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Differential effects of lower body negative pressure and upright tilt on splanchnic blood volume.

Upright posture and lower body negative pressure (LBNP) both induce reductions in central blood volume. However, regional circulatory responses to postural changes and LBNP may differ. Therefore, we studied regional blood flow and blood volume changes in 10 healthy subjects undergoing graded lower-body negative pressure (-10 to -50 mmHg) and 8 subjects undergoing incremental head-up tilt (HUT; 20 degrees , 40 degrees , and 70 degrees ) on separate days. We continuously measured blood pressure (BP), heart rate, and regional blood volumes and blood flows in the thoracic, splanchnic, pelvic, and leg segments by impedance plethysmography and calculated regional arterial resistances. Neither LBNP nor HUT altered systolic BP, whereas pulse pressure decreased significantly. Blood flow decreased in all segments, whereas peripheral resistances uniformly and significantly increased with both HUT and LBNP. Thoracic volume decreased while pelvic and leg volumes increased with HUT and LBNP. However, splanchnic volume changes were directionally opposite with stepwise decreases in splanchnic volume with LBNP and stepwise increases in splanchnic volume during HUT. Splanchnic emptying in LBNP models regional vascular changes during hemorrhage. Splanchnic filling may limit the ability of the splanchnic bed to respond to thoracic hypovolemia during upright posture.

Adolescent↗

Tolerance to lower body negative pressure exposure: comparison between patients with neurocardiogenic syncope and controls.

Lower body negative pressure exposure (LBNPE) produces hemodynamic modifications similar to those produced by head-up tilt test (HUT). Patients with vasovagal syncope are more susceptible to HUT than healthy persons. The supine position during LBNPE would facilitate the simultaneous performance of complementary methods. The aim of this study was to compare tolerance to LBNPE between a group of patients with vasovagal syncope and a group of healthy volunteers. Eleven patients with vasovagal syncope and positive HUT and 13 healthy volunteers without prior history of syncope and negative HUT were included. The following protocol was used: -10 mmHg, 1 minute; -20 mmHg, 1 minute; -30 mmHg, 3 minutes, and -40, -50, -60, and -70 mmHg, 5 minutes for each stage. Tolerance was expressed as: maximum tolerated negative pressure (Max NP), maximum tolerated time (Max T), and sigma P x T, where P = pressure and T = time. Syncope or presyncope during the test was considered positive LBNPE. LBNPE was positive at -50 or -60 mmHg in 8 of 11 patients (73%). One healthy volunteer had presyncope after 5 minutes at -70 mmHg. Tolerance, as expressed by any of the three parameters, was significantly higher for the healthy volunteers (Max NP: -59.1 +/- 7.9 vs -70, P < 0.01; Max T: 19.1 +/- 4.2 vs 24.4 +/- 0.3, P < 0.01; sigma P x T: 836.3 +/- 269.5 vs 1214.6 +/- 18, P < 0.01). We conclude that patients with neurocardiogenic syncope have a significantly lower tolerance to LBNPE than subjects with no previous history of syncope.

Adult↗

The reproducibility of tolerance to lower-body negative pressure and its quantification.

The reproducibility of tolerance to lower-body negative pressure (LBNP) has not been assessed sufficiently. Furthermore, there has been confusion concerning the most appropriate index by which LBNP tolerance can be quantified. The purpose of this study was to assess the degree of reproducibility in presyncopal-symptom-limited LBNP (LBNPtol), using an LBNP chamber. Twenty physically active subjects [median age (range) 21 (18-27) years] underwent three successive LBNPtol tests with 72-120 h between each test. LBNPtol was quantified using the LBNP tolerance index (LTI; delta mmHg.min), cumulative stress index (CSI; mmHg.min), duration of negative pressure (DNP) and maximum magnitude of negative pressure (MNP). Heart rate (fc), systolic (SBP) and diastolic (DBP) blood pressures from the three repeated tests were compared during a control period. The changes from control to maximum response (fc, SBP, DBP) during LBNP were also compared, and percentage changes in estimated blood volume were measured. There were no statistical differences between any of these comparisons (P > 0.05). LTI and CSI were greater in the third test when compared to the first two tests (P < 0.05). The values for DNP and MNP were not statistically different between tests (P > 0.05). Measures of LTI and CSI showed an acceptable level of reproducibility for the first two repeated tests. However, there was an increase in LBNPtol on the third successive exposure to LBNP. These findings have shown that it is possible to achieve reproducible measures of tolerance to LBNP when using a custom-built chamber. This only applies to a test-retest procedure. Furthermore, these data also suggest that DNP and MNP do not adequately reflect the differences shown in LBNP tolerance when using LTI and CSI as measures.

