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Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight.
J Appl Physiol (1985) 2019; 127(4):1050-1057JA

Abstract

We tested the hypothesis that acute changes in arterial blood pressure (BP) when astronauts moved between supine and standing posture before and after spaceflight can be tracked by beat-to-beat changes in pulse arrival time (PAT). Nine male crewmembers (45 ± 7 yr of age; mean mission length: 165 ± 13 days) participated in a standardized supine-to-sit-to-stand test (5 min-30 s-3 min) before flight and 1 day following return to Earth with continuous monitoring of ECG and finger arterial BP. PAT was determined from the R-wave of the ECG to the foot of the BP waveform. On average, modest cardiovascular deconditioning was detected by ~10 beats/min increase in heart rate in supine and standing posture after spaceflight (P < 0.05). When looking across the full data collection period, the r2 values between inverse of PAT (1/PAT) and systolic (SBP) and diastolic BP (DBP) varied considerably between individuals (SBP preflight 0.142 ± 0.186, postflight 0.262 ± 0.243). Individual variability was consistent during periods of transition (SBP preflight 0.284 ± 0.324, postflight 0.297 ± 0.269); however, when SBP dropped >20 mmHg, r2 was significant in 5 of 5 preflight tests and 5 of 7 postflight tests. The standard error of the estimate based on a simple linear model during both pre- and postflight testing was 9-11 mmHg for SBP and 6-7 mmHg for DBP. Overall, the results support the hypothesis that PAT tracked dynamic changes in BP. PAT as a noninvasive, nonintrusive surrogate for changes in BP could be developed as an indicator of risk for syncope on return from spaceflight or other Earth-based applications.NEW & NOTEWORTHY Astronauts returning to Earth's gravity are at increased risk of low blood pressure on standing. Arterial pulse arrival time tracked the decrease in arterial blood pressure on moving from supine to upright posture. Nonintrusive technology providing indicators sensitive to acute changes in blood pressure could act as an early warning system to identify risk for hypotension that place astronauts, or people on Earth, at risk of impaired cognitive performance, fainting, and falls.

Authors+Show Affiliations

Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada.Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada.Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31414954

Citation

Wood, Katelyn N., et al. "Interrelationships Between Pulse Arrival Time and Arterial Blood Pressure During Postural Transitions Before and After Spaceflight." Journal of Applied Physiology (Bethesda, Md. : 1985), vol. 127, no. 4, 2019, pp. 1050-1057.
Wood KN, Greaves DK, Hughson RL. Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight. J Appl Physiol. 2019;127(4):1050-1057.
Wood, K. N., Greaves, D. K., & Hughson, R. L. (2019). Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight. Journal of Applied Physiology (Bethesda, Md. : 1985), 127(4), pp. 1050-1057. doi:10.1152/japplphysiol.00317.2019.
Wood KN, Greaves DK, Hughson RL. Interrelationships Between Pulse Arrival Time and Arterial Blood Pressure During Postural Transitions Before and After Spaceflight. J Appl Physiol. 2019 Oct 1;127(4):1050-1057. PubMed PMID: 31414954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight. AU - Wood,Katelyn N, AU - Greaves,Danielle K, AU - Hughson,Richard L, Y1 - 2019/08/15/ PY - 2020/10/01/pmc-release PY - 2019/8/16/pubmed PY - 2019/8/16/medline PY - 2019/8/16/entrez KW - astronaut KW - cardiovascular deconditioning KW - orthostatic hypotension SP - 1050 EP - 1057 JF - Journal of applied physiology (Bethesda, Md. : 1985) JO - J. Appl. Physiol. VL - 127 IS - 4 N2 - We tested the hypothesis that acute changes in arterial blood pressure (BP) when astronauts moved between supine and standing posture before and after spaceflight can be tracked by beat-to-beat changes in pulse arrival time (PAT). Nine male crewmembers (45 ± 7 yr of age; mean mission length: 165 ± 13 days) participated in a standardized supine-to-sit-to-stand test (5 min-30 s-3 min) before flight and 1 day following return to Earth with continuous monitoring of ECG and finger arterial BP. PAT was determined from the R-wave of the ECG to the foot of the BP waveform. On average, modest cardiovascular deconditioning was detected by ~10 beats/min increase in heart rate in supine and standing posture after spaceflight (P < 0.05). When looking across the full data collection period, the r2 values between inverse of PAT (1/PAT) and systolic (SBP) and diastolic BP (DBP) varied considerably between individuals (SBP preflight 0.142 ± 0.186, postflight 0.262 ± 0.243). Individual variability was consistent during periods of transition (SBP preflight 0.284 ± 0.324, postflight 0.297 ± 0.269); however, when SBP dropped >20 mmHg, r2 was significant in 5 of 5 preflight tests and 5 of 7 postflight tests. The standard error of the estimate based on a simple linear model during both pre- and postflight testing was 9-11 mmHg for SBP and 6-7 mmHg for DBP. Overall, the results support the hypothesis that PAT tracked dynamic changes in BP. PAT as a noninvasive, nonintrusive surrogate for changes in BP could be developed as an indicator of risk for syncope on return from spaceflight or other Earth-based applications.NEW & NOTEWORTHY Astronauts returning to Earth's gravity are at increased risk of low blood pressure on standing. Arterial pulse arrival time tracked the decrease in arterial blood pressure on moving from supine to upright posture. Nonintrusive technology providing indicators sensitive to acute changes in blood pressure could act as an early warning system to identify risk for hypotension that place astronauts, or people on Earth, at risk of impaired cognitive performance, fainting, and falls. SN - 1522-1601 UR - https://www.unboundmedicine.com/medline/citation/31414954/Interrelationships_between_pulse_arrival_time_and_arterial_blood_pressure_during_postural_transitions_before_and_after_spaceflight_ L2 - http://www.physiology.org/doi/full/10.1152/japplphysiol.00317.2019?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -