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Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight

Landing day symptoms from orthostatic hypotension after prolonged spaceflight can be debilitating, but severity of these symptoms can be unpredictable and highly individual. We tested the hypothesis that an impaired baroreflex response to an inflight leg cuff test could predict orthostatic intoleran...

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Autores principales: Wood, Katelyn N., Murray, Kevin R., Greaves, Danielle K., Hughson, Richard L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789148/
https://www.ncbi.nlm.nih.gov/pubmed/31633009
http://dx.doi.org/10.1038/s41526-019-0082-3
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author Wood, Katelyn N.
Murray, Kevin R.
Greaves, Danielle K.
Hughson, Richard L.
author_facet Wood, Katelyn N.
Murray, Kevin R.
Greaves, Danielle K.
Hughson, Richard L.
author_sort Wood, Katelyn N.
collection PubMed
description Landing day symptoms from orthostatic hypotension after prolonged spaceflight can be debilitating, but severity of these symptoms can be unpredictable and highly individual. We tested the hypothesis that an impaired baroreflex response to an inflight leg cuff test could predict orthostatic intolerance on return to Earth. Eight male astronauts (44 ± 7 years of age (mean ± SD); mean mission length: 167 ± 12 days) participated in a standardized supine-to-sit-to-stand test (5 min–30s–3 min) pre- and postflight, and a 3 min thigh cuff occlusion test pre- and inflight with continuous monitoring of heart rate and arterial blood pressure. The arterial baroreflex was not changed inflight as shown by similar reductions in mean arterial pressure (MAP) response to leg cuff deflation (preflight −19 ± 2 mmHg vs. inflight −18 ± 5 mmHg). With the sit/stand test, the nadir of MAP was lower postflight (−17 ± 9 mmHg) than preflight (−11 ± 6 mmHg, p < 0.05). A greater increase in heart rate (25 ± 7; 16 ± 3 bpm) and decrease in stroke volume (−24 ± 11; −6 ± 4 mL) occurred with sit/stand postflight than leg cuffs inflight (p < 0.001). Inflight testing was influenced by elevated cardiac output resulting in a smaller drop in total peripheral resistance. Two of eight subjects exhibited orthostatic hypotension during the postflight stand test; their responses were not predicted by the inflight leg cuff deflation test. These results suggest that the baroreflex response examined by inflight leg cuff deflation was not a reliable indicator of postflight stand responses.
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spelling pubmed-67891482019-10-18 Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight Wood, Katelyn N. Murray, Kevin R. Greaves, Danielle K. Hughson, Richard L. NPJ Microgravity Article Landing day symptoms from orthostatic hypotension after prolonged spaceflight can be debilitating, but severity of these symptoms can be unpredictable and highly individual. We tested the hypothesis that an impaired baroreflex response to an inflight leg cuff test could predict orthostatic intolerance on return to Earth. Eight male astronauts (44 ± 7 years of age (mean ± SD); mean mission length: 167 ± 12 days) participated in a standardized supine-to-sit-to-stand test (5 min–30s–3 min) pre- and postflight, and a 3 min thigh cuff occlusion test pre- and inflight with continuous monitoring of heart rate and arterial blood pressure. The arterial baroreflex was not changed inflight as shown by similar reductions in mean arterial pressure (MAP) response to leg cuff deflation (preflight −19 ± 2 mmHg vs. inflight −18 ± 5 mmHg). With the sit/stand test, the nadir of MAP was lower postflight (−17 ± 9 mmHg) than preflight (−11 ± 6 mmHg, p < 0.05). A greater increase in heart rate (25 ± 7; 16 ± 3 bpm) and decrease in stroke volume (−24 ± 11; −6 ± 4 mL) occurred with sit/stand postflight than leg cuffs inflight (p < 0.001). Inflight testing was influenced by elevated cardiac output resulting in a smaller drop in total peripheral resistance. Two of eight subjects exhibited orthostatic hypotension during the postflight stand test; their responses were not predicted by the inflight leg cuff deflation test. These results suggest that the baroreflex response examined by inflight leg cuff deflation was not a reliable indicator of postflight stand responses. Nature Publishing Group UK 2019-10-11 /pmc/articles/PMC6789148/ /pubmed/31633009 http://dx.doi.org/10.1038/s41526-019-0082-3 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Wood, Katelyn N.
Murray, Kevin R.
Greaves, Danielle K.
Hughson, Richard L.
Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title_full Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title_fullStr Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title_full_unstemmed Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title_short Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
title_sort inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789148/
https://www.ncbi.nlm.nih.gov/pubmed/31633009
http://dx.doi.org/10.1038/s41526-019-0082-3
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