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Biomedical subjects

V A Convertino

Publications and source records attributed to V A Convertino.

At least 73 records · Page 4Linked to original sources

Back pain during 6 degrees head-down tilt approximates that during actual microgravity.

Astronauts often experience back pain during spaceflight. Retrospectively, Wing et al. (14) found that during spaceflight, 14 of 19 Shuttle crewmembers experienced back pain, which they described as dull (62%), localized to the lower back (50%), and with an intensity of 2 on a 5-point scale. Further, the spine lengthens 4-7 cm in microgravity. Our objective was to compare back pain and spinal lengthening (body height increase) during simulated microgravity (6 degrees head-down tilt, HDT) with the same parameters during actual microgravity. Eight male subjects completed a modified McGill pain questionnaire with intensity graded from zero (no pain) to five (intense and incapacitating pain) each day at 7:00 pm during 2 d pre-HDT control, 16 d HDT, and 1 d post-HDT recovery periods. Also, the subjects' heights were measured each day while supine (control and recovery) and during HDT. Back pain increased from zero (pre-tilt control period) to 2.3 +/- 0.4 at days 1 to 3 of HDT, and was categorized as dull and/or burning pain in subjects' lower backs. Only 2 subjects reported any pain after day 9 of HDT and during recovery. Heights increased 2.1 +/- 0.5 cm by day 3 of HDT and remained at that level until the end of the HDT period. Although spinal lengthening in space is greater than that during HDT, the HDT model approximates the level, type, distribution, and time course of back pain associated with actual microgravity. In the HDT model, pain subsides in intensity when spinal lengthening stops.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of training on blood volume and plasma hormone concentrations in the elderly.

The purpose of this investigation was to determine the effects of 6 months of endurance training on resting plasma (PV) and blood volume (BV), and resting hormone and electrolyte concentrations in the elderly. Thirty-eight elderly men and women (ages 60-82 yr) were assigned to endurance exercise training (N = 29) or to control (N = 9) groups. Resting plasma levels of adrenocorticotropic hormone, vasopressin, aldosterone, norepinephrine, epinephrine, sodium, potassium, and protein were measured at the start (T1) and end (T2) of 26 wk of training. PV measurement was performed using the Evan's blue dye technique. Endurance training consisted of uphill treadmill walking or stairclimbing exercise 3 times.wk-1, 30-45 min.d-1, at 75-84% of maximal heart rate reserve. The exercise group increased VO2max by 11.2% (P < or = 0.05) and increased resting PV and BV by 11.2% and 12.7% (P < or = 0.05), respectively. Hormone and electrolyte levels in the exercise group remained unchanged; all variables were unchanged in the control group. These results are similar to findings in younger individuals. Because plasma hormone concentrations were maintained despite a chronically elevated BV, endurance training in healthy, elderly subjects may be associated with a resetting of volume receptors.

Adrenocorticotropic Hormone↗

Advantages and disadvantages of fludrocortisone or saline load in preventing post-spaceflight orthostatic hypotension.

The purpose of this study was to compare the effectiveness of saline load to fludrocortisone (florinef) as countermeasures for reduced plasma volume and orthostatic intolerance after spaceflight. Eleven males (ages 30-50 yr) underwent a 3-day ambulatory baseline period followed by 7 days of 6 degrees head-down bedrest, during which cardiopulmonary and arterial baroreflex sensitivity and plasma volume (PV) were determined. During pre-bedrest and 2.5 h after treatment on day 8, PV was also measured and subjects underwent a 15-min unsupported stand test. Treatments consisted of 8 salt tablets (1 g NaCl per tablet) and 960 ml of water in 5 subjects and 0.6 mg (0.2 mg x 3) over 24 h in the other 6 subjects. PV decreased by 12% on day 7 of bedrest. This was restored on day 8 by florinef but not by saline load. The effect of florinef on PV was paralleled by decreases in urine volume and the urinary sodium/potassium ratio. Reduced PV was associated with greater vascular resistance for the same drop in central venous pressure, suggesting less vasoconstriction reserve after bedrest. Carotid baroreflex control of heart rate was attenuated after 7 days of bedrest. Both baroreflex functions were restored by florinef but not saline load. Only 1 of 6 subjects showed syncopal symptoms in the florinef-treated group, whereas 4 of 5 subjects did so in the saline-load group. Acute florinef treatment appears to have distinct advantages as a protective measure for post-bedrest orthostatic intolerance, not only through its salt retaining, volume-expanding mineralcorticoid effect, but possibly through its actions on baroreflex and sympathetic functions.

