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Biomedical subjects

S M Fortney

Publications and source records attributed to S M Fortney.

At least 19 recordsLinked to original sources

Development of lower body negative pressure as a countermeasure for orthostatic intolerance.

Exposure to prolonged (1-4 hr) lower body negative pressure (LBNP) is a countermeasure against postflight orthostatic intolerance which is used in the Soviet space program and planned for use in the American space program. LBNP in combination with fluid-loading is believed to act by promoting a transient positive fluid balance resulting in an increase in vascular, as well as extravascular fluid. Inflight LBNP also may provide beneficial orthostatic effects by restoring baroreceptor reflex functions and/or lower body venous compliance. Current research efforts at the Johnson Space Center are directed towards increasing the effectiveness and efficiency of the LBNP and saline countermeasure. A promising avenue may involve combining pharmacologic agents, such as inhaled anti-diuretic hormone, or mineralocorticoids, with mechanical stimuli such as LBNP.

Humans

Sweating and skin blood flow during exercise: effects of age and maximal oxygen uptake.

Individuals greater than or equal to 60 yr of age are more susceptible to hyperthermia than younger people. However, the mechanisms involved remain unclear. To gain further insight, we examined the heat loss responses of 7 young (24-30 yr) and 13 older (58-74 yr) men during 20 min of cycle exercise [67.5% maximal O2 uptake (VO2max)] in a warm environment (30 degrees C, 55% relative humidity). Forearm blood flow (FBF) and chest sweat rate (SR) were plotted as a function of the weighted average of mean skin and esophageal temperatures [Tes(w)] during exercise. The sensitivity and threshold for each response were defined as the slope and Tes(w) at the onset of the response, respectively. When the young sedentary men were compared with a subgroup (n = 7) of the older physically active men with similar VO2max, the SR and FBF responses of the two groups did not differ significantly. However, when the young men were compared with a subgroup of older sedentary men with a similar maximal O2 pulse, the SR and FBF sensitivities were significantly reduced by 62 and 40%, respectively. These findings suggest that during a short exercise bout either 1) there is no primary effect of aging on heat loss responses but, rather, changes are associated with the age-related decrease in VO2max or 2) the decline in heat loss responses due to aging may be masked by repeated exercise training.

Adult

Repeatability and protocol comparability of presyncopal symptom limited lower body negative pressure exposures.

Data on repeatability and comparability of different presyncopal symptom-limited lower body negative pressure (PSL-LBNP) exposure protocols, while scarce, are critical to the interpretation of studies using PSL-LBNP methods. To investigate if PSL-LBNP tolerance, heart rate, and blood pressure were repeatable, 11 subjects were exposed to 4 PSL-LBNP tests; each test occurring at the same time of day, separated by at least 72 h, and using the same protocol. No significant differences were found in either the heart rate or blood pressure responses to the PSL-LBNP or the tolerance indices (cumulative stress index; maximum negative pressure tolerated; and duration of negative pressure exposure). To study the comparability of different PSL-LBNP protocols, nine subjects were exposed randomly to five PSL-LBNP tests using protocols that varied in stage duration but not pressure profile. The protocols had 1-, 3-, 5-, 7-, or 9-min stage durations. These PSL-LBNP exposures were conducted at the same time of day and separated by at least 72 h. While no differences were noted in either the response pattern or magnitude of heart rate or blood pressure to the differing protocols, the cumulative stress index and the duration of negative pressure exposure varied proportionally with the length of the stage durations. With the exception of the 1-min protocol, the maximum negative pressure tolerated did not vary regardless of the protocol used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Changes in body fluid compartments during a 28-day bed rest.

The extravascular fluid responses to real or simulated space-flight are not well-documented. In this study serial isotope measurements were used to obtain measurements of the body fluid responses of 10 22-29-year-old men during 28 d of simulated microgravity (bed rest). The subjects were maintained on a controlled metabolic diet for 7 d before the study, during 14 d of ambulatory control, 28 d of horizontal bed rest, and 14 d of ambulant recovery. Fluid compartments were measured on control days 1 and 9, bed rest days 2, 14, and 28, and recovery days 7 and 14. By day 2 of bed rest, plasma volume (PV) and extra-cellular volume (ECV) decreased significantly by an average 209 and 533 ml, respectively. Red cell volume (RCV) and total body water (TBW) decreased more slowly, with average losses of 128 and 1,316 ml, respectively, after 28 d of bed rest. Early in the bed rest, TBW loss was mostly from the ECV. Thereafter, the TBW deficit was derived from the intracellular compartment, which decreased an average of 838 ml after 28 d. These results suggest losses from all fluid compartments during bed rest, with no evidence of restoration of ECV after 1-2 weeks.

Adult

Responses to dehydration and rehydration during heat exposure in young and older men.

Body temperature, plasma responses, and subjective ratings of thirst and hotness were studied in 5 older men (OM, 61-67 yr) and 6 younger men (YM, 21-29 yr) during 180-min thermal dehydration and subsequent 60-min rehydration (45 degrees C, 25% relative humidity). Rectal temperature (Tre) increased more rapidly and to a greater magnitude in OM, while average total body sweat rates and chest sweat rates were not significantly different. During dehydration, both OM and YM lost similar body weight (1.52 +/- 0.11 vs. 1.55 +/- 0.22%, mean +/- SE). However, in OM, plasma volume (Pv) decreased (-11.3 +/- 2.8 vs. -4.9 +/- 2.9%), and plasma osmolality (Posm) increased to a greater extent (+5.0 +/- 0.32 vs. 1.1 +/- 0.24 mosmol/kg) compared with YM. On rehydration, OM and YM similarly replaced water debt (46.6 +/- 4.9 vs. 49.0 +/- 3.0%). Within 30 min of drinking, YM had restored Pv and Posm, whereas OM showed slower responses, restoring Posm after 60 min and Pv only after a subsequent 30 min at 25 degrees C. Despite a higher Tre and greater change in Pv and Posm, OM rated themselves less thirsty and not significantly hotter than YM. These findings suggest that aging results in decreased ability to maintain Tre during heat stress and that the mechanisms comprise a combination of alterations in body fluid distribution and perception.

Adult

Ten weeks of aerobic training do not affect lower body negative pressure responses.

Based mostly on cross-sectional data, it has been suggested that aerobic training may decrease lower body negative pressure (LBNP) tolerance through a hypothesized attenuation in both high- and low-pressure baroreflex gain. An experimental group (EXP) of eight male subjects [22.1 +/- 1.4 (SD) yr] underwent a 10-wk treadmill and cycle ergometer training program, which resulted in a 21% increase in maximal O2 uptake (VO2 max), 45.7 +/- 1.5 vs. 55.2 +/- 1.7 (SE) ml.kg-1.min-1; P less than 0.05]. A control group, (CON; n = 7; 27.3 +/- 5.7 yr), which did not undergo training, had no significant changes in VO2 max (49.4 +/- 3.3 vs. 48.8 +/- 3.2 ml.kg-1.min-1). Before and after training the EXP and CON groups participated in LBNP tolerance tests (terminated at presyncope) and neck pressure-suction testing (to describe the carotid sinus-heart rate baroreflex). LBNP tolerance, as defined by three different indexes, and carotid sinus-heart rate baroreflex gain were not altered in either group after training. Furthermore, there were no changes in LBNP heart rate, blood pressure, leg circumference, forearm blood flow, or forearm vascular resistance responses at any level of LBNP challenge after training. In conclusion, 10 wk of aerobic training did not change LBNP tolerance or alter the reflex cardiovascular compensatory mechanisms activated during LBNP.

Adult

Automated blood pressure measurements during exercise.

One of the critical parameters measured during exercise is blood pressure. However, the accurate measurement of systolic and diastolic blood pressure during exercise is difficult with auscultation and impractical with direct arterial techniques. The purpose of this study was to compare an automated system (Colin, Inc. STBP-680) with auscultation in humans during rest and exercise and to compare the automated system with direct arterial blood pressure measurement in a canine model during pharmacological challenges that resulted in a wide range of blood pressure values. Compared with direct arterial blood pressure taken in the canine model, the STBP-680 gave good estimates of diastolic blood pressure and adequately monitored relative changes in systolic blood pressure, diastolic blood pressure, and mean arterial pressure (mean arterial pressures in all instances were calculated as one-third systolic plus two-thirds diastolic blood pressures). Compared with auscultation methods in humans, the STBP-680 gave similar estimates of resting diastolic blood pressure and monitored relative changes in resting systolic blood pressures, diastolic blood pressures, and mean arterial pressures. During both treadmill and cycle ergometer exercise in humans, the STBP-680 monitored changes in systolic blood pressure, phase IV diastolic blood pressure, and mean arterial pressure. Further, the STBP-680 estimated exactly and noted relative changes in heart rate in every test. However, during exercise, quantitative estimations of systolic blood pressure by the STBP-680 were higher than those found using auscultation. Where exact, quantitative measures of blood pressure are needed, direct arterial measurement continues to be the most accurate method. However, where indirect methods can be used, the STBP-680 may provide a suitable alternative that reduces many of the technical concerns of auscultation in young, healthy individuals.

