Biomedical subjects

V A Convertino

Publications and source records attributed to V A Convertino.

At least 37 records · Page 2Linked to original sources

PubMed1998

Effects of exposure to simulated microgravity on neuronal catecholamine release and blood pressure responses to norepinephrine and angiotensin.

We tested the hypothesis that exposure to microgravity reduces the neuronal release of catecholamines and blood pressure responses to norepinephrine and angiotensin. Eight men underwent 30 days of 6 degrees head-down tilt (HDT) bedrest to simulate exposure to microgravity. Plasma norepinephrine and mean arterial blood pressure (MAP) were measured before and after a cold pressor test (CPT) and graded norepinephrine infusion (8, 16 and 32 ng/kg/min) on day 6 of a baseline control period (C6) and on days 14 and 27 of HDT. MAP and plasma angiotensin II (Ang-II) were measured during graded Ang-II infusion (1, 2 and 4 ng/kg/min) on C8 and days 16 and 29 of HDT. Baseline total circulating norepinephrine was reduced from 1017ng during the baseline control period to 610 ng at day 14 and 673ng at day 27 of HDT, confirming a hypoadrenergic state. An elevation of norepinephrine (+178 ng) to the CPT during the baseline control period was eliminated by HDT days 14 and 27. During norepinephrine infusion, similar elevations in plasma norepinephrine (7.7 pg/ml/ng/kg/min) caused similar elevations in MAP (0.12 mmHg/ng/kg/min) across all test days. Ang-II infusion produced higher levels of plasma Ang-II during HDT (47.3 pg/ml) than during baseline control (35.5 pg/ml), while producing similar corresponding elevations in blood pressure. While vascular responsiveness to norepinephrine appears unaffected, impaired neuronal release of norepinephrine and reduced vascular responsiveness to Ang-II might contribute to the lessened capacity to vasoconstrict after spaceflight. The time course of alterations indicates effects that occur within two weeks of exposure.

Adult↗

PubMed1998

Changes in peak oxygen uptake and plasma volume in fit and unfit subjects following exposure to a simulation of microgravity.

To test the hypothesis that the magnitude of reduction in plasma volume and work capacity following exposure to simulated microgravity is dependent on the initial level of aerobic fitness, peak oxygen uptake (VO2peak) was measured in a group of physically fit subjects and compared with VO2peak in a group of relatively unfit subjects before and after 10 days of continuous 6 degrees head-down tilt (HDT). Ten fit subjects (40 +/- 2 year) with mean +/- SE VO2peak = 48.9 +/- 1.7 mL kg-1 min-1 were matched for age, height, and lean body weight with 10 unfit subjects (VO2peak = 37.7 +/- 1.6 mL kg-1 min-1). Before and after HDT, plasma, blood, and red cell volumes and body composition were measured and all subjects underwent a graded supine cycle ergometer test to determine VO2peak period needed. Reduced VO2peak in fit subjects (-16.2%) was greater than that of unfit subjects (-6.1%). Similarly, reductions in plasma (-18.3%) and blood volumes (-16.0%) in fit subjects were larger than those of unfit subjects (blood volume = -5.6%; plasma volume = -6.6%). Reduced plasma volume was associated with greater negative body fluid balance during the initial 24 h of HDT in the fit group (912 +/- 154 mL) compared with unfit subjects (453 +/- 200 mL). The percentage change for VO2peak correlated with percentage change in plasma volume (r = +0.79). Following exposure to simulated microgravity, fit subjects demonstrated larger reductions in VO2peak than unfit subjects which was associated with larger reductions in plasma and blood volume. These data suggest that the magnitude of physical deconditioning induced by exposure to microgravity without intervention of countermeasures was influenced by the initial fitness of the subjects.

Adult↗

PubMed1998

Restoration of peak vascular conductance after simulated microgravity by maximal exercise.