Adult↗

Renal stone risk in a simulated microgravity environment: impact of treadmill exercise with lower body negative pressure.

PURPOSE: Prolonged exposure to microgravity during spaceflight causes metabolic changes that increase the risk of renal stone formation. Studies during the Gemini, Apollo, Skylab and Shuttle missions demonstrated alterations in renal function, fluid homeostasis and bone resorption that result in increased urinary supersaturation of calcium oxalate, brushite, sodium urate and uric acid. Developing countermeasures to increased urinary supersaturation is an important priority as the duration of space missions increases. MATERIALS AND METHODS: A total of 11 sets of identical twins remained on 6-degree head down, tilt bed rest for 30 days to simulate prolonged microgravity. One twin per pair was randomly selected to exercise while supine in a lower body negative pressure chamber 6 days weekly for 40 minutes, followed by 5 minutes of resting lower body negative pressure at 50 mm Hg. The other twin served as a nonexercise control. Pressure in the exercise lower body negative pressure chamber (52 to 63 mm Hg) was adjusted to produce footward forces equivalent to those for upright running on Earth at 1.0 to 1.2 x body weight. Pre-bed rest urinary stone risk profiles were done elsewhere after 5 days of a standardized diet, consisting of 170 mEq sodium, 1,000 mg calcium, 0.8 gm/kg animal protein and 2,500 kcal, and then throughout the bed rest and recovery phases of the protocol. RESULTS: A significant increase in urinary calcium after just 1 week of bed rest was noted in the nonexercise control group (p = 0.001). However, no such increase was noted in the exercise group. Brushite supersaturation increased significantly from bed rest in each group, although the increase was significantly higher in the nonexercise control group than in the exercise group (p = 0.006). Calcium oxalate supersaturation increased during bed rest in the exercise group (p = 0.004). It trended toward a higher level in the nonexercise control group, although this did not achieve significance (p = 0.055) Mean urine volume +/- SD was significantly higher in the nonexercise control group than in the exercise group at bed rest week 2 and at week 3 (2.01 +/- 0.21 vs 1.63 0.18 l and 2.03 +/- 0.22 vs 1.81 +/- 0.20, respectively). Urinary pH was significantly higher in the nonexercise control group than in the exercise group at week 1 and week 3 (6.62 +/- 0.7 vs 6.49 +/- 0.5 and 6.58 +/- 0.6 vs 6.49 +/- 0.8, respectively, p = 0.01). CONCLUSIONS: Bed rest significantly alters the urinary environment to favor calculous formation. Lower body negative pressure chamber treadmill exercise offers some protection against increases in stone risk during simulated microgravity, particularly with regard to the risks of hypercalciuria and brushite stone formation. The use of lower body negative pressure to augment aerobic exercise in space may decrease the risk of stone formation in astronauts. Adjunct measures, including aggressive hydration and alkalinization therapy, should be considered.

Adult↗

Women have lower tolerance to lower body negative pressure than men.

Studies of the cardiovascular response to lower body negative pressure (LBNP) in men and women have suggested that women may have less tolerance to LBNP than men, although tolerance per se was not determined. To investigate the effect of gender on tolerance to LBNP, 10 men 10 women were subjected to increasing levels of LBNP until presyncopal symptoms developed. The cumulative stress index (CSI) score was determined, as were cardiovascular variables. Women had 62% less tolerance to LBNP with a CSI of 412 +/- 43 mmHg/min compared with a CSI of 1,070 +/- 149 mmHg/min for men. Cardiovascular changes associated with LBNP were similar for men and women when expressed relative to the occurrence of presyncope, but women had a higher heart rate response when the data were expressed at absolute levels of LBNP (-30 and -50 mmHg LBNP). Thus men and women had similar cardiovascular adjustments to the LBNP, with the changes in women occurring lower levels of LBNP. These data are important in a consideration of the development of antigravitational countermeasures for women. These data raise questions as to the manner in which blood pools within the lower body in men and women under LBNP.