Administration, Oral↗

The sympathetic nervous system and the physiologic consequences of spaceflight: a hypothesis.

Many of the physiologic consequences of weightlessness and the cardiovascular abnormalities on return from space could be due, at least in part, to alterations in the regulation of the autonomic nervous system. In this article, the authors review the rationale and evidence for an autonomic mediation of diverse changes that occur with spaceflight, including the anemia and hypovolemia of weightlessness and the tachycardia and orthostatic intolerance on return from space. This hypothesis is supported by studies of two groups of persons known to have low catecholamine levels: persons subjected to prolonged bedrest and persons with syndromes characterized by low circulating catecholamines (Bradbury-Eggleston syndrome and dopamine beta-hydroxylase deficiency). Both groups exhibit the symptoms mentioned. The increasing evidence that autonomic mechanisms underlie many of the physiologic consequences of weightlessness suggests that new pharmacologic approaches (such as administration of beta-blockers and/or sympathomimetic amines) based on these findings may attenuate these unwanted effects.

Anemia↗

Autonomic functions and orthostatic responses 24 h after acute intense exercise in paraplegic subjects.

We tested the hypothesis that a bout of graded exercise designed to elicit maximal effort would increase the sensitivity of autonomically mediated baroreflexes and enhance blood pressure (BP) stability in subjects prone to postural hypotension. Therefore, we measured heart rate (HR), BP, forearm vascular resistance (FVR), and vasoactive hormone responses before and during 15 min of 70 degrees head-up tilt (HUT) in 10 paraplegic subjects (21-65 yr) on two occasions: 1) 24 h after maximal arm-crank exercise (postexercise) and 2) without exercise (control). During HUT, HR increased 30 beats/min in both postexercise and control, but the reduction in systolic BP (SBP) during control (-12.0 +/- 4.6 mmHg) was larger (P = 0.017) than that during HUT after exercise (-0.3 +/- 4.3 mmHg). The postexercise increase in FVR from supine to HUT of 17.0 +/- 2.4 to 24.8 +/- 3.2 peripheral resistance units (PRU) was greater (P = 0.042) than the increase observed during control (18.3 +/- 3.7 to 19.5 +/- 3.1 PRU). The gain of the carotid-cardiac baroreflex was also increased (P = 0.049) after exercise. Responses in norepinephrine, vasopressin, and plasma renin-angiotensin induced by HUT were similar for control and postexercise, and there was no difference in either leg compliance or plasma volume between the two conditions. Additionally, HR and SBP responses to phases II and IV of the Valsalva maneuver, indexes of integrated baroreflex sensitivity, were increased (P < 0.05) after maximal exercise compared with control. Thus acute intense exercise eliminated orthostatic hypotension in paraplegics, was associated with increased FVR and baroreflex sensitivity, and was independent of blood volume changes.

Adult↗

Effect of simulated microgravity on cardiopulmonary baroreflex control of forearm vascular resistance.

The stimulus-response characteristics of cardiopulmonary baroreflex control of forearm vascular resistance (FVR) were studied in 11 healthy men before and after 7 days of 6 degrees head-down bedrest to test the hypothesis that microgravity alters this reflex response. We assessed the relationship between stimulus [changes in central venous pressure (delta CVP)] and reflex response (delta FVR) during unloading of cardiopulmonary baroreceptors with lower body negative pressure (LBNP; 0 to -20 mmHg). delta CVP during bedrest and LBNP was estimated from peripheral vein pressures in the dependent right arm. Compared with prebedrest baseline, plasma volume and estimated CVP were decreased by 13 and 33%, respectively, at 7 days of bedrest. Progressive reflex forearm vasoconstriction occurred in response to graded reductions in estimated CVP during LBNP, and delta FVR per unit delta CVP was doubled after bedrest. The increase in sensitivity of the cardiopulmonary baroreflex control of FVR was related to reduced circulating blood volume, suggesting that enhanced peripheral vasoconstriction in individuals adapted to microgravity can be attributed, in part, to hypovolemia. In addition, microgravity appears to alter the stimulus for cardiopulmonary baroreceptors to a lower operational range of CVP, suggesting the possibility of chronic resetting.

