Biomedical subjects

Marc-Antoine Custaud

Publications and source records attributed to Marc-Antoine Custaud.

12 recordsLinked to original sources

PubMed2005

Blood volume measurement: The comparison of pulse dye densitometry and Dill and Costill's methods.

In many clinical situations, it is crucial to determine circulating blood volume (BV) easily and to repeat this measurement. The Dye DensitoGram Analyzer (DDG, Nihon Kohden Corp) measures semi-automatically BV, using an injection of IndoCyanine Green (ICG, 10 mg), and avoiding intermittent blood samples. The DDG was used during a 90-day microgravity simulation by Head-Down-Tilt bed rest (HDT) to measure BV and compared with the calculation of the plasma volume (PV) variations according to Dill and Costill's formula (DC). Seventeen healthy volunteers were included: 8 control subjects (Co) and 9 subjects submitted to a resistive exercise counter-measure (CM). Measurements were performed, one day before HDT, on days 3 and 90 of HDT and on day 9 after HDT. A double measurement of the BV was performed to assess the repeatability of this method. On the last day of HDT a significant decrease (p < 0.05) in the PV was noted with the DDG (Co: -12.3+/-5.7%, CM: -9.0+/-5.3%) and DC; (Co: -4.7+/-1.8%, CM: -6.8+/-2.5%). A good repeatability of the technique was shown with a low intrasubjects coefficient of variation (4.95+/-0.95%) and an acceptable intersubjects coefficient of variation (15.30+/-1.13%). No correlation was noted between DDG and DC (r2 = 0.27). The DDG gives a good repeatability, not affected by the microgravity exposure. Thanks to its capacity to measure accurately the BV within 7-10 min, this device presents major advantages for clinical use and research purpose.

Adult↗

PubMed2005

[Regulation of blood volume during weightlessness simulation of long duration].

To study the effects of microgravity on the mechanisms involved in the regulation of body hydrous status, total body water (TBW), plasma volume (PV), and its main regulating hormones (plasma renin, aldosterone, atrial natriuretic peptide (ANP), anti-diuretic hormone (ADH)) were determined, by isotopic dilution, Dill and Costill's formula, and radio-immunologic dosages, in 9 male subjects submitted to a 90-d head-down bed rest (HDBR). ADH was determined in 24 h urinary collection as well as osmolality, sodium, and potassium. Body mass decreased (-2.8 +/- 0.8 kg) as well as TBW(-7.2% +/- 0.9%, i.e., -2.6 +/- 0.7 kg) and PV (-4.7% +/- 1.8%). Renin and aldosterone were enhanced (+109.0% +/- 15.4% and +87.2% +/- 38.9%, respectively). Simultaneously, we observed a decrease in ANP (-33.2% +/- 20.4%). Other variables, including ADH, were not affected by HDBR. Body mass and TBW decrease (and consequently lean body mass) are associated with muscle atrophy. Renin, aldostrerone, and ANP modifications are well explained by the decrease in PV, which was not enough to induce ADH changes. It suggests that in man, the main regulatory factor for ADH secretion is osmolality, when PV is modestly and progressively decreased without arterial pressure modification, which was the case in the present protocol.

Adult↗

PubMed2004

Calf venous volume during stand-test after a 90-day bed-rest study with or without exercise countermeasure.

The objectives to determine both the contribution to orthostatic intolerance (OI) of calf venous volume during a stand-test, and the effects of a combined eccentric-concentric resistance exercise countermeasure on both vein response to orthostatic test and OI, after 90-day head-down tilt bed-rest (HDT). The subjects consisted of a control group (Co-gr, n = 9) and an exercise countermeasure group (CM-gr, n = 9). Calf volume and vein cross-sectional area (CSA) were assessed by plethysmography and echography during pre- and post-HDT stand-tests. From supine to standing (post-HDT), the tibial and gastrocnemius vein CSA increased significantly in intolerant subjects (tibial vein, +122% from pre-HDT; gastrocnemius veins, +145%; P < 0.05) whereas it did not in tolerant subjects. Intolerant subjects tended to have a higher increase in calf filling volume than tolerant subjects, in both sitting and standing positions. The countermeasure did not reduce OI. Absolute calf volume decreased similarly in both groups. Tibial and gastrocnemius vein CSA at rest did not change during HDT in either group. During the post-HDT stand-test, the calf filling volume increased more in the CM-gr than in the Co-gr both in the sitting (+1.3 +/- 5.1%, vs. -7.3 +/- 4.3%; P < 0.05) and the standing positions (+56.1 +/- 23.7% vs. +1.6 +/- 9.6%; P < 0.05). The volume ejected by the muscle venous pump increased only in the CM-gr (+38.3 +/- 21.8%). This study showed that intolerant subjects had a higher increase in vein CSA in the standing position and a tendency to present a higher calf filling volume in the sitting and standing positions. It also showed that a combined eccentric-concentric resistance exercise countermeasure had no effects on either post-HDT OI or on the venous parameters related to it.

Adult↗

PubMed2004

Does resistance exercise prevent body fluid changes after a 90-day bed rest?

Although various exercise regimens are commonly used as countermeasures to reduce the cardiovascular deconditioning induced by microgravity, the underlying mechanisms are not well understood. In this study we aimed to test whether lower limb resistance exercise with flywheel technology can prevent the fluid homeostasis alterations induced by 90-day head-down tilt bed-rest (HDT), and thus improve orthostatic tolerance. Total body water (TBW, measured by isotope dilution) and plasma volume (PV, calculated from the haemoglobin and the haematocrit) were measured in a control group (Co, n=9) and a countermeasure group (CM, n=9). Simultaneously, plasma atrial natriuretic peptide (ANP), renin (AR), and aldosterone (Aldo), as well as urinary anti-diuretic hormone (ADH), were measured. Orthostatic tolerance was evaluated with a 10 min +80 degrees tilt-test the first day of recovery. After HDT, both groups showed a comparable decrease in orthostatic tolerance [8.2 (0.9) min, Co; 8.0 (0.7) min, CM], PV [-4.7 (1.8)%, Co; -6.2 (2.5)%, CM, P<0.05] and TBW [-6.3 (5.4)%, Co; -3.7 (2.1)%, CM, P<0.05]. AR [97.4 (22.0)%, Co; 117.3 (26.4)%, CM] and Aldo [111.3 (58.4)%, Co; 100.6 (52.0)%, CM] increased significantly in both groups but the countermeasures produced no noticeable effects [data are expressed as mean (SE)]. The drop in ANP was also similar in both groups [-42.0 (15.2)%, Co; -51.1 (27.7)% for the CM]. Surprisingly, urinary ADH declined similarly in both groups during the basal data control period [-25.3 (5.2)%, Co; -26.1 (9.6)%, CM) and was sustained at this level during the 90-day HDT. These results show that, under the conditions described, the flywheel exercise device failed to improve characteristic manifestations of cardiovascular deconditioning and suggest that more frequent and powerful exercise, associated with another device (e.g. LBNP) might be a better countermeasure.

Adult↗

PubMed2004

Effect of centrifuge-induced artificial gravity and ergometric exercise on cardiovascular deconditioning, myatrophy, and osteoporosis induced by a -6 degrees head-down bedrest.

We have reported that centrifuge-induced artificial gravity with ergometric exercise could reduce developing cardiovascular deconditioning in humans. In the present study, we examined this load could prevent the myatrophy and osteoporosis induced by head-down bedrest for 20 days. Subjects were ten healthy male volunteers with informed consent. They were requested to lie down at -6 degrees for 20 days, and evaluation for cardiovascular deconditioning, myatrophy, and osteoporosis. As the result, high G-load with low intensity exercise suppressed the orthostatic intolerance and increase in serum osteoporotic marker, whereas low G-load with high intensity ergometric exercise maintained the maximal oxygen intake, heart dimension, and prevented myatrophy. The combination of high/low G-load with low/high intensity exercise will determine the optimal protocol for prevention of cardiovascular deconditioning, myatrophy, and osteoporosis.