Adult

Adaptation to repeated presyncopal lower body negative pressure exposures.

Adaptation to chronic stressors, such as exercise and thermal challenges, are well-documented. However, it is not known whether the body can adapt to repeated central hypovolemia. The purpose of this study was to determine if tolerance to presyncopal symptom limited lower body negative pressure (PSL-LBNP; a central hypovolemic stressor), as measured by a cumulative stress index (CSI), was altered by daily PSL-LBNP exposures. On each of nine consecutive days, with a 2-d break between Days 5 and 6, six subjects underwent a PSL-LBNP exposure. By the fifth PSL-LBNP exposure, LBNP tolerance had increased 47%. No further significant improvement was seen after the fifth exposure. While, there was no alteration in mean arterial pressure response during the repeated PSL-LBNP exposures, maximum heart rates were increased significantly over Day 1 after the third daily PSL-LBNP exposure. Rate-pressure product was also significantly increased over Day 1 on Days 7 and 8. These findings suggest that adaptation to a simulated hypovolemic stress does occur. Presumably, either the body's compensatory mechanisms become more effective, or there is a resetting of the threshold needed to elicit the presyncopal reactions.

Adaptation, Physiological

Effect of exercise hemoconcentration and hyperosmolality on exercise responses.

We investigated the effects of a decrease in plasma volume (PV) and an increase in plasma osmolality during exercise on circulatory and thermoregulatory responses. Six subjects cycled at approximately 65% of their maximum O2 uptake in a warm environment (30 degrees C, 40% relative humidity). After 30 min of control (C) exercise (no infusion), PV decreased 13.0%, or 419 +/- 106 (SD) ml, heart rate (HR) increased to 167 +/- 3 beats/min, and esophageal temperature (Tes) rose to 38.19 +/- 0.09 degrees C (SE). During infusion studies (INF), infusates were started after 10 min of exercise. The infusates contained 5% albumin suspended in 0.45, 0.9, or 3.0% saline. The volume of each infusate was adjusted so that during the last 10 min of exercise PV was maintained at the preexercise level and osmolality was allowed to differ. HR was significantly lower (10-16 beats/min) during INF than during C. Tes was reduced significantly during INF, with trends for increased skin blood flow and decreased sweating rates. No significant differences in HR, Tes, or sweating rate occurred between the three infusion conditions. We conclude that the decrease in PV, which normally accompanies moderate cycle exercise, compromises circulatory and thermal regulations. Increases in osmolality appear to have small if any effects during such short-term exercise.

Body Temperature Regulation

Changes in plasma volume during bed rest: effects of menstrual cycle and estrogen administration.

Bed rest (BR) is associated with a decrease in plasma volume (PV), which may contribute to the impaired orthostatic and exercise tolerances seen immediately after BR. The purpose of this study was to determine whether increases in blood estrogen concentration, either during normal menstrual cycles or during exogenous estrogen administration, would attenuate this loss of PV. Nineteen healthy women (21-39 yr of age) completed the study. Twelve women underwent duplicate 11-day BR without estrogen supplementation. PV decreased significantly (P less than or equal to 0.01) during both BR's, from 2,531 +/- 113 to 2,027 +/- 102 ml during BR1 and from 2,445 +/- 115 to 2,244 +/- 96 ml during BR2. The women who began BR in the periovulatory stage of the menstrual cycle (n = 3), a time of elevated endogenous estrogens, had a transient delay in loss of PV during the first 5 days of BR. Women who began BR during other stages of the menstrual cycle (n = 17) showed the established trend to decrease PV primarily during the first few days of BR. Seven additional women underwent a single 12-day BR while taking estrogen supplementation (1.25 mg/day premarin). PV decreased during the first 4-5 days of BR, then returned toward the pre-BR level during the remainder of the BR (pre-BR PV, 2,525 +/- 149 ml; post-BR PV, 2,519 +/- 162 ml). Thus menstrual fluctuations in endogenous estrogens appear to have only small transient effects on the loss of PV during BR, whereas exogenous estrogen supplementation significantly attenuates PV loss.

Adult

Effect of prolonged bed rest on lung volume in normal individuals.