Adult↗

Cardiovascular and cerebrovascular responses to lower body negative pressure in type 2 diabetic patients.

In diabetic patients, vascular disease and autonomic dysfunction might compromise cerebral autoregulation and contribute to orthostatic intolerance. The aim of our study was to determine whether impaired cerebral autoregulation contributes to orthostatic intolerance during lower body negative pressure in diabetic patients. Thirteen patients with early-stage type 2 diabetes were studied. We continuously recorded RR-interval, mean blood pressure and mean middle cerebral artery blood flow velocity at rest and during lower body negative pressure applied at -20 and -40 mm Hg. Spectral powers of RR-interval, blood pressure and cerebral blood flow velocity were analyzed in the sympathetically mediated low (LF: 0.04-0.15 Hz) and the high (HF: 0.15-0.5 Hz) frequency ranges. Cerebral autoregulation was assessed from the transfer function gain and phase shift between LF oscillations of blood pressure and cerebral blood flow velocity. In the diabetic patients, lower body negative pressure decreased the RR-interval, i.e. increased heart rate, while blood pressure and cerebral blood flow velocity decreased. Transfer function gain and phase shift remained stable. Lower body negative pressure did not induce the normal increase in sympathetically mediated LF-powers of blood pressure and cerebral blood flow velocity in our patients indicating sympathetic dysfunction. The stable phase shift, however, suggests intact cerebral autoregulation. The dying back pathology in diabetic neuropathy may explain an earlier and greater impairment of peripheral vasomotor than cerebrovascular control, thus maintaining cerebral blood flow constant and protecting patients from symptoms of presyncope.

Autonomic Nervous System Diseases↗

Reproducibility of the heart rate variability responses to graded lower body negative pressure.

The reproducibility of heart rate variability (HRV) measures during graded lower body negative pressure (LBNP) have not been studied in sufficient detail. Active college age men (n=14) underwent an orientation exposure and two trials of graded LBNP to presyncope or -100 mmHg, separated by 1 week. Heart rate, stroke volume (impedance cardiography), blood pressure (Finapres), and forearm blood flow were assessed, as was HRV in both time and frequency domains. The trial-to-trial responses to LBNP common to all subjects (LBNP< or =-60 mmHg and at test termination) showed parallel changes, suggesting similar responses between both trials. Good reproducibility estimates were found for the resting HRV data (lowest: R=0.62 for low frequency/high frequency ratio; highest: R=0.94 for standard deviation of normal R-R intervals). During LBNP, reproducibility estimates varied but were generally similar to that seen at rest. At test termination, they were unacceptably low (R<0.41) for the HRV data assessed in the frequency domain and expressed in absolute units. LBNP tolerance was lower in the first trial [LBNP tolerance index: 404 (21) versus 437 (15) mmHg min(-1); P<0.05] but the intraclass correlation coefficient was high (R=0.87). These data suggest that (1) HRV responses to submaximal LBNP up to -60 mmHg are consistent across trials, (2) the considerable variability seen in the HRV parameters at maximal LBNP can be reduced by expressing these data in either the time domain or using normalized units in the frequency domain, and (3) cardiovascular responses to sub- and maximal LBNP are reproducible. Data are presented as mean (SEM) unless otherwise stated.

Adaptation, Physiological↗

Haemodynamic responses to nonhypotensive central hypovolaemia induced by lower body negative pressure in men and women.

