Hussain Iqbal, Ullah Rehmat, Simran Bharti F N U, Kaur Parvinder, Kumar Mahendra, Raj Rohan, Faraz Maria, Mehmoodi Amin, Malik Jahanzeb
Department of Cardiovascular Medicine Cardiovascular Analytics Group Islamabad Pakistan.
Department of Medicine Ibn e Seena Hospital Kabul Afghanistan.
Health Sci Rep. 2024 Aug 12;7(8):e2305. doi: 10.1002/hsr2.2305. eCollection 2024 Aug.
Early studies exploring the physiological effects of space travel have indicated the body's capacity for reversible adaptation. However, the impact of long-duration spaceflight, exceeding 6 months, presents more intricate challenges.
Extended exposure to microgravity and radiation profoundly affects the CV system. Notable phenomena include fluid shifts toward the head and modified arterial pressure. These changes disrupt blood pressure regulation and elevate cardiac output. Additionally, the loss of venous compression leads to a reduction in central venous pressure.
The displacement of fluid from the vascular system to the interstitium, driven by baroreceptor stimulation, results in a 10%-15% decline in plasma volume.
Intriguingly, despite potential increases in cardiac workload, cardiac muscle atrophy and perplexing variations in hematocrit levels have been observed. The mechanism underlying atrophy appears to involve a shift in protein synthesis from the endoplasmic reticulum to the mitochondria via mortalin-mediated mechanisms.
Instances of arrhythmias have been recurrently documented, although generally nonlethal, in both Russian and American space missions. Long-duration spaceflight has been associated with the prolongation of the QT interval, particularly in extended missions.
Exposure of the heart to the proton and heavy ion radiation pervasive in deep space contributes to coronary artery degeneration, augmented aortic stiffness, and carotid intima thickening through collagen-mediated processes. Moreover, it accelerates the onset of atherosclerosis and triggers proinflammatory responses.
Upon reentry, astronauts frequently experience orthostatic intolerance and altered sympathetic responses, which bear potential hazards in scenarios requiring rapid mobilization or evacuation.
Consequently, careful monitoring of these cardiac risks is imperative for forthcoming missions. While early studies illuminate the adaptability of the body to space travel's challenges, the intricacies of long-duration missions and their effects on the CV system necessitate continued investigation and vigilance to ensure astronaut health and mission success.
早期探索太空旅行生理影响的研究表明,身体具有可逆适应能力。然而,超过6个月的长期太空飞行所带来的影响则呈现出更为复杂的挑战。
长时间暴露于微重力和辐射环境中会对心血管系统产生深远影响。显著现象包括体液向头部转移以及动脉血压改变。这些变化会扰乱血压调节并提高心输出量。此外,静脉压迫的丧失会导致中心静脉压降低。
在压力感受器刺激的驱动下,体液从血管系统向间质转移,导致血浆容量下降10% - 15%。
有趣的是,尽管心脏工作负荷可能增加,但仍观察到心肌萎缩和血细胞比容水平出现令人困惑的变化。萎缩的潜在机制似乎涉及通过mortalin介导的机制使蛋白质合成从内质网转移到线粒体。
心律失常和QT间期延长:在俄罗斯和美国的太空任务中,心律失常的情况屡有记录,尽管通常不致命。长期太空飞行与QT间期延长有关,特别是在长时间任务中。
心脏暴露于深空普遍存在的质子和重离子辐射下,会通过胶原蛋白介导的过程导致冠状动脉退化、主动脉僵硬度增加和颈动脉内膜增厚。此外,它还会加速动脉粥样硬化的发生并引发促炎反应。
重返大气层时,宇航员经常会出现体位性不耐受和交感神经反应改变,这在需要快速行动或撤离的情况下存在潜在危险。
因此,对于即将开展的任务而言,仔细监测这些心脏风险至关重要。虽然早期研究阐明了身体对太空旅行挑战的适应能力,但长期任务的复杂性及其对心血管系统的影响需要持续的研究和警惕,以确保宇航员的健康和任务的成功。