Adult↗

Altered thermoregulatory responses after 15 days of head-down tilt.

To determine whether extended exposure to a simulation of microgravity alters thermoregulatory reflex control of skin blood flow, six adult males (mean age 40 +/- 2 yr) were exposed to 15 days of 6 degrees head-down tilt (HDT). On an ambulatory control day before HDT exposure and on HDT day 15, the core temperature of each subject was increased by 0.5-1.0 degree C by whole body heating with a water-perfused suit. Mean skin temperature, oral temperature (Tor), mean arterial pressure, and forearm blood flow were measured throughout the protocol. Forearm vascular conductance (FVC) was calculated from the ratio of forearm blood flow to mean arterial pressure. After HDT exposure, the Tor threshold at which reflex thermally induced increases in FVC began was elevated (36.87 +/- 0.06 to 37.00 +/- 0.09 degrees C; P = 0.043), whereas the slope of the Tor-FVC relationship after this threshold was reduced (13.7 +/- 2.3 to 9.5 +/- 1.1 FVC units/degrees C; P = 0.038). Moreover, normothermic FVC and FVC at the highest common Tor between pre- and post-HDT trials were reduced after HDT (normothermic: 4.2 +/- 0.5 to 3.0 +/- 0.4 ml.100 ml-1.min-1.100 mmHg-1, P = 0.04; hyperthermic: 12.4 +/- 1.0 to 7.8 +/- 0.7 ml.100 ml-1.min-1.100 mmHg-1, P < 0.001). These data suggest that HDT exposure reduces thermoregulatory responses to heat stress. The mechanisms resulting in such an impaired thermoregulatory response are unknown but are likely related to the relative dehydration that accompanies this exposure.

Adult↗

Aortic baroreflex control of heart rate after 15 days of simulated microgravity exposure.

To determine the effects of simulated microgravity on aortic baroreflex control of heart rate, we exposed seven male subjects (mean age 38 +/- 3 yr) to 15 days of bed rest in the 6 degrees head-down position. The sensitivity of the aortic-cardiac baroreflex was determined during a steady-state phenylephrine-induced increase in mean arterial pressure combined with lower body negative pressure to counteract central venous pressure increases and neck pressure to offset the increased carotid sinus transmural pressure. The aortic-cardiac baroreflex gain was assessed by determining the ratio of the change in heart rate to the change in mean arterial pressure between baseline conditions and aortic baroreceptor-isolated conditions (i.e., phenylephrine + lower body negative pressure + neck pressure stage). Fifteen days of head-down tilt increased the gain of the aortic-cardiac baroreflex (from 0.45 +/- 0.07 to 0.84 +/- 0.18 beats.min-1.mmHg-1; P = 0.03). Reductions in blood volume and/or maximal aerobic capacity may represent the underlying mechanism(s) responsible for increased aortic baroreflex responsiveness after exposure to a ground-based analogue of microgravity.

Adult↗

Altered baroreflex control of forearm vascular resistance during simulated microgravity.