We sought to determine if (i) peak vascular conductance of the calf was reduced following prolonged exposure to simulated microgravity, and (ii) if maximal cycle ergometry performed at the end of microgravity exposure stimulated a restoration of peak calf vascular conductance. To do this, peak vascular conductance of the calf was recorded following ischaemic plantar flexion exercise to fatigue in seven men after 16 days of head-down tilt (HDT) under two conditions: (i) after one bout of maximal supine cycle ergometry completed 24 h prior to performance of ischaemic plantar flexion exercise, and (ii) in a control (no cycle ergometry) condition. Following HDT, peak vascular conductance was reduced in the control condition (0.38 +/- 0.02 to 0.24 +/- 0.02 ml 100 ml-1 min-1 mmHg-1; P = 0.04), but was restored when subjects performed cycle ergometry (0.33 +/- 0.05 to 0.28 +/- 0.04 ml 100 ml-1 min-1 mmHg-1; P = 0.46). After HDT, time to fatigue during ischaemic plantar flexion exercise was not different from pre-HDT 24 h after performance of exhaustive cycle ergometry (120 +/- 24 vs. 122 +/- 19 s), but was decreased in the control condition (116 +/- 11 vs. 95 +/- 8 s; P = 0.07). These data suggest that a single bout of maximal exercise can provide a stimulus to restore peak vascular conductance and maintain time to fatigue during performance of ischaemic plantar flexion exercise.

Blood Pressure↗

PubMed1998

Evidence for increased cardiac compliance during exposure to simulated microgravity.

We measured hemodynamic responses during 4 days of head-down tilt (HDT) and during graded lower body negative pressure (LBNP) in invasively instrumented rhesus monkeys to test the hypotheses that exposure to simulated microgravity increases cardiac compliance and that decreased stroke volume, cardiac output, and orthostatic tolerance are associated with reduced left ventricular peak dP/dt. Six monkeys underwent two 4-day (96 h) experimental conditions separated by 9 days of ambulatory activities in a crossover counterbalance design: 1) continuous exposure to 10 degrees HDT and 2) approximately 12-14 h per day of 80 degrees head-up tilt and 10-12 h supine (control condition). Each animal underwent measurements of central venous pressure (CVP), left ventricular and aortic pressures, stroke volume, esophageal pressure (EsP), plasma volume, alpha1- and beta1-adrenergic responsiveness, and tolerance to LBNP. HDT induced a hypovolemic and hypoadrenergic state with reduced LBNP tolerance compared with the control condition. Decreased LBNP tolerance with HDT was associated with reduced stroke volume, cardiac output, and peak dP/dt. Compared with the control condition, a 34% reduction in CVP (P = 0.010) and no change in left ventricular end-diastolic area during HDT was associated with increased ventricular compliance (P = 0.0053). Increased cardiac compliance could not be explained by reduced intrathoracic pressure since EsP was unaltered by HDT. Our data provide the first direct evidence that increased cardiac compliance was associated with headward fluid shifts similar to those induced by exposure to spaceflight and that reduced orthostatic tolerance was associated with lower cardiac contractility.

Animals↗

PubMed1998

Gender differences in autonomic functions associated with blood pressure regulation.

Functions of carotid and aortic baroreflex control of heart rate (HR), cardiopulmonary baroreflex control of vascular resistance, adrenoreceptor responsiveness, indexes of baseline vagal and sympathetic tone, circulating blood volume, and venous compliance were compared in men and women to test the hypothesis that lower orthostatic tolerance in women would be associated with lower responsiveness of specific mechanisms of blood pressure regulation. HR, stroke volume (SV), cardiac output (Q), mean arterial blood pressure (MAP), central venous pressure, forearm (FVR) and leg (LVR) vascular resistance, catecholamines, and changes in leg volume (%DeltaLV) were measured during various protocols of lower body negative pressure (LBNP), carotid stimulation, and infusions of adrenoreceptor agonists in 7 females and 10 males matched for age and fitness. LBNP tolerance for the women (797 +/- 63 mmHg/min) was 35% lower (P = 0.002) than 1,235 +/- 101 mmHg/min for the men. At presyncope, SV, Q, MAP, and %DeltaLV were lower (P < 0.05) in females compared with males, whereas HR, FVR, and total peripheral resistance were similar in both groups. Lower LBNP tolerance in females was associated with reduced HR response to carotid baroreceptor stimulation, lower baseline cardiac vagal activity, greater decline in Q induced by LBNP, increased beta1-adrenoreceptor responsiveness, greater vasoconstriction under equal LBNP, lower levels of circulating NE at presyncope, and lower relative blood volume. The results of this investigation support the hypothesis that women have less responsiveness in mechanisms that underlie blood pressure regulation under orthostatic challenge.

Adult↗

PubMed1998

High sustained +Gz acceleration: physiological adaptation to high-G tolerance.

Since the early 1940s, a significant volume of research has been conducted in an effort to describe the impact of acute exposures to high-G acceleration on cardiovascular mechanisms responsible to maintaining cerebral perfusion and conscious in high performance aircraft pilots during aerial combat maneuvers. The value of understanding hemodynamic characteristics that underlie G-induced loss of consciousness has been instrumental in the evolution of optimal technology development (e.g., G-suits, positive pressure breathing, COMBAT EDGE, etc.) and pilot training (e.g., anti-G straining maneuvers). Although the emphasis of research has been placed on the development of protection against acute high +Gz acceleration effects, recent observations suggest that adaptation of cardiovascular mechanism associated with blood pressure regulation may contribute to a protective 'G-training' effect. Regular training at high G enhances G tolerance in humans, rats, guinea pigs, and dogs while prolonged layoff from exposure in high G profiles (G-layoff) can result in reduced G endurance. It seems probable that adaptations in physiological functions following chronically-repeated high G exposure (G training) or G-layoff could have significant impacts on performance during sustained high-G acceleration since protective technology such as G-suits and anit-G straining maneuvers are applied consistently during these periods of training. The purpose of this paper is to present a review of new data from three experiments that support the notion that repeated exposure on a regular basis to high sustained +Gz acceleration induces significant physiological adaptations which are associated with improved blood pressure regulation and subsequent protection of cerebral perfusion during orthostatic challenges.

Acceleration↗

PubMed1998

Insight into mechanisms of reduced orthostatic performance after exposure to microgravity: comparison of ground-based and space flight data.

Since the beginning of human spaceflight, the value of understanding mechanisms of physiological adaptation to microgravity became apparent to life scientists who were interested in maintining crew health and developing countermeasures agains adverse effects of the mission. However, several characteristics associated the the logistics of spaceflight presented significant limitations to the scientific study of human adaptation to microgravity. Because space missions are so infrequent and involve minimal numbers of crewmembers, meaninful statistical analysis of data are limited. Reproducibility of results from spaceflight experiments is difficult to assess since there are few repeated space missions involving the same crewmembers. Since the emphasis of space missions is placed on operations, experiments are compromised without adequate control over various factors (e.g., time, diet, physical activities, etc.) that can impact measured responses. With the mimimal opportunity to collect spaceflight data, there is a high risk of experiments that simultaneously interfere with other experiments by the increasing demand on the crewmembers to participate in mumerous experiments proposed by multiple investigators. The technology and ability to measure physiological functions necessary to test specific hypotheses can be severely limited by physical space and power constraints of the space enviroment. Finally, technical and logistical aspects of space missions such as launch delays, extended missions, and inflight operational emergencies can significantly compromise the timing and control of experiments. These limitations have stimulated scientists to develop ground-based analogs of microgravity in an effort to investigate the effects of spaceflight on physiological function in a controlled experimental setting. The purpose of this paper is to provide a selected comparison of data collected from ground-based experiments with those obtained from spaceflight in an effort to assess the adequacy of ground analogs of actual flight for the study of human physiological adaptation to microgravity. Specifically, results from ground and spaceflight will be used to provide insight into mechanisms underlying adaptations of blood pressure regulation and reduced orthostatic performance to the microgravity environment.

