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EXPERIMENT
CIRCA - One-day (24-hour) pattern of blood pressure and heart rate in weightlessness
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 | Physiology: Integrative gravitational physiology |
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 | ISS 8S (Soyuz TMA-4) Dutch "Delta" Mission |
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 | J.M. Karemaker (1), C. Gharib (2), A. Aubert (3), M.A. Custaud (4), J. Gisolf (1), G.A. van Montfrans (1), W. Stok (1), F. Beckers (3), B. Verheyden (3) |
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 | | (1) | Academic Medical Center M01-08
University of Amsterdam
Meibergdreef 9
1105AZ Amsterdam
THE NETHERLANDS
| | (2) | Laboratoire de physiologie de l'Environnement
Faculté de Médecine Lyon Grange Blanche
69373 Lyon
FRANCE
| | (3) | Laboratory of Experimental Cardiology
University Hospital Gasthuisberg O/N
K.U. LEUVEN
Herestraat 49
3000 Leuven
BELGIUM
| | (4) | Laboratoire de physiologie Faculté de medicine d'Angers
49045 Angers
FRANCE
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 | | [1] | B.E. Westerhof, J. Gisolf, W.J. Stok, K.H. Wesseling, J.M. Karemaker, (2004), "Time-domain cross-correlation baroreflex sensitivity: performance on the EUROBAVAR data set", Journal of Hypertension, 22, pp. 1371-1380. | | [2] | J. Gisolf, R. Wilders, R.V. Immink, J.J. van Lieshout, J.M. Karemaker, (2004), "Tidal volume, cardiac output and functional residual capacity determine end-tidal CO2 transient during standing up in humans", The Journal of Physiology, 554, pp. 579-590. | | [3] | J. Gisolf, B.E. Westerhof, N. van Dijk, K.H. Wesseling, W. Wieling, J.M. Karemaker, (2004), "Sublingual nitroglycerin used in routine tilt testing provokes a cardiac output-mediated vasovagal response", American College of Cardiology Foundation, 44, pp. 588-593. | | [4] | J. Gisolf, J.J. van Lieshout, K. van Heusden, F. Pott, W.J. Stok, J.M. Karemaker, (2004), "Human cerebral venous outflow pathway depends on posture and central venous pressure", The Journal of Physiology, 560, pp. 317-327. | | [5] | J. Gisolf, E.M. Akkerman, A.W. Schreurs, J. Strackee, W.J. Stok, J.M. Karemaker, (2004), "Tilt table design for rapid and sinusoidal posture change with minimal vestibular stimulation", Aviation, Space, and Environmental Medicine, 75, pp. 1086-1091. | | [6] | A. Aubert, F. Beckers, B. Verheyden, (2005), "Cardiology in Space. A review", Acta Cardiologica, 60, 2, pp. 129-151. | | [7] | J. Gisolf, R.V. Immink, J.J. van Lieshout, W.J. Stok, J.M. Karemaker, (2005), "Orthostatic blood pressure control before and after spaceflight, determined by time-domain baroreflex method", Journal of Applied Physiology, 98, 5, pp. 1682-1690. | | [8] | J. Gisolf, (2005), "Postural changes in humans: effects of gravity on the circulation", Dissertation, University of Amsterdam. | | [9] | J. Gisolf, A. Gisolf, J.J. van Lieshout, J.M. Karemaker, (2005), "The siphon controversy: an integration of concepts and the brain as 'baffle'", American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, 289, 2, pp. R627-R629. | | [10] | N. van Dijk, I.G. de Bruin, J. Gisolf, H.A. de Bruin-Bon, M. Linzer, J.J. van Lieshout, W. Wieling, (2005), "Hemodynamic effects of leg crossing and skeletal muscle tensing during free standing in patients with vasovagal syncope", Journal of Applied Physiology, 98, pp. 584-590. | | [11] | B. Verheyden, F. Beckers, K. Couckuyt, L. Jiexin, A. Aubert, (2006), "Heart reflexes and arterial pressure control after short duration spaceflight", Journal of Gravitational Physiology, 13, pp. 59-60. | | [12] | K. van Heusden, J. Gisolf, W.J. Stok, S. Dijkstra, J.M. Karemaker, (2006), "Mathematical modeling of gravitational effects on the circulation; the importance of the time course of venous pooling and blood volume changes in the lungs", American Journal of Physiology - Heart and Circulatory Physiology, 291, pp. H2152-2165. | | [13] | J.J.W.A. van Loon, F.J. Medina, H. Stenuit, E. Istasse, M. Heppener, R. Marco, (2007), "The National-ESA Soyuz missions Andromède, Marco Polo, Odissea, Cervantes, DELTA and Eneide", Microgravity Science and Technology, 19, 5-6, DOI: 10.1007/BF02919448, pp. 9-32. | | [14] | B. Verheyden, F. Beckers, K. Couckuyt, J. Liu, A. Aubert, (2007), "Respiratory modulation of cardiovascular rhythms before and after short-duration human space flight.", Acta Physiol, 191(4), pp. 297-308. | | [15] | B. Verheyden, F. Beckers, K. Couckuyt, J. Liu, A. Aubert, (2007), "Respiratory modulation of cardiovascular rhythms before and after short-duration human spaceflight", Abstract book 16th IAA Humans in Space Symposium, 27. | | [16] | J.M. Karemaker, J. Gisolf, W.J. Stok, G.A. van Montfrans, (2007), "24-hr blood pressure in HDT-bed rest and short-lasting space flight", Journal of Gravitional Physiology, 14, 1, pp. P49-50. | | [17] | M. Di Rienzo, P. Castiglioni, F. Tellamo, M. Volterrani, M. Pagani, G. Mancia, J.M. Karemaker, G. Parati, (2008), "Dynamic adaptation of cardiac baroreflex sensitivity to prolonged exposure to microgravity: data from a 16-day spaceflight", Journal of Applied Physiology, 105, 5, pp. 1569-1575. | | [18] | P. Norsk, J.M. Karemaker, (2008), "Counteracting hypertension with weightlessness?", Scientific American, Special Issue:, pp. 16-23. | | [19] | J.M. Karemaker, J. Berecki-Gisolf, (2009), "24-h blood pressure in Space: The dark side of being an astronaut", Respiratory Physiology & Neurobiology, 169, Supplement, pp. S55?S58. |