Pulmonary function was assessed in supine subjects before, during, and after three separate bed-rest studies of 11 and 12 days duration. Forced vital capacity (FVC) increased during bed rest in each subject. Total lung capacity (TLC) was measured by helium dilution in one bed-rest study and increased in each subject, while residual volume and functional residual capacity of the respiratory system did not change. No change in FVC was found in an ambulatory control group using identical measurement techniques. Maintaining base-line plasma volume during one bed rest by the use of exogenous estrogen did not prevent an increase in FVC, and decreasing plasma volume with diuretics in ambulatory subjects to the same degree as seen in the bed rests did not cause an increase in FVC. We conclude that prolonged bed rest results in a small significant increase in TLC and that this change is not dependent on alterations in plasma volume.

Adult

Effect of hyperosmolality on control of blood flow and sweating.

To study the effect of hyperosmolality on thermoregulatory responses, five men [average maximal O2 consumption (VO2 max) = 48 ml X kg-1 X min-1] cycled at 65-75% VO2max for up to 30 min in a 30 degrees C, 40% relative humidity environment under three conditions. First, control tests (C) were performed where preexercise plasma volume (PV) and osmolality (Osm) averaged 3,800 ml and 282 mosmol X kg-1, respectively. Second, exercise tests (D) were performed following dehydration induced by fluid restriction and mild exercise (30% VO2max) in hot (40 degrees C) ambient conditions. Each subject then rested in cool surroundings 1 h before performing the exercise test. Preexercise PV and Osm averaged 3,606 ml and 293 mosmol X kg-1, respectively. Third, exercise tests (I) were performed following dehydration, but during the 1-h rest interval, 3% saline was infused so that PV was restored to 3,826 ml and Osm averaged 294 mosmol X kg-1 prior to exercise. During D, esophageal temperatures (Tes) were significantly higher than C, an avg 0.56 degrees C after 20 min exercise due to a 0.22 degrees C increase in Tes threshold for vasodilation, a 39% reduction in slope of the forearm blood flow (BF)-Tes relationship, a 32% average reduction in maximal exercise BF, and a 0.22 degrees C increase in Tes sweating threshold. During I, responses were similar to D, except the BF-Tes slope and the maximum BF were not significantly different from C. Thus hyperosmolality modifies thermoregulation by elevating thresholds for both vasodilation and sweating even without decreases in PV.

Adult

Effect of blood volume on forearm venous and cardiac stroke volume during exercise.

Five healthy men exercised at 65-70% of maximum O2 uptake (VO2 max) for 30 min in an ambient temperature of 30 degrees C. Duplicate experiments were conducted at three levels of plasma volume:control, hypovolemia, in which blood volume (BV) was reduced an average of 490 ml (9.7%) with diuretics, and hypervolemia, in which BV was increased an average of 440 ml (7.8%) by infusing an isotonic solution containing 5% human serum albumin. Marked venoconstriction occurred during exercise in all conditions and persisted despite large increases in deep body temperature. The degree of venoconstriction was similar during control and hypervolemic conditions, but was potentiated during hypovolemia. The observed venoconstriction appeared to consist of two components: an early one related to autonomic adjustments at the onset of exercise, and a later one possibly related to progressive decreases in cardiac filling. Heart rate, cardiac stroke volume (SV), and cardiac output during exercise were significantly affected by changes in BV. During hypovolemia the average differences from control values were 10 beats X min-1, -14 ml, and -2.2 l X min-1, respectively; during hypervolemia the differences from control were -7 X min-1, 10 ml, and 1.0 l X min-1, respectively. The pattern of SV over the course of exercise indicates that pooling of blood in veins may be quantitatively more important than plasma water loss in reducing cardiac filling pressure in the heat.

Adult

Effects on heat tolerance of physical training in water and on land.

A 4-wk training program was undertaken by 15 untrained non-heat-acclimated males who were divided into three groups matched on maximal aerobic capacity (VO2max) and trained either in water or on land to determine how physical training (PT) in these different media affects heat tolerance. Subjects trained on a cycle ergometer for 1 h/day, 5 days/wk at 75% VO2max, with the exercise intensity progressively increased to maintain a constant training stimulus. Group I exercised on land, whereas groups II and III exercised while immersed to the neck in water of either 32 degrees C (II) or 20 degrees C (III). Daily exercise increased core temperature (Tc) in groups I and II but not in group III. Training elicited similar increases (approximately 15%) in VO2max in the three groups. Before and after PT, all subjects exercised at approximately 30% VO2max for 3 h at 49 degrees C, 20% rh. Compared with before training, groups I and II showed a decrease in final Tc and heart rate (HR) in the posttraining heat exposure. Sweat rate increased 25% in group II but remained the same in group I. Group III demonstrated a decrease in final HR, but final Tc was higher than before training. Sweat rate did not increase in group III and was lower than the other groups. It was concluded that PT can improve the cardiovascular response to dry heat without affecting thermoregulatory capacity. PT appears to enhance heat tolerance only if Tc is permitted to rise during exercise, thus stimulating the temperature-regulating center for heat dissipation.