Haemodynamic responses to low levels of lower body negative pressure (LBNP) were investigated in two groups of healthy, normotensive volunteers (8 men and 8 women) during two repeated experimental runs on two occasions, the latter determined by the different phases of the menstrual cycle in the women. The data consisted of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), pulse rate (fc), forearm blood flow (FBF) and forearm vascular conductance (FC). The resting cardiovascular status was similar in men and women, except that women had a significantly higher fc than men. LBNP (1.3, 2.7 and 4 kPa) had no significant effect on any BP variable or on fc. However, FBF and FC were reduced at all levels of LBNP. Significant overshoots in FBF and FC were seen in all subjects following the release of LBNP of 2.7 and 4 kPa and, in most cases, after release of LBNP of 1.3 kPa. There were no significant gender differences in any of the responses to LBNP. Furthermore, none of the cardiovascular variables measured showed significant differences between the follicular and luteal phases of the menstrual cycle in women, either at rest or during exposure to LBNP, and the responses in the men on the two occasions were not different. These findings indicate that gender differences in responses to LBNP hypothesized previously are not apparent during and after exposure to low levels of LBNP.

Adult↗

Reduction of left ventricular preload by lower body negative pressure alters Doppler transmitral filling patterns.

The objective of this study was to evaluate the effect of alterations in preload induced by lower body negative pressure on Doppler transmitral filling patterns. Echocardiograms and Doppler recordings were performed in 18 normal young men (aged 23 to 32 years) during various levels of lower body negative pressure (0, -20 and -50 mm Hg). Lower body negative pressure induced a reduction in diastolic velocity integral (from 12.17 +/- 0.79 to 8.42 +/- 0.71 cm, p = 0.0067) and consequently left ventricular diastolic diameter (from 5.11 +/- 0.09 to 4.45 +/- 0.1 cm, p less than 0.0001). There was a significant reflex increase in heart rate from 59.9 +/- 1.9 to 77.1 +/- 2.4 beats/min (p less than 0.0001), but blood pressure was unchanged. This reduction in preload altered Doppler transmittral filling patterns as follows: 1) peak early velocity (E) decreased from 59.2 +/- 3.8 to 39.1 +/- 1.7 cm/s (p less than 0.0001); 2) atrial filing velocity (A) was unchanged (35.58 +/- 1.5 to 33.52 +/- 1.4 cm/s, p = 0.517); 3) E/A ratio decreased from 1.7 +/- 0.13 to 1.19 +/- 0.08 (p = 0.0087); 4) mean acceleration (from 482 +/- 37 to 390 +/- 27 cm/s2, p = 0.03) and mean deceleration (from 327 +/- 31 to 169 +/- 21 cm/s2, p less than 0.001) of the early filling wave were significantly reduced; and 5) peak acceleration (from 907 +/- 42 to 829 +/- 29 cm/s2) and peak deceleration (from 771 +/- 94 to 547 +/- 76 cm/s2) also decreased, but not significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Supine exercise during lower body negative pressure effectively simulates upright exercise in normal gravity.

Exercise within a lower body negative pressure (LBNP) chamber in supine posture was compared with similar exercise against Earth's gravity (without LBNP) in upright posture in nine healthy male volunteers. We measured footward force with a force plate, pressure in soleus and tibialis anterior muscles of the leg with transducer-tipped catheters, calf volume by strain gauge plethysmography, heart rate, and systolic and diastolic blood pressures during two conditions: 1) exercise in supine posture within an LBNP chamber during 100-mmHg LBNP (exercise-LBNP) and 2) exercise in upright posture against Earth's gravity without LBNP (exercise-1 G). Subjects exercised their ankle joints (dorsi- and plantarflexions) for 5 min during exercise-LBNP and for 5 min during exercise-1 G. Mean footward force produced during exercise-LBNP (743 +/- 37 N) was similar to that produced during exercise-1 G (701 +/- 24 N). Peak contraction pressure in the antigravity soleus muscle during exercise-LBNP (115 +/- 10 mmHg) was also similar to that during exercise-1 G (103 +/- 13 mmHg). Calf volume increased significantly by 3.3 +/- 0.5% during exercise-LBNP compared with baseline values. Calf volume did not increase significantly during exercise-1 G. Heart rate was significantly higher during exercise-LBNP (99 +/- 5 beats/min) than during exercise-1 G (81 +/- 3 beats/min). These results indicate that exercise in supine posture within an LBNP chamber can produce similar musculoskeletal stress in the legs and greater systemic cardiovascular stress than exercise in the upright posture against Earth's gravity.

Adult↗

Gender differences in tolerance to lower body negative pressure.

BACKGROUND: Previous studies suggest that women have lower tolerance than men do to lower body negative pressure (LBNP). The mechanism(s) responsible has not been determined. HYPOTHESES: Women would be less tolerant to presyncopal LBNP than men as determined by several indices of LBNP tolerance. Additionally, men and women, regardless of LBNP tolerance, would have similar cardiovascular responses to LBNP as presyncope was reached. METHODS: The subjects were 18 men and 18 women (average age 25) of similar fitness levels who volunteered for the study. A step-wise LBNP protocol to presyncope was employed. HR, stroke volume (SV), cardiac output (Q), BP, and systemic vascular resistance (SVR) were measured before and throughout the LBNP stress. Data from women were compared with those from all men, and to men with similar and higher LBNP tolerance. RESULTS: Women had significantly less LBNP tolerance than men regardless of index used: 30% less by duration of LBNP, 21% less by maximal LBNP tolerated, 44% less by a cumulative stress index, and 27% less by a linear tolerance index. Cardiovascular responses to LBNP were similar for women and men as presyncope was approached, whether the men were low-tolerant (LT) or high-tolerant (HT). In the 2 min pre-presyncope, HR increased by 80 +/- 6% in women, 72 +/- 7% in LT men and 96 +/- 14% in HT men; Q decreased by 47 +/- 3% in women, 52 +/- 6% in LT men and 55 +/- 2% in HT men. Similar comparisons occurred for the decline in BP and the rise in SVR. CONCLUSION: Women have lower LBNP tolerance than do men, although there is considerable gender overlap in tolerances. The cardiovascular response to LBNP is similar regardless of gender or tolerance level as presyncope is approached. Understanding the gender differences in LBNP tolerance may lie in determining how the LBNP stress is translated into a "trigger" for cardiovascular decompensation.

Adult↗

Combined head-up tilt and lower body negative pressure as an experimental model of orthostatic syncope.

INTRODUCTION: The combination of head-up tilt and incremental lower body negative pressure has shown promise in the diagnosis of orthostatic hypotension and neurocardiogenic syncope, although prior methodologies limited conclusions as to the reproducibility of the test. The aim of this study was to assess the efficacy and reproducibility of a protocol combining tilt and stages of incremental lower body negative pressure. METHODS AND RESULTS: Ten volunteers (6 men and 4 women; mean age 21 +/- 1 years) participated in the study, which was composed of three sessions, 1 month apart, each consisting of 60 degrees tilt followed by lower body suction in incremental levels of -10 mmHg for 5 minutes at each level. The primary outcome variable was the time to presyncope. Secondary variables were the levels of heart rate, blood pressure, cerebral blood flow, and end-tidal CO2 at each level of the test. Presyncope could be achieved in all subjects. The mean times to presyncope were 24.6 +/- 1.4 minutes, 26.2 +/- 1.8 minutes, and 31.8 +/- 1.6 minutes and were not different across tests (P = 0.3). Intrasubject variability was assessed by determining the mean average deviation from the mean, which was 3.2 +/- 2.0 minutes. Changes in heart rate, blood pressure, end-tidal CO2, and cerebral blood flow were consistent with repeat testing. CONCLUSION: Lower body negative pressure combined with head-up tilt in a staged protocol can safely and reliably induce presyncope in all normal subjects tested. The test is a potent and reproducible investigational tool for inducing hypotension and transient cerebral hypoperfusion.

Adult↗

Carotid baroreceptor influence on forearm vascular resistance during low level lower body negative pressure.

The degree of forearm vasoconstriction induced by low levels of lower body negative pressure (LBNP) provides a measure of the responsiveness of the cardiopulmonary baroreflex. The validity of this measurement is based on the assumption that this vasoconstriction response is not influenced by unloading of carotid baroreceptors. To test the hypothesis that arterial baroreceptor unloading does not alter the degree of forearm vascular resistance during low levels of LBNP, we exposed 12 subjects to -15 and -20 mm Hg LBNP with and without additional artificial (+10 mm Hg neck pressure) unloading of the carotid baroreceptors. There was no measurable influence of carotid unloading on forearm vascular resistance at either level of LBNP. We conclude that forearm vascular resistance measured during cardiopulmonary baroreceptor unloading is unaffected by carotid baroreceptor unloading within the magnitude encountered during low levels of LBNP.