Reflex peripheral vasoconstriction induced by activation of cardiopulmonary baroreceptors in response to reduced central venous pressure (CVP) is a basic mechanism for elevating systemic vascular resistance and defending arterial blood pressure during orthostatically-induced reductions in cardiac filling and output. The sensitivity of the cardiopulmonary baroreflex response [defined as the slope of the relationship between changes in forearm vascular resistance (FVR) and CVP] and the resultant vasoconstriction are closely and inversely associated with the amount of circulating blood volume. Thus, a high-gain FVR response will be elicited by a hypovolemic state. Exposure to microgravity during spaceflight results in reduced plasma volume. It is therefore reasonable to expect that the FVR response to cardiopulmonary baroreceptor unloading would be accentuated following adaptation to microgravity. Such data could provide better insight about the physiological mechanisms underlying alterations in blood pressure control following spaceflight. We therefore exposed eleven men to 6 degrees head-down bedrest for 7 days and measured specific hemodynamic responses to low levels of the lower body negative pressure to determine if there are alterations in cardiopulmonary baroreceptor stimulus-FVR reflex response relationship during prolonged exposure to an analog of microgravity.

Adult↗

Power spectral and time based analysis of heart rate variability following 15 days head-down bed rest.

Power spectral and time based analyses were applied to the cardiac inter-beat interval (RRI) of 8 healthy men before and after 15 d of bed rest in the 6 degrees head-down tilt position (HDT) to determine changes in indices of cardiac parasympathetic and sympathetic activity after this exposure. At 24 h prior to HDT and on HDT day 15, a minimum of 256 RRI's were obtained from an electrocardiogram (ECG) while the subjects were in the supine position. RRI was subjected to power spectral and two methods of time-based analyses. Power spectral analysis demonstrated that the index of cardiac vagal activity was reduced (95.2 +/- 28.5 to 48.2 +/- 17.4 ms2) without affecting the index of cardiac sympathetic activity (1.18 +/- 0.7 to 0.69 +/- 0.4). The two methods of time-based analyses, time series and standard deviation analyses, further demonstrated a reduction of cardiac vagal activity post-HDT (5.5 +/- 4 to 4.8 +/- 0.6 ms2; and 42.8 +/- 4.8 to 33.9 +/- 3.3 ms, respectively). These data suggest that exposure to 15 d of HDT reduces cardiac vagal activity, while changes in cardiac sympathetic activity were indistinguishable.

Adult↗

Predicting orthostatic intolerance: physics or physiology?

To adequately assess the viability of any particular causal theory of orthostatic intolerance, physical and physiological parameters thought to be associated with orthostasis must be evaluated simultaneously within the same individual. Time, cost, and complexity of instrumentation generally limit studies of orthostatic intolerance to a single independent effect for any given sample of subjects. We, therefore, measured 6 key physical and physiological variables associated with various theories of orthostatic intolerance in 14 males to test the hypothesis that physical factors rather than physiological reflex mechanisms were dominant in contributing to orthostatic tolerance. Measurements included height, plasma volume (expressed as percent of total weight), variation in R-R interval, leg compliance, and carotid-cardiac (high pressure), and cardiopulmonary (low pressure) baroreflex sensitivity. Subjects' orthostatic intolerance was quantified by time to syncope during progressive supine lower body decompression. Correlations, regression coefficients, and indices of replicability were calculated using 500 to 1,000 bootstrap resamplings of the original 14 observations. Although all six measurements correlated with time to syncope when evaluated individually, only height (negative), percent plasma volume weight (positive), and, to a lesser extent, carotid-cardiac baroreflex sensitivity yielded consistent (reproducible) results when all measures were tested simultaneously. These results suggest that while orthostatic intolerance may be dependent upon a variety of physiological reflexes, physical factors such as height and plasma volume tend to dominate the prediction of time to syncope during lower body negative pressure (LBNP). Physiological reflexes, which act to maintain adequate profusion to the brain during normal terrestrial posture in humans, may be overwhelmed by the additional orthostatic challenge imposed by progressive lower body decompression.

Adult↗

Hemodynamic and hormonal responses to lower body negative pressure in men with varying profiles of strength and aerobic power.