Adaptation, Physiological↗

PubMed1998

A comparative bear model for immobility-induced osteopenia.

The National Institutes of Health (NIH) and the National Aeronautics and Space Administration (NASA) are seeking solutions to the human problem of osteopenia, or immobility-induced bone loss. Bears, during winter dormancy, appear uniquely exempted from the debilitating effects of immobility osteopenia. NIH and ESA, Inc. are creating a large database of metabolic information on human ambulatory and bedrest plasma samples for comparison with metabolic data obtained from bear plasma samples collected in different seasons. The database generated from NASA's HR113 human bedrest study showed a clear difference between plasma samples of ambulatory and immobile subjects through cluster analysis using compounds determined by high performance liquid chromatography with coulometric electrochemical array detection (HPLC-EC). We collected plasma samples from black bears (Ursus americanus) across 4 seasons and from 3 areas and subjected them to similar analysis, with particular attention to compounds that changed significantly in the NASA human study. We found seasonal differences in 28 known compounds and 33 unknown compounds. A final database contained 40 known and 120 unknown peaks that were reliably assayed in all bear and human samples; these were the primary data set for interspecies comparison. Six unidentified compounds changed significantly but differentially in wintering bears and immobile humans. The data are discussed in light of current theories regarding dormancy, starvation, and anabolic metabolism. Work is in progress by ESA Laboratories on a larger database to confirm these findings prior to a chemical isolation and identification effort. This research could lead to new pharmaceuticals or dietary interventions for the treatment of immobility osteopenia.

Animals↗

PubMed1998

Plasma colloid osmotic pressure increases in humans during simulated microgravity.

BACKGROUND: On exposure to microgravity, astronauts lose up to 12% of their plasma volume which may contribute to post-flight orthostatic intolerance. HYPOTHESIS: Whole-body dehydration during prolonged microgravity, simulated by 6(0) head-down tilt (HDT), may increase plasma colloid osmotic pressure (COP). METHODS: There were seven healthy male subjects (30-55 yr of age) were placed in 6(0) HDT for 16 d. Plasma COP was measured from blood samples drawn immediately before HDT, on day 14 of HDT, and 1 h following bed rest termination using a 20 muL colloid osmometer. Plasma volume was determined before HDT, on day 16 of HDT, and 1 h following bed rest termination using a modified Evans blue dye technique. RESULTS: Plasma COP on day 14 of bed rest (29.9 +/- 0.7 mm Hg) was higher (p = 0.01) than pre-HDT value (23.1 +/- 0.8 mm Hg), coinciding with a decrease of plasma volume. At 1 h of upright recovery following HDT, plasma volume stayed below baseline and plasma COP remained elevated (26.6 +/- 0.6 mm hg; p = 0.003) as compared with the pre-HDT value. CONCLUSION: Our results indicate that reduced plasma volume and significantly elevated plasma COP probably reflect an overall loss of extracellular fluids during simulated microgravity.

Adult↗

PubMed1998

Red cell volume and [erythropoietin] responses during exposure to simulated microgravity.

In order to test the hypothesis that normal gravity is an important influence on human serum [Erythropoietin] ([Epo]), the hematologic response to 16 d of 6 degrees head-down tilt (HDT, n = 6 men) was compared with 16 d of normal gravity exposure (CON, n = 7 men). Prior to bed rest, CON and HDT subjects, respectively, were similar in the following characteristics (mean +/- SD): age = 40 +/- 3, 39 +/- 6 yr; height = 181 +/- 5, 182 +/- 6 cm; weight = 88.5 +/- 11.3, 81.7 +/- 12.0 kg; maximal oxygen consumption in supine 6 degrees head-down tilt position (VO2max) = 2.63 +/- 0.38, 2.67 +/- 0.52 L.min-1; hematocrit = (Hct) 41.6 +/- 2.4, 43.0 +/- 3.4%; hemoglobin ([Hb]) = 15.1 +/- 1.0, 14.5 +/- 1.0 g.100 ml-1; plasma volume (PV) = 3829 +/- 857, 3768 +/- 512 ml; and [Epo] = 11.6 +/- 2.9, 10.0 +/- 6.2 mU.ml-1. Calculated red cell volume (RCV) was greater in HDT than CON (2845 +/- 410 vs. 2139 +/- 253 ml, p < 0.05) at baseline. Decreases in PV (-15%, 580 ml, p < 0.05) and an insignificant decrease in RCV (-12%, 354 ml, p = 0.07) were observed in the HDT group, with a concurrent 6% increase in [Hb] (p < 0.05). PV, RCV and [Hb] remained unchanged in the CON group. [Epo] remained unchanged during HDT (12.2 +/- 3.2; 10.8 +/- 3.8; 11.2 +/- 3.1; 11.2 +/- 2.6 mU.ml-1 for HDT days 1, 2, 8 and 16, respectively). There was no difference between CON and HDT groups in [Epo] before or during HDT. It was concluded that the insignificant change (-12%) in RCV observed during HDT was insufficient to stimulate an increase in [Epo], probably because the content of oxygen in arterial blood remained unaffected. The observation that [Epo] remained unchanged despite this loss of RCV during HDT also suggests a possible decrease in the responsiveness of the erythropoietic system to [Epo].

Adult↗

PubMed1998

Mediating effect of onset rate on the relationship between +Gz and LBNP tolerance and cardiovascular reflexes.

INTRODUCTION: Research attempting to establish a relationship between human response to lower body negative pressure (LBNP) and +Gz acceleration has in general, disregarded the moderating effects of negative pressure and +Gz onset rates. Many of the past studies designed to examine the relationship between lower body decompression and +Gz acceleration tolerances have also ignored the problem of differences in body position typically encountered during LBNP and +Gz testing (supine LBNP vs. seated +Gz). METHODS: There were 17 male subjects (24-34 yr) who were tested in a seated LBNP chamber and received 3 pressure onset rates of 0.067, 0.33, and 2.0 mm Hg x s(-1). Relaxed acceleration tolerance was assessed on a 6.1 -m centrifuge using three gradual onset rates of 0.01, 0.05, and 0.2 +Gz x s(-1). LBNP and +Gz tolerances were subjected to principle components (factor) analysis, and the resulting factors correlated with variables derived from autonomic reflex control tests (Valsalva and carotid-cardiac baroreflex responsiveness) and height. RESULTS: The factor model suggested a two-dimensional solution consisting of an acceleration factor and an orthostatic factor. The general pattern of the factor loadings indicates the relationship between tolerances of the two forms of orthostatic stress (acceleration and LBNP) is a function of how fast each stress is delivered. The correlation between LBNP tolerance and acceleration tolerance increases as LBNP onset rate is increased, or +Gz onset rate is decreased. Height was highly correlated (-0.71) and carotid-cardiac baroreflex responsiveness moderately correlated (0.54) with general orthostatic tolerance. Valsalva measures of autonomic reflex control had low correlations with general orthostatic tolerance (<0.30). CONCLUSIONS: Although both LBNP and +Gz exposure can lead to eventual loss of consciousness, syncopal events associated with intolerance to either stress are a function of somewhat different cardiovascular mechanisms. There are however, specific situations where LBNP may constitute a viable substitute for +Gz.

Acceleration↗

PubMed1998

Female exposure to high G: chronic adaptations of cardiovascular functions.

INTRODUCTION: Exposure to microgravity is associated with increased leg venous compliance and reductions in cardiac output, baroreflex functions, and tolerance to orthostatism. However, the effects of chronic exposure to high-G environments are unknown. In addition, there is evidence that females have lower orthostatic tolerance than males, although the underlying mechanisms are unclear. Therefore, we tested the hypotheses that high-G training will enhance baroreflex and orthostatic functions and that females will demonstrate similar adaptations compared with males. METHODS: Calf venous compliance, baroreflex function, and orthostatic performance were measured in six men and seven women before and after repeated exposures on the centrifuge (G-training) for 4 wk, 3 times/wk, with gradual levels of G starting with +3 Gz without G-suit protection during week 1 and advancing to +9 Gz with G-suit protection by the end of week 4. Calf venous compliance was measured by occlusion plethysmography using impedance rheographic recordings of volume change. Baroreflex function was assessed from beat-by-beat changes in heart rate (HR) and mean arterial pressure (MAP) that were measured before, during, and after a Valsalva maneuver strain at 30 mmHg expiratory pressure. The orthostatic performance of reflex responses was assessed from beat-by-beat changes in HR, MAP, stroke volume (SV), cardiac output (Q; by impedance plethysmography), and systemic peripheral resistance during the last 10 cardiac beats of a 4-min squat position and during the initial 10 cardiac beats in a standing position. RESULTS: G-training increased calf compliance in both men and women. SV and Q were increased during the squat-to-stand test in the males, but not in the females, following G-training and provided protection against the development of acute hypotension in the men. CONCLUSIONS: G-training caused adaptations in orthostatic functions opposite to those observed following exposure to microgravity environments. However, adaptations to G-training were limited in females, a finding that may provide a physiological basis for their lower simulated combat tracking performance during simulated aerial combat maneuvers compared with males.

Adaptation, Physiological↗

PubMed1997

Efficacy of compression of different capacitance beds in the amelioration of orthostatic hypotension.

Orthostatic hypotension (OH) is the most disabling and serious manifestation of adrenergic failure, occurring in the autonomic neuropathies, pure autonomic failure (PAF) and multiple system atrophy (MSA). No specific treatment is currently available for most etiologies of OH. A reduction in venous capacity, secondary to some physical counter maneuvers (e.g., squatting or leg crossing), or the use of compressive garments, can ameliorate OH. However, there is little information on the differential efficacy, or the mechanisms of improvement, engendered by compression of specific capacitance beds. We therefore evaluated the efficacy of compression of specific compartments (calves, thighs, low abdomen, calves and thighs, and all compartments combined), using a modified antigravity suit, on the end-points of orthostatic blood pressure, and symptoms of orthostatic intolerance. Fourteen patients (PAF, n = 9; MSA, n = 3; diabetic autonomic neuropathy, n = 2; five males and nine females) with clinical OH were studied. The mean age was 62 years (range 31-78). The mean +/- SEM orthostatic systolic blood pressure when all compartments were compressed was 115.9 +/- 7.4 mmHg, significantly improved (p < 0.001) over the head-up tilt value without compression of 89.6 +/- 7.0 mmHg. The abdomen was the only single compartment whose compression significantly reduced OH (p < 0.005). There was a significant increase of peripheral resistance index (PRI) with compression of abdomen (p < 0.001) or all compartments (p < 0.001); end-diastolic index and cardiac index did not change. We conclude that denervation increases vascular capacity, and that venous compression improves OH by reducing this capacity and increasing PRI. Compression of all compartments is the most efficacious, followed by abdominal compression, whereas leg compression alone was less effective, presumably reflecting the large capacity of the abdomen relative to the legs.

Adult↗

PubMed1997

Increased finger arterial blood pressure after exercise detraining in women with parental hypertension: autonomic tasks.