Adaptation, Physiological

Effect of acute alterations of blood volume on circulatory performance in humans.

Six subjects exercised (60% VO2 max) in a 35 degree C environment on the day prior to (C1) and 1 h after withdrawal (PW) of 10% of each subject's blood volume, and 2 wk later on the day prior to (C2) and 1 h after infusion (PI) of the stored blood. Esophageal and mean skin temperatures (Tes and Tsk), forearm blood flow (FBF), cardiac output (Q), heart rate (HR), and blood samples were taken at intervals. Blood withdrawal had no major effect on either Q or stroke volume (SV), as plasma volume was largely restored prior to exercise. Following blood infusion Q and SV during exercise were significantly increased 1.4 1.min-1 and 15 ml.beat-1 above C2 levels and HR was significantly reduced at any Tes. Blood withdrawal decreased the slope of the FBF:Tes relationship. The resulting decrease in cutaneous perfusion caused a significantly greater body heat storage during PW. In contrast during PI, the slope of the FBF:Tes relation was somewhat increased. We conclude that cardiac stroke volume and cutaneous blood flow vary in proportion to changes in absolute blood volume. The rise in body temperature during exercise was significantly greater in hypovolemia but was not significantly reduced following volume expansion.

Adult

Effect of blood volume on sweating rate and body fluids in exercising humans.

Five relatively fit men performed cycle ergometer exercise (65-70% VO2max) for up to 30 min at 30 degrees C, 40% rh. The data from control (normo-volemic), hypovolemic [8.7% reduction in blood volume (BV) induced by diuretics], and hypervolemic [7.9% expansion of BV induced by infusion if isotonic serum albumin] tests revealed significant effects of BV on body fluid and sweating responses. During control exercise, BV decreased an average (+/- SE) 370 +/- 64 ml at 20 min. A significantly smaller loss occurred after 20 min of hypovolemic exercise (270 +/- 29 ml). The decrease in BV during 30 min of hypervolemic exercise (541 +/- 43 ml) was significantly greater than during control (421 +/- 50 ml). Blood volume reduction also significantly altered the control of sweating rate independent of changes in plasma osmolality. The slope of the sweating rate-to-esophageal temperature relationship (SR/Tes) was significantly reduced from the mean value of 1.07 +/- 0.16 and 1.09 +/- 0.18 mg X min-1 X cm-2 X degrees C-1 during control tests, measured from the chest and arm, respectively, to 0.64 +/- 0.11 and 0.63 +/- 0.11 mg X min-1 X cm-2 X degrees C-1 during hypovolemia. The SR/Tes slope was unchanged in hypovolemia over active tissues (calf). Hypervolemia had no effect on the control of sweating at any site. Both the body fluid and sweating responses during hypovolemia act to conserve circulating blood volume during exercise.

Adult

Effect of hydration state of circulatory and thermal regulations.

To determine the influence of hydration state upon circulatory controls, we studied four relatively fit subjects during duplicate 30-min cycle ergometer exercise bouts (55% VO2max) in euhydrated, hypohydrated, and hyperhydrated conditions. Ambient temperature was 35 degrees C. Hypohydration was achieved by 4 days of diuretic administration and resulted in a whole-body weight loss of 2.2 kg and a plasma volume decrease of approximately 700 ml. Hyperhydration was achieved by ADH administration plus ingestion of 2 liters water but caused only a minor increase volume. Hypohydration resulted in a significantly reduced cardiac output during exercise; this the result of a reduction in stroke volume of 17 ml.beat-1 without adequate elevation in heart rate. the internal temperature (Tes) threshold for cutaneous vasodilation was elevated by 0.42 degree C in hypohydrated conditions; but once vasodilation occurred, the slope of the arm blood flow:Tes relation was unchanged from control. Maximal arm blood flow was reduced by nearly 50% in hypohydration. These restrictions in cutaneous blood flow served to maintain an already compromised venous return, but due to the limitation of core-to-skin heat transfer, forced Tes to nearly 39 degrees C, significantly higher than in euhydrated conditions.

Adult