Guinet Patrick, MacNamara James Patrick, Berry Matthieu, Larcher Françoise, Bareille Marie-Pierre, Custaud Marc-Antoine, Pavy-Le Traon Anne, Levine Benjamin D, Navasiolava Nastassia
Département d'Anesthésie Réanimation, Centre Hospitalier Universitaire de Rennes, Rennes, France.
Centre Hospitalier de Fougères, Fougères, France.
Front Physiol. 2020 Jul 16;11:812. doi: 10.3389/fphys.2020.00812. eCollection 2020.
Current inflight countermeasures do not completely prevent bone and cardiovascular changes induced by microgravity. High load Resistance Exercise combined with whole body Vibration (RVE) demonstrated benefits on bone and cardiovascular system during previous Head-Down Bed Rest (HDBR) studies. We examined the effectiveness of RVE alone or combined with a nutritional supplementation of Whey protein (NeX) on cardiovascular deconditioning. Eight male subjects (age 34 ± 8 years) in a crossover design completed three 21-day HDBR campaigns (Control-CON, RVE, and NeX). Pre and post HDBR Orthostatic Tolerance (OT) was evaluated by a 15-min head-up tilt test followed by increasing levels of Lower Body Negative Pressure (LBNP). Heart rate (HR), blood pressure (BP), and Sympathetic Index (ΣI) through spectral analysis were measured during OT test. Plasma Volume (PV), and Maximal Oxygen Uptake (VOmax) were measured before and after each campaign. Left ventricular mass, left ventricular end diastolic (LVEDV), end systolic (LVESV), stroke (SV) volumes, and circumferential deformation at rest and during an orthostatic stress simulated by a 30 mmHg LBNP were measured by cardiac MRI. RVE failed to prevent any change in these variables and NeX did not have any additional effect over exercise alone. In the 3 groups, (1) OT time dropped similarly (bed rest < 0.001), (2) HR and ΣI were increased at rest at the end of HDBR and HR increased markedly during LBNP-tilt test, with inability to increase further the ΣI, (3) PV dropped (bed rest < 0.001), along with LVEDV, LVESV and SV ( = 0.08, < 0.001, and = 0.045, respectively), (4) Left ventricle mass did not change significantly, (5) Deformation of the heart assessed by global circumferential strain was preserved and early diastolic circumferential strain rate was increased during orthostatic stress at the end of HDBR, illustrating preserved systolic and diastolic function respectively, without any difference between groups. Despite the drop in PV and LV volumes, RVE and NeX tended to alleviate the decrease in VOmax. In conclusion, RVE and NeX failed to prevent the cardiovascular deconditioning induced by a 21 day-HDBR.
目前的飞行中应对措施并不能完全预防微重力引起的骨骼和心血管变化。在之前的头低位卧床休息(HDBR)研究中,高负荷抗阻运动结合全身振动(RVE)已证明对骨骼和心血管系统有益。我们研究了单独的RVE或与乳清蛋白营养补充剂(NeX)联合使用对心血管失健的有效性。八名男性受试者(年龄34±8岁)采用交叉设计完成了三次为期21天的HDBR活动(对照组-CON、RVE和NeX)。通过15分钟的头高位倾斜试验,随后增加下体负压(LBNP)水平,评估HDBR前后的直立耐力(OT)。在OT试验期间,通过频谱分析测量心率(HR)、血压(BP)和交感神经指数(ΣI)。在每次活动前后测量血浆容量(PV)和最大摄氧量(VOmax)。通过心脏磁共振成像测量静息状态下以及由30 mmHg LBNP模拟的直立应激期间的左心室质量、左心室舒张末期(LVEDV)、收缩末期(LVESV)、搏出量(SV)以及圆周变形。RVE未能预防这些变量的任何变化,并且NeX相对于单独运动没有任何额外效果。在这三组中,(1)OT时间同样下降(卧床休息P<0.001),(2)HDBR结束时静息状态下HR和ΣI增加,并且在LBNP倾斜试验期间HR显著增加,而ΣI无法进一步增加,(3)PV下降(卧床休息P<0.001),同时LVEDV、LVESV和SV也下降(分别为P = 0.08、P<0.001和P = 0.045),(4)左心室质量没有显著变化,(5)通过整体圆周应变评估的心脏变形得以保留,并且在HDBR结束时的直立应激期间舒张早期圆周应变率增加,分别说明了收缩和舒张功能得以保留,各组之间无差异。尽管PV和左心室容积下降,但RVE和NeX倾向于减轻VOmax的降低。总之,RVE和NeX未能预防21天HDBR引起的心血管失健。