Hemodynamic, cardiac, and hormonal responses to lower-body negative pressure (LBNP) were examined in 24 healthy men to test the hypothesis that responsiveness of reflex control of blood pressure during orthostatic challenge is associated with interactions between strength and aerobic power. Subjects underwent treadmill tests to determine peak oxygen uptake (VO2max) and isokinetic dynamometer tests to determine knee extensor strength. Based on predetermined criteria, subjects were classified into one of four fitness profiles of six subjects each, matched for age, height, and body mass: (a) low strength/average aerobic fitness, (b) low strength/high aerobic fitness, (c) high strength/average aerobic fitness, and (d) high strength/high aerobic fitness. Following 90 min of 0.11 rad (6 degrees) head-down tilt (HDT), each subject underwent graded LBNP to -6.7 kPa or presyncope, with maximal duration 15 min, while hemodynamic, cardiac, and hormonal responses were measured. All groups exhibited typical hemodynamic, hormonal, and fluid shift responses during LBNP, with no intergroup differences between high and low strength characteristics. Subjects with high aerobic power exhibited greater (P < 0.05) stroke volume and lower (P < 0.05) heart rate, vascular peripheral resistance, and mean arterial pressure during rest, HDT, and LBNP. Seven subjects, distributed among the four fitness profiles, became presyncopal. These subjects showed greatest reduction in mean arterial pressure during LBNP, had greater elevations in vasopressin, and lesser increases in heart rate and peripheral resistance. Neither VO2max nor leg strength were associated with fall in arterial pressure or with syncopal episodes. We conclude that interactions between aerobic and strength fitness characteristics do not influence responses to LBNP challenge.

Adult↗

Renal and cardiovascular responses to water immersion in trained runners and swimmers.

The purpose of this study was to determine if fluid-electrolyte, renal, hormonal, and cardiovascular responses during and after multi-hour water immersion were associated with aerobic training. Additionally, we compared these responses in those who trained in a hypogravic versus a 1-g environment. Seventeen men comprised three similarly aged groups: six long-distance runners, five competitive swimmers, and six untrained control subjects. Each subject underwent 5 h of immersion in water [mean (SE)] 36.0 (0.5) degrees C to the neck. Immediately before and at each hour of immersion, blood and urine samples were collected and analyzed for sodium (Na), potassium, osmolality, and creatinine (Cr). Plasma antidiuretic hormone and aldosterone were also measured. Hematocrits were used to calculate relative changes in plasma volume (% delta Vpl). Heart rate response to submaximal cycle ergometer exercise (35% peak oxygen uptake) was measured before and after water immersion. Water immersion induced significant increases in urine flow, Na clearance (CNa), and a 3-5% decrease in Vpl. Urine flow during immersion was greater (P < 0.05) in runners [2.4 (0.4) ml.min-1] compared to controls [1.3 (0.1) ml.min-1]. However, % delta Vpl, CCr, CNa and CH2O during immersion were not different (P > 0.05) between runners, swimmers, and controls. After 5 h of immersion, there was an increase (P < 0.05) in submaximal exercise heart rate of 9 (3) and 10 (3) beats.min-1 in both runners and controls, respectively, but no change (P > 0.05) was observed in swimmers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Changes in plasma volume and baroreflex function following resistance exercise.

The dynamics of change in plasma volume (PV) and baroreflex responses have been reported over 24 h immediately following maximal cycle exercise. The purpose of this study was to determine if PV and baroreflex showed similar changes for 24 h after resistance exercise. Eight men were studied on 2 test days, 1 week apart. On 1 day, per cent change (% delta) in PV was estimated at 0,3, and 6 h after resistance exercise using haematocrit and haemoglobin. Baseline PV was measured 24 h after exercise using Evans blue dye. The carotid baroreceptor-cardiac reflex response was measured before, and 3, 6, 9, 12, and 24 h post-exercise. Each subject performed six sets of the bench press and leg press with 10 repetitions per set with a load that induced failure within each set. On a control day, the protocol was used without exercise. Plasma volume did not change during the control day. There was a 20% decrease in PV immediately post-exercise; the recovery of the PV was rapid and complete within 3 h. PV was 20% greater 24 h post-exercise than on the control day. There were no differences in any of the baroreflex measurements. Therefore, it is suggested that PV shifts may occur without altering baroreflex sensitivity.

Adult↗

Gender differences in endocrine responses to posture and 7 days of -6 degrees head-down bed rest.