Adult↗

PubMed2003

Hormonal changes during 17 days of head-down bed-rest.

We investigated in six men the impact of 17 days of head-down bed rest (HDBR) on the daily rhythms of the hormones involved in hydroelectrolytic regulation. This HDBR study was designed to mimic a real space flight. Urine samples were collected at each voiding before, during and after HDBR. Urinary excretion of Growth Hormone (GH), Cortisol, 6 Sulfatoxymelatonin, Normetadrenaline (NMN) and Metadrenaline (NM) was determined. A decrease in urinary cortisol excretion during the night of HDBR was noted. For GH, a rhythm was found before and during HDBR. The rhythm of melatonin, evaluated with the urine excretion of 6 Sulfatoxymelatonin (aMT6S), the main hepatic metabolite, persisted throughout the experiment without any modification to the level of phase. A decrease during the night was noted for normetadrenaline urinary derivates, but only during the HDBR.

Adult↗

PubMed2003

Instant centre frequency at anaesthetic induction--a new way to analyse sympathovagal balance.

The instant centre frequency (ICF) of RR interval has been proposed as a global index to analyse the sympathovagal interaction in the heart. The aim of this study was to assess the ICF during anaesthesia to test if it can reliably capture the neural control of the cardiovascular system. Twenty-four ASA II or III patients scheduled for cardiac surgery were included in the study. They were allocated in two groups: control, no treatment (group 1, n = 12), and beta-adrenergic blockade by atenolol (group 2, n = 12). Spectra of pulse interval series were computed with a time-frequency method and they were divided into: very low frequency (VLF, 0.000-0.040 Hz), low frequency (LF, 0.050-0.150 Hz) and high frequency (HF, 0.160-0.500 Hz). Normalized power was obtained by dividing the cumulative power within each frequency band (LF or HF) by the sum of LF and HF; the ratio of LF/HF was also calculated. Instant centre frequency is a time-varying parameter that the evolution along time of the gravity centrum of a local spectrum. All spectral indexes were recorded at the following time points: before induction, after induction and before intubation, during intubation, and after intubation. The atenolol group had lower normalized LF and the LF/HF ratio (P < 0.05) higher HF before induction; and lower LF/HF ratio after induction and before intubation (P < 0.05). The ICF was higher in atenolol group at all times. The ICF shifted towards HF frequency after induction and before intubation and shifted towards LF during intubation in both groups. The autonomic nervous system control on the heart through the interaction of sympathetic and parasympathetic reflex mechanisms could be studied by the ICF. The ICF may assess the autonomic cardiac modulation and may provide useful information for anaesthetic management.

Adrenergic beta-Antagonists↗

PubMed2003

Changes in intraocular pressure during prolonged (7-day) head-down tilt bedrest.

