications are probably related to isolation and confinement stress.

Adult↗

Blood volume regulating hormones, fluid and electrolyte modifications during 21 and 198-day space flights (Altair-MIR 1993).

During the Altair MIR '93 mission we studied several parameters involved in blood volume regulation. The experiment was done on two cosmonauts before (B-60, B-30), during (D6, D12, D18 for French and D7, D12, D17 for Russian) and after the flight (R+1, R+3 and R+7). Space flight durations were different for two cosmonauts: for the Russian the flight duration was 198 days and for the French 21 days. On board the MIR station only urinary (volume and electrolytes, atrial natriuretic peptide (ANP), cyclic guanosine monophosphate (cGMP) and catecholamines) and salivary (cGMP and cortisol) samples were collected, centrifuged and stored in freezer. Lithium was used as a tracer to know exactly the 24 h urine output (CNES urine collection Kit). Before and after flight, blood was drawn with an epicite needle and vacutainer system for hormonal assays (renin, antidiuretic hormone, cGMP, ANP and aldosterone) in two positions: after 30 min rest in upright seated position and after 90 min of supine position. Salivary samples were collected simultaneously. During flight a decrease of diuresis and ANP and an increase of osmolality were found. No modifications of hematocrit, but an increase of salivary cGMP and cortisol were also observed. The decrease of urinary ANP is in favor of hypovolemia as described in previous flights. The postflight examinations revealed changes in fluid-electrolyte metabolism which indicate a hypohydration status and a stimulation of hormonal system responsible for water and electrolyte retention in order to readapt to the normal gravity.

Aldosterone↗

Clinical effects of thigh cuffs during a 7-day 6 degrees head-down bed rest.

Thigh cuffs are used by Russian cosmonauts to limit the fluid shift induced by space flight. A ground simulation using the head-down bed rest (HDBR) model was performed to assess the effects of thigh cuffs on clinical tolerance and orthostatic adaptation. 8 male healthy volunteers (32.4 +/- 1.9 years) participated twice in a 7-day HDBR--one time with thigh cuffs (worn daily from 9 am to 7 pm) (TC) and one time without (WTC). Orthostatic tolerance was assessed by a 10 minute stand test and by a LBNP test (5 min at -15, -30, -45 mmHg) before (BDC-1) and at the end of the HDBR period (R+1). Plasma volume was measured before and at the end of HDBR by the Evans blue dye dilution technique. Thigh cuffs limits headache due to fluid shift, as well as the loss in plasma volume (TC: -5.85 +/- 0.95%; WTC: -9.09 +/- 0.82%, p<0.05). The mean duration of the stand test (R+1) did not differ in the two group (TC 7.1 +/- 1.3 min; WTC 7.0 +/- 1.0 min). The increase in HR and decrease in diastolic blood pressure were slightly but significantly larger without thigh cuffs. Duration of the LBNP tests did not differ with thigh cuffs. Thigh cuffs limit the symptoms due to fluid shift and the loss in plasma volume. They partly reduced the increase in HR during orthostatic stress but had no effect on duration of orthostatic stress tests.

Adult↗

Effect of acute atenolol on short-term blood pressure variability and baroreflex sensitivity in rats.

Beta-blocker therapy for hypertension or coronary artery disease is common, but there are a lot of controversies about its effects on short-term blood pressure variability and arterial baroreceptor reflexes. The aim of this study was to evaluate the effects of acute atenolol on baroreflex sensitivity (BRS) and on the spontaneous variability of systolic blood pressure (SBP) and RR intervals in conscious rats. Ten Wistar rats equipped with telemetry system were evaluated: 1) under control conditions; 2) after injection of saline; and 3) during beta1-adrenergic blockade by atenolol. Fast Fourier transform analysis was applied to RR intervals and SBP. Atenolol increased RR intervals significantly by 14% and the variation coefficient of the RR intervals by 31%. SBP was reduced significantly by 9%. In frequency domain, beta1-blockade in RR intervals increased very low frequency by 33% and the total power by 22% and decreased low frequency by 25%. The ratio of low to high frequency power decreased by 60%. Frequency domain variables in SBP were not significantly changed after beta1-adrenergic receptor blockade. BRS (gain alpha) was not significantly altered by beta-blockers. Acute atenolol decreased SBP and increased RR intervals with no change in BRS, indicating 'resetting' of baroreflex function.

Adrenergic beta-Antagonists↗