Endocrine regulation of fluids and electrolytes during 7 days of -6 degrees head-down bed rest (HDBR) was compared in male (n = 8) and, for the first time, female (n = 8) volunteers. The subjects' responses to quiet standing for 2 h before and after HDBR were also tested. In both sexes, diuresis and natriuresis were evident during the first 2-3 days of HDBR, resulting in a marked increase in the urinary Na(+)-to-K+ ratio and significant Na+ retention on re-ambulation. After the 1st day of HDBR, plasma renin activity (PRA) was increased relative to aldosterone (Aldo), plasma volume was decreased, and the renal response to Aldo appeared to be appropriate. Circulating levels of arginine vasopressin, cortisol, and ACTH were unchanged during HDBR. Plasma testosterone decreased slightly on day 2 of HDBR in males. The ratio of early morning ACTH to cortisol was lower in females than in males because ACTH was lower in females. Urinary cortisol increased and remained elevated throughout the HDBR in males only. There were no gender differences in the responses to 7 days of HDBR, except those in the pituitary-adrenal system; those differences appeared unrelated to the postural change. The provocative cardiovascular test of quiet standing before and after HDBR revealed both sex differences and effects of HDBR. There were significant sex differences in cardiovascular responses to standing before and after HDBR. Females had greater PRA and Aldo responses to standing before HDBR and larger Aldo responses to standing after HDBR than males.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Endurance exercise training: conditions of enhanced hemodynamic responses and tolerance to LBNP.

In cross-sectional comparisons, several investigators have reported highly trained endurance athletes to have a prevalence toward orthostatic hypotension and intolerance compared with average fit individuals. These observations have raised concern that regular exercise designed to increase aerobic capacity may impair regulatory mechanisms of blood pressure control and that perhaps certain populations of individuals with a predisposition for fainting exhibit an inability to elevate heart rate, vasoactive hormones, and peripheral resistance during an orthostatic challenge. In longitudinal experiments, when exercise training was performed by subjects who increased their aerobic capacity by 20% but maintained VO2max below 50 ml.kg-1.min-1, tolerance to lower body negative pressure (LBNP) was increased by 28%. Exercise training did not compromise baroreflex functions despite evidence of increased resting vagal cardiac tone and reduced sympathetic tone. In contrast to fainters, increased orthostatic tolerance in the exercised-trained subjects was associated with no alteration in their ability to elevate heart rate, vasoactive hormones, and peripheral resistance at peak LBNP. However, cardiac output and mean arterial blood pressure were maintained during higher submaximal LBNP levels by a 20% increase in stroke volume. The elevation in stroke volume during LBNP after training was associated with blood volume expansion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗

Effect of exercise training on cardiopulmonary baroreflex control of forearm vascular resistance in humans.

We studied the stimulus-response characteristics of cardiopulmonary baroreflex control of forearm vascular resistance (FVR) in four groups of male volunteer subjects: i) unfit, ii) physically fit, iii) before and after 10 wk of endurance training (chronic blood volume expansion), and iv) before and after acute blood volume expansion. We assessed the relationship between reflex stimulus, i.e., changes in central venous pressure and response, i.e., FVR, during unloading of cardiopulmonary mechanoreceptors with lower body negative pressure (LBNP, 0 to -20 mm Hg). The slope of the linear relationship between FVR and CVP, the index of the responsiveness of this baroreflex, was significantly diminished (> 50%) in the fit subjects compared with the unfit. The slope of the FVR-CVP relationship was inversely correlated with the subject's total blood volume, suggesting that blood volume expansion was related to the attenuated CP baroreflex. In the exercise training study, maximal oxygen consumption and blood volume increased following 10 wk of endurance training (N = 14) but were unchanged in the time control group (N = 7). The slope of the FVR-CVP relationship was significantly reduced (32%) following 10 wk of training but was unchanged in the time control group. The reduction in slope of the FVR-CVP relationship was inversely related to the increase in blood volume associated with exercise training. Acute blood volume expansion 8 ml.kg-1 body weight with 5% human serum albumin solution) significantly reduced the slope of the FVR-CVP relationship. These data support the hypothesis that the attenuated forearm vascular reflex in physically fit individuals is related to a training-induced hypervolemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