Postural hemodynamic parameters in older persons have a seasonal dependency

Trozić, Irhad; Platzer, Dieter; Fazekas, Franz; Bondarenko, Alexander I.; Brix, Bianca; Rössler, Andreas; Goswami, Nandu

doi:10.1007/s00391-019-01525-3

Cited by 16 publications

(18 citation statements)

References 42 publications

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“…Therefore, we recommend in future studies the measurement of baseline galanin levels – in combination with other clinical tools (e.g., questionnaire, tilt-test or Schellong-test) – to confirm galanin’s ability to predict development of presyncope in subjects. Furthermore, as falls occur during changes in posture, especially in older persons (Goswami et al, 2018, 2019; Trozic et al, 2019), our data could have clinical relevance. Galanin and adrenomedullin could act as biomarkers for predicting which older persons can potentially develop orthostatic intolerance.…”

Section: Conclusion and Further Directionsmentioning

confidence: 81%

Galanin and Adrenomedullin Plasma Responses During Artificial Gravity on a Human Short-Arm Centrifuge

et al. 2019

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Galanin and adrenomedullin plasma responses to head-up tilt and lower body negative pressure have been studied previously. However, to what extent short-arm human centrifugation (SAHC) affects these responses is not known. In this study, we assessed how the application of variable gradients of accelerations (ΔGz) via shifting of the rotation axis during centrifugation affects selected hormonal responses. Specifically, we tested the hypothesis, that cardiovascular modulating hormones such as galanin and adrenomedullin will be higher in non-finishers (participants in whom at least one of the pre-defined criteria for presyncope was fulfilled) when compared to finishers (participants who completed the entire protocol in both sessions) during SAHC exposure. Twenty healthy subjects (10 women and 10 men) were exposed to two g-levels [1 Gz and 2.4 Gz at the feet (Gz_Feet)] in two positions (axis of rotation placed above the head and axis of rotation placed at the heart level). Elevated baseline levels of galanin appeared to predict orthostatic tolerance (p = 0.054) and seemed to support good orthostatic tolerance during 1 Gz_Feet SAHC (p = 0.034). In finishers, 2.4 Gz_Feet SAHC was associated with increased galanin levels after centrifugation (p = 0.007). For adrenomedullin, the hypothesized increases were observed after centrifugation at 1 Gz_Feet (p = 0.031), but not at 2.4 Gz_Feet, suggesting that other central mechanisms than local distribution of adrenomedullin predominate when coping with central hypovolemia induced by SAHC (p > 0.14). In conclusion, baseline galanin levels could potentially be used to predict development of presyncope in subjects. Furthermore, galanin levels increase during elevated levels of central hypovolemia and galanin responses appear to be important for coping with such challenges. Adrenomedullin release depends on degree of central hypovolemia induced fluid shifts and a subject’s ability to cope with such challenges. Our results suggest that the gradient of acceleration (ΔGz) is an innovative approach to quantify the grade of central hypovolemia and to assess neurohormonal responses in those that can tolerate (finishers) or not tolerate (non-finishers) artificial gravity (AG). As AG is being considered as a preventing tool for spaceflight induced deconditioning in future missions, understanding effects of AG on hormonal responses in subjects who develop presyncope is important.

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Section: Conclusion and Further Directionsmentioning

confidence: 81%

Galanin and Adrenomedullin Plasma Responses During Artificial Gravity on a Human Short-Arm Centrifuge

et al. 2019

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“…Future studies should examine how cardio-postural interactions are influenced by varying periods of bedrest confinement in older patients. This is important as falls and fall related injuries commonly occur upon change of posture (from supine to standing or from sitting to standing position) 5,53,54 . In addition, only male participants were included in this study while women are even more prone to OI in the age ranges found in this study 6,[55][56][57][58][59] .…”

Section: Limitations and Future Workmentioning

confidence: 99%

Cardio-postural interactions and muscle-pump baroreflex are severely impacted by 60-day bedrest immobilization