Adult↗

Onset of mild lower body negative pressure induces transient change in mean arterial pressure in humans.

Mild (0 to -20 mmHg) lower body negative pressure (LBNP) has traditionally been considered to elicit reflex responses mediated by cardiopulmonary baroreceptors only, without any arterial baroreflex involvement. Mild LBNP has therefore frequently been used to study the influence of cardiopulmonary baroreceptors on the human circulatory system. In a previous study we found that mean arterial pressure (MAP) was transiently but strongly affected by rapid (0.3 s) onset and release of -20 mmHg LBNP. In the present study we tested whether MAP is also transiently affected by slow onset and release of -20 mmHg LBNP. A group of 12 subjects participated in this study, which was approved by the local Ethics Committee. Heart rate, stroke volume, cardiac output, MAP, total peripheral resistance, acral and non-acral skin blood flow, and blood flow velocity in the brachial artery were continuously recorded during the pre-LBNP period, during LBNP and during the post-LBNP period. The LBNP was gradually applied and released over a 15 s period. The main finding was that MAP was transiently but strongly affected by the gradual onset of LBNP as mild as -20 mmHg. During onset of LBNP MAP was significantly ( P=0.003) lower than MAP in the pre-LBNP period. This shows that not only the cardiopulmonary baroreceptors but also the arterial baroreceptors must be activated during mild LBNP.

Adult↗

[Changes of human cerebral blood flow velocity and blood oxygen saturation under lower body negative pressure in upright seated position].

Objective. To investigate the effect of lower body negative pressure (LBNP) in upright seated position on cerebral blood flow velocity, heart rate (HR), and blood oxygen saturation (SaO2) in human. Method. Fifteen young men were selected as subjects. Blood flow velocity in middle cerebral artery (VMCA), HR and SaO2 were measured at 0.5, 1, 2, 3, 4, and 5 min during LBNP and 1, 3, 5 min after -4.00 kPa and -6.67 kPa LBNP in upright seated position respectively. Result. Under -4.00 kPa LBNP, VMCA slowed down at 4, 5 min during LBNP (P<0.05), and HR speeded up at 3, 4, 5 min during LBNP (P<0.05). There were no significant changes of SaO2. Under -6.67 kPa LBNP, VMCA became slow at 2, 3 min (P<0.05), and at 4 and 5 min (P<0.01) during LBNP. At 1 min after release of LBNP, VMCA did not recover, after which it recovered to control level. HR significantly increased (P<0.01) and SaO2 decreased at 5 min (P<0.05) during LBNP. Conclusion. LBNP can cause blood pooling in lower body so that VMCA and brain blood volume decrease. Then it causes loss of consciousness. The results of this experiment may provide experimental data for diagnosis of flight syncope and orthostatic intolerance.

Adult↗

Influence of alterations in loading produced by lower body negative pressure on aortic blood flow acceleration.