PURPOSE: To determine the change in intraocular pressure (IOP) due to postural changes in young healthy volunteers. MATERIALS AND METHODS: Intraocular pressure was measured using a calibrated Pulsair noncontact tonometer in both eyes of 25 female volunteers in a sitting position and after 1, 3, and 10 minutes in a supine position. In the second part of the experiment (a 7-day -6 degrees head-down tilt [HDT]), IOP (at 8 am, 12 am and 6 pm) and corneal thickness (12 am) were monitored in 8 female volunteers before, during, and after the HDT period. Blood pressure, hematocrit, plasma volume and osmolality, and plasma catecholamines concentrations were also measured. RESULTS: Intraocular pressure was significantly higher in the supine position (16.1 +/- 3.6 mm Hg) than in the sitting position, with a mean pressure difference of 2.23 +/- 2.9 mm Hg after 1 minute, 0.9 +/- 3 mm Hg after 3 minutes, and 1.9 +/- 3.8 mm Hg after 10 minutes in a supine position (P < 0.001). During the period of HDT, IOP values decreased significantly on the fifth day (13.3 +/- 1.6 mm Hg, P = 0.03) and the seventh day (12.7 +/- 1.7 mm Hg, P = 0.02) when compared with IOP in the supine position (14.26 +/- 2 mm Hg). The corneal thickness increased significantly (P < 0.0001) at day 5 (549.25 +/- 48.7 microm) and day 7 (540.31 +/- 46.9 microm) compared with baseline (532.45 +/- 38.6 microm). Two days after the end of the HDT bedrest, the mean supine IOP significantly increased (14.1 +/- 1.8 mm Hg, P = 0.003) and corneal thickness was similar to that found at baseline. The mean decrease of IOP was positively correlated with that of the plasma volume (-10%, r = 0.61, P = 0.02) and negatively correlated with the mean rise of hematocrit (r = -0.5, P = 0.07), variables that are considered to be indirect measures of plasma dehydration. CONCLUSIONS: During a 7-day HDT bedrest experiment in healthy women, eyes seemed to compensate the moderate rise of IOP described between a sitting and a supine position, and exhibited a slight and progressive average decrease of 1.3 mm Hg. These physiological modifications could be related to an ocular dehydration or to systemic cardiovascular and hormonal variations during bedrest.

Adult↗

PubMed2002

Orthostatic tolerance and spontaneous baroreflex sensitivity in men versus women after 7 days of head-down bed rest.

Many factors are involved in the development of orthostatic intolerance after real or simulated weightlessness. The aim of our study was to compare the effects of 7-day head-down bed rest (HDBR) in eight women and eight men on the spontaneous baroreflex sensitivity (standard spectral method and new time-frequency algorithm) during lower body negative pressure (LBNP) tests. Results obtained before HDBR have shown in women, compared to men, higher heart rate, lower blood pressure, higher parasympathetic modulation at rest and greater decrease in baroreflex sensitivity with greater increase in sympathetic activity during LBNP. After HDBR, we observed in both men and women a dramatic decrease in orthostatic tolerance (7.0 min at R + 1 vs. 10.0 min, p<0.05, at BDC-1 in men; 5.4 vs. 9.0 min, p<0.05, in women) together with a decrease in plasma volume (-9.1 +/- 0.9% in men, -9.5 +/- 1.4% in women) and in spontaneous baroreflex sensitivity without gender effect. After HDBR, at the highest level of LBNP, diastolic blood pressure increased in men (+5.6 +/- 1.3 mm Hg) and decreased in women (-1.0 +/- 2.7 mm Hg) with a gender difference (p<0.05). This result suggests impaired vasoconstriction in women after HDBR. Neither endocrine response nor alterations to the cardiac baroreflex can explain gender differences in orthostatic tolerance after HDBR as reported by previous studies. Further studies need to be conducted in order to obtain a more precise analysis of gender difference in arteriolar vasoconstriction after HDBR. The time frequency method we developed to study changes in spontaneous baroreflex might be applied to the analysis of LBNP tests.

Adult↗

PubMed2002

Heart rate variability after prolonged spaceflights.

