The cardiovascular and pulmonary systems supply the body with the oxygen needed for life. On Earth, the heart must work against gravity constantly to push oxygenated blood through the arteries. In space, the lack of gravitational force causes blood and other fluids to shift from the lower to the upper body. This headward fluid shift triggers many changes in the cardiovascular system. Long- and short-term studies of humans in space have documented increased heart rate, narrowed pulse pressure, reduced plasma volume, decreased heart chamber volume and facial edema. Animal studies indicate that the myocardium may degenerate during microgravity exposure. The return of astronauts to Earth is accompanied by decreased exercise capacity and orthostatic intolerance. These factors decrease performance during descent from orbit and increase risk during emergency egress from the spacecraft. The mechanisms behind these phenomena remain uncertain, though hypotheses include decreased intravascular volume, increased post-flight venous pooling due to structrual and reflex vascular changes, and alterations in overall cardiovascular reflex control.

In-flight exercise appears to be only partially effective in treating cardiovascular deconditioning in space. Other preventative methods under examination include lower body negative pressure (LBNP) treatment and saline loading before return to Earth. The main goals of cardiovascular research in space are to understand the acute and long-term cardiovascular and pulmonary adaptation to space and readaptation to a gravity environment, including the associated mechanisms, and to ensure adequate physiological countermeasures to cardiovascular deconditioning.

Teaching Goals:

• Review the basic structure and function of the human cardiovascular system.
• Relate the normal distribution of blood pressure on Earth and how the body has adapted to this distribution (e.g., in the head versus the feet).
• State the Starling Law of the Capillary and interrelate factors causing or preventing fluid shifts and edema.
• Understand the loss of blood pressure gradient in space and its impact on local fluid shifts.
• Understand cardiovascular and fluid adaptations to space flight.
• Describe current countermeasures for cardiovascular and fluid changes in space.
• Understand cardiovascular and fluid adaptations to space flight.
• Describe current countermeasures to limit orthostatic intolerance upon re-entry.

Discipline Lead

Colonel Ronald D. Reed, Ph.D.