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 | The total duration of each experimental session is 25 hr hours. During each session the following activities are executed:
- recording with the Bloodpressure Measurement Instrument (BMI) during 25 hours
- two specific protocols (one during the morning : protocol 1, one during the afternoon : protocol 2) with Portapres recording and BMI off.
- Portapres recording session as long as possible within the 25h. The following periods are of very high importance for science:
- From the beginning of lunch until 30 minutes after the end of lunch
- From the beginning of dinner until 30 minutes after the end of dinner
- From one hour before the cosmonaut goes to sleep until minimum one hour after the transition awake-sleep. Recording can last until the end of the sleep phase if the battery capacity allows it.
- From wake up until one hour after wake up.
- The cosmonaut shall do his normal work during the day of the experiment.
- The in-flight part of the experiment will be conducted in the Russian module of ISS, and will be repeated twice at the beginning and at the end of the flight.
- The overall experiment has two pre-flight baseline data collection sessions.
- The post-flight part of the experiment will record return to normal gravity circumstances. This part will also be performed twice.
In five cosmonauts, we measured finger arterial pressure noninvasively in supine and upright positions. Preflight measurements were repeated using venous occlusion thigh cuffs to impede venous return and "trap" an increased blood volume in the lower extremities; postflight sessions were between 1 and 3 days after return from 10- to 11-day spaceflight. BaroReflex Sensitivity (BRS) was determined by spectral analysis and by PRVXBRS, a time-domain BRS computation method. |
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 | Although all completed the stand tests, two of five cosmonauts had drastically reduced pulse pressures and an increase in heart rate of ∼30 beats/min or more during standing after spaceflight. Averaged for all five subjects in standing position, high-frequency interbeat interval spectral power or transfer gain did not decrease postflight. Low-frequency gain decreased from 8.1 (SD 4.0) preflight baseline to 6.8 (SD 3.4) postflight (P = 0.033); preflight with thigh cuffs inflated, low-frequency gain was 9.4 (SD 4.3) ms/mmHg. There was a shift in time-domain-determined pulse interval-to-pressure lag, Tau, toward higher values (P < 0.001). None of the postflight results were mimicked during preflight venous occlusion. In conclusion, two of five cosmonauts showed abnormal orthostatic response 1 and 2 days after spaceflight. Overall, there were indications of increased sympathetic response to standing, even though we can expect (partial) restoration of plasma volume to have taken place. Preflight venous occlusion did not mimic the postflight orthostatic response.
Blood pressure (BP)-levels in Space were not very much changed from preflight; the circadian BP-rhythm seemed dampened. Only daytime diastolic pressures (both subjects) and nighttime HR (one subject) were significantly lower in Space. However, compared to the effect of a control tilt manoeuvre on the ground, even lower BP values might have been expected. Striking were the BP- and HR-surges during the working days in Space, often related to stressful moments like live appearances on public TV. Systemic vascular resistance (SVR) dropped during the night, unlike HDT. Thus, actual spaceflight refuted our earlier findings in HDT both for BP-levels and for daytime to nighttime changes.
The combined observations lead to the hypothesis that short-lasting spaceflight may induce strong psychological stress in astronauts. When interpreting space-physiological observations this must be taken into account. |
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 |  | For a very comprehensive overview on the first six ESA missions to the ISS, please, consult the following reference document - see also document no. 10 in the list of references above:
The National - ESA Soyuz missions Andromède, Marco Polo, Odissea, Cervantes, Delta and Eneide;
Jack J. W. A. van Loon, F. Javier Medina, Hilde Stenuit, Eric Istasse, Marc Heppener and Roberto Marco;
Microgravity Science and Technology;
Volume 19, Numbers 5-6 (2007), 9-32, DOI: 10.1007/BF02919448 |  |
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 | Patrik Sundblad (e-mail: patrik.sundblad@esa.int) |
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