Astronauts returning from spaceflight often experience post-flight orthostatic intolerance. This study was designed to determine whether cosmonauts with post-flight syncope could be distinguished from those with no post-flight syncope. The autonomic function was determined in a group of ten subjects, with no previous history of syncope, during a stand test before and after a long-term spaceflight (90 to 198 days). Heart rate (HR) and systolic blood pressure (SBP) were measured beat-by-beat, pre- and post-flight and the spontaneous baroreflex sensitivity and HR variability were studied. Individuals were categorized according to their ability to remain standing for 5 min the day after landing. Three of the ten cosmonauts failed to finish the standing test performed the day after landing (nonfinishers). The spontaneous baroreflex slope was reduced in both groups after the spaceflight. The non-finisher group had a lower SBP (P < 0.05) at rest in pre-flight tests than the group that completed the test (finisher group). The non-finisher group also had higher indicators of parasympathetic activity when supine, both pre- and post-flight, but this difference disappeared with standing. At the end of the stand test, SBP and HR were lower in non-finisher cosmonauts than the finishers, while HR did not increase compared to early measurements in the stand test of the finisher group. These results suggest an impairment in autonomic control of HR, which might contribute to the fainting response.

Adult↗

PubMed2002

Spontaneous baroreflex sensitivity: toward an ideal index of cardiovascular risk in hypertension?

OBJECTIVE: Estimating the risk entailed by classical risk factors like blood pressure (BP) or serum cholesterol may be difficult because of their variability and the often unknown duration of exposure. Having variables integrating the impact of those classical risk factors on the cardiovascular system would probably aid the prediction of cardiovascular events. The present study aimed at determining whether cardiac baroreflex sensitivity (BRS), correlates with several risk factors and thus is a good candidate for being such an integrative variable. As a comparison, left ventricular mass (LVM), pulse wave velocity (PWV), and creatinine were also tested for association with risk factors. DESIGN: A total of 302 subjects referred for hypertension, were considered. They had a 24-h BP recording and a determination of BRS by two different methods (sequence and alpha coefficient), in two different positions (lying and standing). They were also tested for the presence of left ventricular hypertrophy (LVH) (by echocardiography and electrocardiogram) and had a PWV measurement. Biological testing included serum lipids, blood glucose, creatinine, proteinuria and urinary excretion of microalbumin. RESULTS: There was a strong correlation between the two methods of BRS measurement in each position (P < 0.001). BRS determined by the sequence method in the lying position was correlated significantly and independently with age, 24-h systolic BP, heart rate, and serum cholesterol with P values < 0.001, < 0.001, < 0.01, and < 0.05, respectively. In an univariate analysis, BRS was also correlated with echocardiographic LVM index (r = -0.21, P < 0.05) and PWV (r = -0.27, P < 0.001), which possibly reflects its dependence on both vascular and cardiac damages. CONCLUSION: The present study supports the hypothesis that BRS could encompass the impact over time of several risk factors on the cardiovascular system. Thus, it may constitute a valuable parameter in assessing more precisely the risk of cardiovascular events.

Adult↗

PubMed2002

[Orthostatic tolerance after spaceflight or simulated weightlessness by head-down bed-rest].

Cardiovascular modifications, specially orthostatic intolerance (OI) are well known after spaceflight or long duration head-down bed-rest (HDBR) There is no agreement about their mechanisms. The aim of the study was to compare OI after a 42 day HDBR (n = 7) and after a 90 to 198 day spaceflight (n = 10). The studies were made during a stand test of 10 minutes for HDBR following 10 min in supine position and 5 min in sitting position. In both groups the variables measured were blood pressure (BP by transcutaneous plethysmography, Finapres) and ECG for RR interval (RRi) determination which allowed us to calculate autonomic indexes by spectral analysis of RRi and to determine spontaneous baroreflex sensitivity. In the cosmonaut group, 1 subject experienced a vaso-vagal syncope and 2 asked to stop the test without a decrease in BP. In HDBR, 4 subjects out of 7 did not perform the whole stand test (1 vaso-vagal syncope, 1 tachycardia and 2 hypotensions). Cosmonauts or HDBR subjects had common profiles: tachycardia and a decrease in parasympathetic index and baroreflex sensitivity. Both groups have an OI (30% of the subjects). However the mechanisms are different even if they have a common postural orthostatic tachycardia syndrome (POTS). The spaceflight duration was not determinant and we have no indice to predict OI which was one of the aims of the study.

Adult↗