[From the scientific heritage of V.V. Parin (to the development of problems of space medicine and physiology)].
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Biomedical subjects
Publications and source records attributed to R M Baevskiĭ.
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To study vegetative regulation and emotional status of ischemic heart disease (IHD) patients with various pain severity, 81 patients with IHD were examined. Personality characteristics were studied by the data of MMPI questionnaire, reactive and personal anxiety--of Spilberger questionnaire, depressive changes--of Beck's questionnaire, vegetative status--by vegetative discharge, Seattle angina questionnaire of life quality, heart rhythm variability and cardiovascular tests. All the patients have undergone clinical examination, exercise stress tests, echocardiography. Selective coronary angiography was made in some examinees. The patients were divided into two groups by anginal pain severity. The patients with more severe anginal pain had higher reactive and personal anxiety, neurotization. This was not associated with changes in the vegetative status and hemodynamics at rest. The detected emotional disorders in IHD patients may cause higher sensitivity of these patients to pain, on the one side, and changes in vegetative regulation of cardiovascular system and hemodynamics, on the other.
Presented are results of studying 24-hr variability of the cardiac rhythm which characterizes individual difference in reactions of two crew members to the same set of stresses during a 115-day MIR mission. Spacelab (USA) cardiorecorders were used. Data of monitoring revealed significantly different baseline health statuses of the cosmonauts. These functional differences were also observed in the mission. In one of the cosmonauts, the cardiac regulation changed over to a more economic functioning with the autonomous balance shifted towards enhanced sympathetic activity. After 2-3 months on mission he had almost recovered pre-launch level of regulation. In the other, the regulatory system was appreciably strained at the beginning of the mission as compared with preflight baseline. Later on, on flight months 2-3, this strain kept growing till a drastic depletion of the functional reserve. On return to Earth, this was manifested by a strong stress reaction with a sharp decline in power of high-frequency and grow in power of very low frequency components of the heart rhythm. The data suggest that adaptation to space flight and reactions in the readaptation period are dependent on initial health status of crew members, and functional reserve.
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Specificity of the use of ballistocardiography (BCG) in space flight is considered. In particular, the contactless method makes it possible to continue recording during the night hours and study the ultradian rhythms reflective of the state of higher autonomous centers. As was stated, on months 7 to 8 of the mission by cosmonaut-physician Polyakov the BCG amplitude rose in concert with activation of the higher autonomous centers that were apparently involved in maintaining the established cardiovascular homeostasis. By months 11 to 13 on mission, the BCG amplitude decline resulted in an increase in the SCG/BCG index representing the amount of myocardium energy spent on blood transport.
Adjusting reactions of human body were evaluated using mathematical analysis of the cardiac rhythm. Variability of cardiac intervals was reduced in consequence of an elevation of sympathetic tone within the autonomous nervous system. Analyzed were diurnal arrays of cardiac intervals derived from Holter monitoring data. Pulse rate and standard deviation of the cardiac interval length were calculated for each of the 5-minute periods of recording. These data were used to calculate values of the parameters per an hour, 8 hours, and 24 hours. The analysis revealed that generally the body stress-reaction to prolonged isolation consists of increased strain of regulating systems in an effort to mobilize functional reserves. Depending on individual characteristics and functional reserves, the regulating systems become overstrained at some time-point and higher level regulators may be involved in adaptation. Criteria of overstrain include exaggerated pulse rate versus rising standard deviation. Combination of these shifts during morning and night hours should be qualified as least favorable. Test-subject 003, in whom regulation overstrain has been never observed in the experiment, was distinguished by the largest functional reserve.
The article demonstrates an algorithm to evaluate functional state of operators exposed to ecologic hazards. The evaluation of the functional state includes analysis of the heart rhythm registered for 2 minutes. The functional state is assessed through an Indicator of Regulatory Systems Activity (IRSA), obtained by summation of all the values in modulus. IRSA values define 5 functional states: norm; functional strain moderate, marked and extreme; asthenia of regulatory systems. The algorithm suggested differs from the known ones in some features as follows. The diagnosis of heterotopic arrhythmia serves for more precise code demonstrating the heart automatism; formed on the basis of variation coefficient, the code demonstrating stability of the regulation proves the status of stable or disordered regulation; the code demonstrating activities of subcortical neural centers is formed on the basis of measured relative capacity of primary and secondary respiratory waves.
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The influence of scientific and technical progress on the health of population is analysed. It is noted, that modern medicine deals with negative consequences of scientific and technical progress mainly, with the people, who weren't able to adapt to the conditions of environment. A necessity of improvement and development of approaches to estimation of the levels of health is revealed. The two important problems of human ecology are described: the monitoring of environment and the influence of the environment on the health and socio-labour people's potential. The examples of bio-ecological monitoring of environment on the basis of population's health structure in different territorial and industrial complexes are presented. The health of human population is examined as a socio-economic subjects.
A task of distinguishing of functional states on the verge of norm and pathology is becoming more actual now. A possibility of functional organism state estimation is depicted. This estimation is achieved by three components: the level of vital functions, their functional reserve and the degree of regulatory system's tension. A structure of the system of mass prognostic population's examination is: proposed. This system consists of three steps: 1) estimation of adaptive potential and dynamic observation for health status; 2) prognostic examination with determination of functional organism's state and revealing of early and latent forms of diseases; 3) profound specialized examination with diagnostic aim.
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The authors report on the study of the members of four lengthy expeditions on the orbital station "Saliut-6" in the exercise test with the bicycle ergometer at the station. The cybernetic analysis of the cardiac rhythm during its adaptation to weightlessness shows the definite changes of the controlling systems of the body. It is shown that the "cost" od adaptation to exercise is determined by the results of the cybernetic analysis of the cardiac rhythm.
The results of employing the method of variation pulsimetry and dynamic electrocardiography in 30 patients are discussed. Analysis of the circadian dynamics of the statistical characteristics of cardiac rhythm showed that the activity of the sympathetic part of the vegetative nervous system was higher in patients with ischemic heart disease than in those with functional disorders. Disbalance of neurohumoral control of cardiac rhythm in various types of arrhythmias was disclosed.
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In 112 patients mathematical analysis of the cardiac rhythm indices and a biochemical investigation were effected during operative interventions with diverse types of endotracheal anesthesia. The correlation analysis of the cardiac rhythm parameters showed that at the most traumatic moment of the operation the synchronization of the functional links aimed at maintaining homeostasis was going up. Pharmacological block of adrenergic receptors results in weakening correlational interlinks. By analyzing the degree of synchronization marking functional links of the cardiac rhythm parameters that characterize the vegetative homeostasis it becomes possible to obtain information as to the level of the level of the adaptive-regulatory mechanisms tension and the correspondence of the depth of anesthesia to the seriousness of the operation trauma at different stages of surgery.