The objectives of this study were to evaluate the effects of alterations in loading induced by lower body negative pressure on aortic blood flow velocity and acceleration. Twenty-seven normal men were studied during various levels of lower body negative pressure (0 to -60 mm Hg) during which echocardiographic, Doppler and hormonal measurements were obtained. Lower body negative pressure induced a decrease in left ventricular diastolic diameter from 5.18 +/- 0.08 to 4.41 +/- 0.1 cm (p less than 0.0001) and in left ventricular systolic diameter from 3.33 +/- 0.09 to 2.84 +/- 0.1 cm (p less than 0.0001). Shortening fraction remained unchanged. The decrease in diastolic diameter resulted in a reduction in flow velocity integral from 13.8 +/- 0.8 to 7.5 +/- 0.4 cm (p less than 0.0001) and, therefore, in stroke volume from 89.6 +/- 4.7 to 49.5 +/- 2.8 ml (p less than 0.0001). Heart rate reflexly increased from 62.5 +/- 1.9 to 82.2 +/- 2.3 beats/min (p less than 0.0001) as did systemic vascular resistance from 1,280.8 +/- 69.5 to 1,863.4 +/- 121.4 dyne.s.cm-5 (p less than 0.0001). The increase in heart rate was insufficient to maintain cardiac output, which decreased from 5.53 +/- 0.29 to 3.99 +/- 0.21 liters/min (p less than 0.0001). Systolic, diastolic and mean arterial blood pressure was maintained. The negative pressure resulted in a concomitant significant increase in norepinephrine levels from 1.46 +/- 0.09 to 2.056 +/- 0.2 nmol/liter (p = 0.0019) but no change in plasma epinephrine: 0.845 +/- 0.22 to 0.78 +/- 0.11 nmol/liter (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Haemodynamics of leg veins during a 30-days-6 degrees head-down bedrest with and without lower body negative pressure.

Venous distensibility of the lower limbs was assessed in six healthy men who were submitted twice successively to 1 month of -6 degrees head-down bedrest, with and without lower body negative pressure (LBNP) (LBNP subjects and control subjects, respectively). Venous capacity (delta Vv,max, in ml.100 ml-1) of the legs was determined by mercury strain gauge plethysmography with venous occlusion. Plethysmographic measurements were made on each subject before (Dc), during (D6 and D20) and after (5th day of recovery, D+5) bedrest. During bedrest, LBNP was applied daily, several times a day to the subjects submitted to this procedure. Results showed a gradual increase in Vv,max (ml.100 ml-1) throughout the bedrest, both in the control group [delta Vv,max = 2.11 SD 0.54 at Dc, 2.69 SD 0.29 at D6, 4.39 SD 2.08 at D20, 2.39 SD 0.69 at D+5, P less than 0.001 (ANOVA)] and in the LBNP group [delta Vv,max = 2.07 SD 0.71 at Dc, 2.85 SD 1.19 at D6, 3.75 SD 1.74 at D20, 2.43 SD 0.94 at D+5, P less than 0.001 (ANOVA)], without significant LBNP effect. These increases were of the same order as those encountered during spaceflight. It is concluded that -6 degrees head-down bedrest is a good model to simulate the haemodynamic changes induced by exposure to weightlessness and that LBNP did not seem to be a good technique to counteract the adverse effects of weightlessness on the capacitance vessels of the lower limbs. This latter conclusion raises the question of the role and magnitude of leg venous capacitance in venous return and cardiac regulation.

Adult↗

Leg mass and lower body negative pressure tolerance in men and women.

To explore the hypothesis that lower body muscle mass correlates with orthostatic tolerance, 18 healthy volunteers (age 18-48 yr; 10 men, 8 women) underwent a graded lower body negative pressure (LBNP) protocol consisting of six, 5-min stages of suction up to 60 mmHg in 10-mmHg increments. Forearm blood flow, heart rate, and blood pressure were measured, and forearm vascular resistance was calculated. Leg muscle mass was assessed by dual-energy X-ray absorptiometry. All subjects received standard intravenous hydration for at least 8 h before the study. Six men and four women completed all stages of LBNP. Four men and four women developed presyncopal symptoms, including marked bradycardia and/or hypotension, at LBNP levels of 30 mmHg (n = 2;1 man, 1 woman), 40 mmHg (n = 2;1 man, 1 woman), and 50 mmHg (n = 4;2 men, 2 women). The presyncopal subjects had leg muscle masses ranging from 19.5 to 25.2 kg in men and from 11.7 to 16.6 kg in women. In subjects who completed all stages of LBNP, leg muscle mass ranged from 17.5 to 24.1 kg in men and from 10.4 to 18.0 kg in women. Leg muscle mass did not differ between presyncopal subjects and those who completed the protocol. Furthermore, there were no differences in the hemodynamic responses to LBNP between subjects with low vs. high leg mass. These data suggest that leg muscle mass is not a critical determinant of LBNP tolerance in otherwise healthy men and women.

Absorptiometry, Photon↗