Tremblay

Verma

et al. 2020

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To understand fundamental mechanisms associated with post-flight orthostatic intolerance we investigated the interaction between the cardiovascular and postural functions before and after 60 days of head down bedrest (HDBR). Twenty healthy young males (35.0 ± 1.7 years) were subjected to 60-day HDBR at 6˚ to simulate spaceflight-induced fluid shifts. A supine-to-stand (STS) test was conducted to evaluate cardio-postural control before and after (R) HDBR while an assessment of cardiovascular function was performed during HDBR. Beat-to-beat heart period, systolic blood pressure, and electromyography impulses were derived for wavelet transform coherence and causality analyses of the cardio-postural control and used to assess changes in the muscle-pump baroreflex. During quiet stand of the STS test, compared to baseline, heart rate was 50% higher on the day of exit from bedrest (R0) and 20% higher eight days later (R8). There was a 50% increase in deoxygenated hemoglobin on R0 and R8. Leg muscle activity reduced, and postural sway increased after HDBR. Causality of the muscle-pump baroreflex was reduced on R0 (0.73 ± 0.2) compared to baseline (0.87 ± 0.2) with complete recovery by R8. The muscle-pump baroreflex also had decreased gain and fraction time active following HDBR. Overall, our data show a significantly impaired muscle-pump baroreflex following bedrest. Spaceflight-induced weightlessness produces time-dependent physiological adaptation responses 1-3. Once adapted to weightlessness, many responses become inappropriate upon return to a gravitational environment. The resulting physiological deconditioning could pose a serious challenge in the event of a critical post-landing situation requiring rapid escape from a spacecraft. Orthostatic intolerance after spaceflight remains a health and safety concern for astronauts, not just on landing day but also in the days of recovery 4. Similar physiological deconditioning is seen following long lasting bedrest confinements (e.g. in young persons participating in head down bedrest studies, or in older persons due to chronic diseases or after falls and falls-related injuries) 5. Gravitational effects on the cardiovascular system during upright posture (orthostatic loading) induce a decrease in blood pressure which, if not compensated for, will cause loss of consciousness 6. Baroreflex plays an essential role in maintaining blood pressure equilibrium under orthostatic loading. In regards to the arterial baroreflex, two processes exist in tandem: one in which blood pressure alters baroreceptor output and hence heart rate and vasomotor tone 7-9 ; and, a second in which changes in heart rate and vasomotor tone alters blood pressure-the former a baroreflex (feed-back) and the latter a non-baroreflex (feed-forward) control of blood pressure 10. Similarly, conscious movement could place a person in a position of instability, which would require post-movement adjustment to maintain an upright stance. Therefore, any change in body position (feed-forward) must be accompanied with ...

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“…Clean data were then exported from the TFM device as .txt files into an excel sheet and transferred into the Origin software (OriginLab Corp., Northampton, USA) for further analysis via customized functions. Specific time points (10-s time epochs) were used to characterize each different phase of the rest and exercise relevant for the statistical analysis: baseline (epoch 1 = 290–300 s); stepping warm-up (epoch 2 = 290–300 s); exercise 1 (epoch 3 = last 10 s); rest (epoch 4 = 60–70 s); exercise 2 (epoch 5 = last 10 s) as described in the literature 28 , 29 ; while the post-exercise recovery data were analyzed as the mean value of each successive 30 s time-epoch during the entire 5 min of recovery, as recently proposed by Peçanha et al 8 . Regarding the HR recovery indicators, these data were calculated from the absolute difference between the peak HR (mean HR, averaged over last 10 beats during exercise) and the HR values measured at 30, 60, and 300 s of recovery 8 .…”

Section: Methodsmentioning

confidence: 99%

Independent influence of age on heart rate recovery after flywheel exercise in trained men and women

Zubac

Goswami

Ivančev

et al. 2021

Sci Rep

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The present study examined whether differences in the heart rate recovery following flywheel exercise cessation were associated with differences in maximal oxygen uptake ($${\dot{\text{V}}}$$ V ˙ O2 max.), age and sex in trained adults. Eleven men (age range 22–49 years, $${\dot{\text{V}}}$$ V ˙ O2 max. = 43.6 ± 7.6 mL kg min−1) and ten women (age range 20—53 years, $${\dot{\text{V}}}$$ V ˙ O2 max. = 38.0 ± 5.7 mL kg min−1) were randomly assigned to complete a squat-exercise on the flywheel ergometer set at three different moments of inertia, while their cardiovascular responses were continuously monitored. During the flywheel exercise the mean arterial pressure rose by ~ 35 to 40% (p = .001), and the increment was more robust in men than women. The cardiac index was two-fold greater across both sexes compared to the baseline (p = .001), while the rise in heart rate (~ 144 bpm) was more pronounced in women to compensate for their load-dependent stroke index decline (p = .001). The load-independent time-course changes in heart rate recovery markers were comparable between the sexes. When these indicators were pooled, a stepwise regression revealed age as the only relevant predictor of both fast and slow components of the heart rate recovery (~ 30% of the shared variance explained, p = .014). The present data suggest that the heart rate recovery declines with age, irrespective of sex, or well-preserved cardiorespiratory fitness in moderately-trained adults.

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Postural hemodynamic parameters in older persons have a seasonal dependency

Abstract: Postural hemodynamic parameters in older persons have a seasonal dependency A pilot study 146 Zeitschrift für Gerontologie und Geriatrie 2 • 2020

Cited by 16 publications

References 42 publications

Galanin and Adrenomedullin Plasma Responses During Artificial Gravity on a Human Short-Arm Centrifuge

Galanin and Adrenomedullin Plasma Responses During Artificial Gravity on a Human Short-Arm Centrifuge

Cardio-postural interactions and muscle-pump baroreflex are severely impacted by 60-day bedrest immobilization

Independent influence of age on heart rate recovery after flywheel exercise in trained men and women

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