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Liexin Liu, Frank Beckers, Bart Verheyden, Kurt Couckuyt , André Aubert

中国宇航员 太空飞行后心脏自主功能分析 Autonomic control after spaceflight 2005. Liexin Liu, Frank Beckers, Bart Verheyden, Kurt Couckuyt , André Aubert. Laboratory of Experimental Cardiology Univ. Hospital Gasthuisberg, & Interdisciplinary Center for Space Studies (ICSS), K.U.Leuven, Leuven, Belgium.

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Liexin Liu, Frank Beckers, Bart Verheyden, Kurt Couckuyt , André Aubert

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  1. 中国宇航员 太空飞行后心脏自主功能分析 Autonomic control after spaceflight 2005 Liexin Liu,Frank Beckers, Bart Verheyden, Kurt Couckuyt , André Aubert Laboratory of Experimental Cardiology Univ. Hospital Gasthuisberg, & Interdisciplinary Center for Space Studies (ICSS), K.U.Leuven, Leuven, Belgium

  2. Wan Hu (16th cent Ming Dynasty) He had a chair built with forty-seven rockets attached. On the day of lift-off, Wan, splendidly attired, climbed into his rocket chair and forty seven servants lit the fuses and then hastily ran for cover. There was a huge explosion. When the smoke cleared, Wan and the chair were gone. He was never seen again.

  3. 背景情况 Background

  4. Cardiovascular Adaptation & Deconditioning

  5. Cardiovascular system resting • No effort for moving • No liquid transfer • No flow redistribution • No stimulation of 1G reflexes When returning to 1G redistribution of flow towards brain less efficient  risk for syncope

  6. Experiment science objectives • Autonomic cardiovascular control before, during and after space flight • ECG and BP measurements • Respiration • Induce changes: head flexion • Orthostatic intolerance • Stand test

  7. Brains sympathetic Parasympathetic (vagal) + - Heart rate cardiac output Blood pressure Model of cardiovascular regulation Simplified scheme

  8. Neurocardiovasclar Regulation of Blood Pressure

  9. Model of cardiovascular variability BRAIN STEM symppara Baroreflex Sensitivity - + BAROREFLEX -  ()  n. vagus + (-) + - + VASOMOTOR TONE HEART RATE SV arterial baroreceptors TPR CO BLOOD PRESSURE Heart Rate Variability Blood Pressure Variability

  10. HRV, BPV are influenced by: • Baroreceptor • Chemoreceptor • Atrial stretch receptors • Position (supine, standing) • Interventions: • Respiration • Valsalve • Carotis massage • Stress (Gravity…) • …

  11. HRV and BPV indices can be used to quantify autonomic cardiovascular modulation

  12. 从心电、血压 到心率变异、血压变异 及压力反射敏感性 From HR & BP to HRV, BPV & BRS

  13. 研究方法 Method

  14. Experiment Hardware Ground BDC’s / postflight

  15. Parameters • ECG (electrocardiogram) • BP (continuous blood pressure) • Respiration with pressure sensor

  16. Heart Rate Variability & Blood Pressure Variability ( ms ) 816 848 784 832 864 800 704 976 880 768 800 944 ( mmHg ) 120 117 115 120 122 119 119 120 115 109 113 115 112 Time

  17. BP(mmHg) RR RR RR RR Time BRS BPV HRV HRV & BPV ECG

  18. 分析方法 Analysis

  19. 频域分析Frequency Analysis

  20. Tachogram & Systogram FFT • HRV: • Low Frequencypower (LF) [0.04-0.15 Hz] ~ sympathetic modulation + BRS+ Vagal modulation • High Frequency power (HF) [0.16-0.4 Hz] ~ vagal modulation • Total power[0.0078-0.5 Hz] ~ global autonomicmodulation • BPV: • Low Frequencypower (LF) [0.04-0.15 Hz] ~ sympathetic modulation • High Frequency power (HF) [0.16-0.4 Hz] ~ mechanical effect of respiration

  21. RR BP Algorithms to evaluate cardiovascular autonomic function- Baroreflex sensitivity (BRS) • Calculation of the slope between dynamic HR responses to systolic BP changes: index of dynamic baroreflex sensitivity (BRS) • Sequence method: at least 3 sequences • Other methods: alpha method, statistical dependency, cross correlation…

  22. Heart Rate (ESA)

  23. Results HRV standing Sympathetic modulation Vagal modulation Beckers et al. J Gravit Phys, 2003

  24. Baroreflex sensitivity

  25. 中国航天员研究 Chinese Astronauts Study 2005

  26. Putting on Equipment FLEXION FREQ_1 FREQ_2 BASELINE supine 10 min 1 min 5 min 5 min sitting Check cables, check signals FREQ_2 FREQ_1 BASELINE standing 5 min 5 min 10 min Putting off Equipment China experimental protocol Recording 1 Freq1 : 5 seconds breathing in – 5 seconds breathing out Freq2 : 3 seconds breathing in – 3 seconds breathing out Recording 2

  27. 结果 Result

  28. 心率变异 HRV

  29. HR Supine: heart rate decreases, stabilized at R+7 Standing: heart rate remains similar -23% -12%

  30. LF Supine: increase post-flight with stabilization at R+7 +312% -6%

  31. LF% Supine: small decrease, but most likely not significant -13% -27%

  32. HF Supine: increase postflight with stabilization at R+7 +218% +145%

  33. HF% HF% shows contrasting evolution between astronauts -33% +90%

  34. LF/HF Stable post-flight (high percentages due to low values) +30% -62%

  35. 血压变异 BPV

  36. BP After space flight, in both astronauts SBP had no obvious alteration at supine position, as well as at stand position. -1% +27%

  37. LF Supine: increase immediately post-flight, but rather fast normalization +104% +340%

  38. 压力反射敏感性 BRS

  39. BRS Rather stable evolution post-flight +44% -12%

  40. Results： • In the Chinese group there was no difference in pre- and post-flight HRV parameters • Similar differences after 10 day flights of ESA and Russian cosmonauts were between 13% and 54%. • No evolution until R+9. • Similar behavior was observed for BPV parameters.

  41. 结论 Conclusion

  42. Conclusion： • No significant differences were found between pre and post flight in the Chinese group in contrast to the ESA/Russian group • No evolution post-flight until R+9 in the Chinese group • This different behavior could be due to specific training methods and/or nutrition methods?

  43. 初步结果： • 在短期航天飞行后，中国宇航员的心血管自主神经功能变化情况与俄罗斯宇航员、欧洲宇航员存在着明显的差异。 • 中国宇航员经过5天的短期太空飞行返回地面后，心率、血压稳定；迷走神经张力有一过性升高。

  44. 可能因素： • 太空飞行时间短。目前欧洲、美国的短期载人航天飞行一般都在10天左右。以前的研究结果大多数都是建立在这个时间基础上的。 • 训练水平高。也许因为中国航天员的训练方法更加有效。 • 药物因素。太空飞行结束后，服用中药可能对航天员的心血管功能恢复有帮助。 • 基因差异。

  45. 相关问题： • 返回10天之后，是否还继续监测心电图和血压情况？情况怎样？ • 杨利伟的飞行时间更短，是否可以做一参照，对其血压、心率及心脏自主神经功能进行回顾性的研究？ • 两名航天员的飞行前后体重情况？ • 应对另外4个航天员的基础检测数据进行参照分析，已得到基础情况，以便进行统计学分析。

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