Effects of weightlessness on the cardiovascular system: a systematic review and meta-analysis

Author(s)

Zambetta, Rafaella Mendes ; Signini, etore De Favari ; Ocamoto, Gabriela Nagai ; Catai, Aparecida Maria ; Uliam, Nicoly Ribeiro ; Santarnecchi, Emiliano ; Russo, Thiago Luiz

• Document type: Journal article
• Source: FRONTIERS IN PHYSIOLOGY; v. 15, p. 27-pg., 2024-07-26.

Abstract

Background: The microgravity environment has a direct impact on the cardiovascular system due to the fluid shift and weightlessness that results in cardiac dysfunction, vascular remodeling, and altered Cardiovascular autonomic modulation (CAM), deconditioning and poor performance on space activities, ultimately endangering the health of astronauts. Objective: This study aimed to identify the acute and chronic effects of microgravity and Earth analogues on cardiovascular anatomy and function and CAM. Methods: CINAHL, Cochrane Library, Scopus, Science Direct, PubMed, and Web of Science databases were searched. Outcomes were grouped into cardiovascular anatomic, functional, and autonomic alterations, and vascular remodeling. Studies were categorized as Spaceflight (SF), Chronic Simulation (CS), or Acute Simulation (AS) based on the weightlessness conditions. Meta-analysis was performed for the most frequent outcomes. Weightlessness and control groups were compared. Results: 62 articles were included with a total of 963 participants involved. The meta-analysis showed that heart rate increased in SF [Mean difference (MD) = 3.44; p = 0.01] and in CS (MD = 4.98; p < 0.0001), whereas cardiac output and stroke volume decreased in CS (MD = -0.49; p = 0.03; and MD = -12.95; p < 0.0001, respectively), and systolic arterial pressure decreased in AS (MD = -5.20; p = 0.03). According to the qualitative synthesis, jugular vein cross-sectional area (CSA) and volume were greater in all conditions, and SF had increased carotid artery CSA. Heart rate variability and baroreflex sensitivity, in general, decreased in SF and CS, whereas both increased in AS. Conclusion: This review indicates that weightlessness impairs the health of astronauts during and after spaceflight, similarly to the effects of aging and immobility, potentially increasing the risk of cardiovascular diseases. (AU)

• FAPESP's process: 19/14877-8 - Effect of the head-down tilt on intracranial pressure and cardiovascular control in healthy individuals: perspectives for spaceflights
• Grantee: Rafaella Mendes Zambetta
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 18/25082-3 - Study of the metabolic profile in active and sedentary aging: metabolomic approach
• Grantee: Étore de Favari Signini
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 23/00839-2 - Brain oscillations in Alzheimer's Disease: a resting state EEG analysis
• Grantee: Rafaella Mendes Zambetta
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate (Direct)
• FAPESP's process: 23/04712-7 - EFFICACY OF MULTIMODAL CIRCUIT TRAINING WITH MODERATE TO HIGH INTENSITY TO INCREASE THE NUMBER OF STEPS AND TO REDUCE SEDENTARY TIME IN PEOPLE WHO HAD STROKE: A RANDOMIZED CLINICAL TRIAL
• Grantee: Thiago Luiz de Russo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 19/25569-2 - Effects of negative inclination of the head on intracranial pressure and cardiovascular control in healthy individuals: perspectives for spatial travels
• Grantee: Thiago Luiz de Russo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/22173-5 - Characterization of intracranial pressure by non-invasive method in post-stroke subjects: relationship with sedentarism and cardiovascular system
• Grantee: Gabriela Nagai Ocamoto
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 23/09582-4 - Study of the integrated profile of cardiovascular autonomic modulation and cardiorespiratory fitness on metabolome and blood count in individuals without diagnosed diseases.
• Grantee: Étore de Favari Signini
• Support Opportunities: Scholarships in Brazil - Support Program for Fixating Young Doctors