The effects of exercise detraining on resting finger arterial blood pressure (BP), the carotid-cardiac vagal baroreflex, and BP and heart rate (HR) responses to mental arithmetic and forehead cold exposure were studied in young (19 +/- 1.1 years) normotensive women with parental history of hypertension. Following 8 weeks of aerobic exercise for 25 min, 3 days week-1 at an intensity of 60% VO2peak, subjects ceased training for 6-8 weeks. After detraining, VO2peak (mL kg-1 min-1) was reduced by 11.5% (41.1 +/- 6.9 to 36.4 +/- 4.8) coincident with an approximately equal to 10% increase in submaximal exercise heart rate. Responses to the laboratory tasks were then compared. Detraining was accompanied by increases (P < 0.05) in resting systolic (SBP) (113.6 +/- 8.9 to 121.2 +/- 9.0), diastolic (DBP) (63.0 +/- 8.4 to 68.3 +/- 6.8), and mean arterial (MAP) (78.7 +/- 8.4 to 84.2 +/- 7.3) BP (mmHg). None of the above changes occurred in sedentary matched-control subjects. Systolic blood pressure was elevated during forehead cold exposure and MAP was elevated during mental arithmetic after detraining, but the rates of response and recovery for SBP, DBP and MAP were not altered by detraining. Despite higher submaximal exercise HR after detraining, HR responses to autonomic challenges, including the carotid-cardiac vagal baroreflex, were unchanged between training and detraining. Our results indicate that exercise detraining increases resting finger arterial BP in young normotensive women at risk for hypertension with no effects on the rate of response or recovery of heart rate and BP during autonomic tasks known to elicit sympathetic and carotid-cardiac vagal activities in this population. The use of auscultatory brachial artery pressures in a similar study of women diagnosed with hypertension will clarify the clinical meaning of our findings.

Adolescent↗

PubMed1997

An overview of the issues: physiological effects of bed rest and restricted physical activity.

Reduction of exercise capacity with confinement to bed rest is well recognized. Underlying physiological mechanisms include dramatic reductions in maximal stroke volume, cardiac output, and oxygen uptake. However, bed rest by itself does not appear to contribute to cardiac dysfunction. Increased muscle fatigue is associated with reduced muscle blood flow, red cell volume, capillarization and oxidative enzymes. Loss of muscle mass and bone density may be reflected by reduced muscle strength and higher risk for injury to bones and joints. The resultant deconditioning caused by bed rest can be independent of the primary disease and physically debilitating in patients who attempt to reambulate to normal active living and working. A challenge to clinicians and health care specialists has been the identification of appropriate and effective methods to restore physical capacity of patients during or after restricted physical activity associated with prolonged bed rest. The examination of physiological responses to bed rest deconditioning and exercise training in healthy subjects has provided significant information to develop effective rehabilitation treatments. The successful application of acute exercise to enhance orthostatic stability, daily endurance exercise to maintain aerobic capacity, or specific resistance exercises to maintain musculoskeletal integrity rather than the use of surgical, pharmacological, and other medical treatments for clinical conditions has been enhanced by investigation and understanding of underlying mechanisms that distinguish physical deconditioning from the disease. This symposium presents an overview of cardiovascular and musculoskeletal deconditioning associated with reduced physical work capacity following prolonged bed rest and exercise training regimens that have proven successful in ameliorating or reversing these adverse effects.

Bed Rest↗

PubMed1997

Cardiovascular consequences of bed rest: effect on maximal oxygen uptake.

Maximal oxygen uptake (VO2max) is reduced in healthy individuals confined to bed rest, suggesting it is independent of any disease state. The magnitude of reduction in VO2max is dependent on duration of bed rest and the initial level of aerobic fitness (VO2max), but it appears to be independent of age or gender. Bed rest induces an elevated maximal heart rate which, in turn, is associated with decreased cardiac vagal tone, increased sympathetic catecholamine secretion, and greater cardiac beta-receptor sensitivity. Despite the elevation in heart rate, VO2max is reduced primarily from decreased maximal stroke volume and cardiac output. An elevated ejection fraction during exercise following bed rest suggests that the lower stroke volume is not caused by ventricular dysfunction but is primarily the result of decreased venous return associated with lower circulating blood volume, reduced central venous pressure, and higher venous compliance in the lower extremities. VO2max, stroke volume, and cardiac output are further compromised by exercise in the upright posture. The contribution of hypovolemia to reduced cardiac output during exercise following bed rest is supported by the close relationship between the relative magnitude (% delta) and time course of change in blood volume and VO2max during bed rest, and also by the fact that retention of plasma volume is associated with maintenance of VO2max after bed rest. Arteriovenous oxygen difference during maximal exercise is not altered by bed rest, suggesting that peripheral mechanisms may not contribute significantly to the decreased VO2max. However reduction in baseline and maximal muscle blood flow, red blood cell volume, and capillarization in working muscles represent peripheral mechanisms that may contribute to limited oxygen delivery and, subsequently, lowered VO2max. Thus, alterations in cardiac and vascular functions induced by prolonged confinement to bed rest contribute to diminution of maximal oxygen uptake and reserve capacity to perform physical work.

Bed Rest↗

PubMed1997

Evidence for increased beta-adrenoreceptor responsiveness induced by 14 days of simulated microgravity in humans.

We studied hemodynamic responses to alpha- and beta-receptor agonists in eight healthy men before and after 14 days of 6 degrees head-down tilt (HDT) to test the hypothesis that increased adrenoreceptor responsiveness is induced by prolonged exposure to simulated microgravity. Steady-state infusions of isoproterenol (Iso) at rates of 0.005, 0.01, and 0.02 microgram.kg-1.min-1 were used to assess beta 1- and beta 2-adrenoreceptor responsiveness. Infusions of phenylephrine (PE) at rates of 0.25, 0.50, and 1.00 microgram.kg-1.min-1 were used to assess responsiveness of alpha 1-vascular adrenoreceptors. Slopes calculated from linear regressions between Iso and PE doses and changes in beat-to-beat heart rate, blood pressure, and leg vascular resistance (occlusion plethysmography) for each subject were used as an index of alpha- and beta-adrenoreceptor responsiveness. HDT increased the slopes of heart rate (1,056 +/- 107 to 1,553 +/- 83 beats micrograms-1.kg-1.min-1; P = 0.014) and vasodilation (-469 +/- 111 to -1,446 +/- 309 peripheral resistance units.microgram-1.kg-1.min-1; P = 0.0224) to Iso infusion. There was no alteration in blood pressure or vascular resistance responses to PE infusion after HDT. Our results provide evidence that simulated microgravity causes selective increases in beta 1- and beta 2-adrenoreceptor responsiveness without affecting alpha 1-vascular adrenoreceptor responses.

Adult↗

PubMed1997

Effects of vestibular and oculomotor stimulation on responsiveness of the carotid-cardiac baroreflex.

Twelve healthy men underwent measurement of their carotid-cardiac baroreflex response during varying conditions of vestibulo-oculomotor stimulation to test the hypothesis that vestibular and/or oculomotor stimulation associated with head movements in the yaw plane inhibit baroreflex control of heart rate. We assessed the carotid-cardiac baroreflex response by plotting R-R intervals (in milliseconds) at each of eight neck pressure steps with their respective carotid distending pressures (in millimeters mercury). Baroreflex sensitivity was measured under four experimental conditions: 1) sinusoidal whole body yaw rotation of the subject in the dark without visual fixation (combined vestibular-oculomotor stimulation); 2) yaw oscillation of the subject while tracking a small head-fixed light moving with the subject (vestibular stimulation without eye movements); 3) subject stationary while fixating on a small light oscillating in yaw at the same frequency, peak acceleration, and velocity as the chair (eye movements without vestibular stimulation); and 4) subject stationary in the dark (no eye or head motion). Head motion alone reduced baseline baroreflex responsiveness by 30% from 3.8 +/- 0.5 to 2.6 +/- 0.5 ms/mmHg. Eye motion alone also reduced the baroreflex response by 13% (0.5 ms/mmHg) to 3.3 +/- 0.5 ms/mmHg. During head motion, the effect of eye motion was negligible (2.7 +/- 0.4 ms/mmHg). These results suggest that vestibular stimulation associated with head movements in yaw inhibits vagally mediated baroreflex control of heart rate, whereas oculomotor stimulation is less of a factor and only in the absence of vestibular stimulation.

Adult↗