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  • Evaluation of the effects of 60-days Head-Down Bed Rest and Nutritional Countermeasure on cardiac circadian rhythms

    Paper number

    IAC-19,A1,2,3,x49056

    Author

    Ms. Sarah Solbiati, Italy, Politecnico di Milano

    Coauthor

    Ms. Martina Turcato, Italy, Politecnico di Milano

    Coauthor

    Ms. Alba Martin-Yebra, Sweden, Lund University

    Coauthor

    Dr. Lorenzo Costantini, Italy

    Coauthor

    Prof. Pierre Vaïda, France, Université Bordeaux Segalen

    Coauthor

    Ms. Federica Landreani, Italy

    Coauthor

    Prof.Dr. Enrico Gianluca Caiani, Italy, Politecnico di Milano

    Year

    2019

    Abstract
    Aims. Prolonged weightlessness exposure associated to space flight generates cardiac deconditioning, with potential implications on ECG circadian rhythms. Head-down (-6 degrees) bed-rest (HDBR), as model of chronic circulatory unloading, simulates sustained microgravity exposure. We aimed at evaluating the impact of 60-days HDBR on beat-by-beat RR and ventricular repolarization (QTend) duration circadianity and the effectiveness of nutritional countermeasure (CM).
    
    Methods. 20 males (34$\pm$7 years), enrolled at MEDES (Toulouse, France) after study ethical approval and signed informed consent, were randomly allocated into a CM group (N=10), undergoing daily nutritional vitamin and antioxidant cocktail supplementation during HDBR, or control group (CTRL, N=10). Day (7AM-11PM) and night (11PM-7AM) cycle was imposed. For each subject, 12-leads 24-hours Holter ECG (1000 Hz, H12+, Mortara Instrument Inc.) was acquired 9 days before HDBR (BCD-9), the 5th (HDT5), 21st (HDT21) and 58th (HDT58) day of HDBR, the first (R+0) and 8th (R+7) day after HDBR.
    For each extracted 24h RR and QTend beat-to-beat series, circadianity was evaluated by Cosinor analysis, resulting in MESOR (Midline Statistic of Rhythm), oscillation amplitude (OA, measuring half variation within a night-day cycle), and acrophase (temporal value at the maximal amplitude of the fitting sinusoid). Statistical analysis was applied to test the effects of 60-days HDBR versus BCD-9 (Wilcoxon, p$<$0.05), and to compare CTRL and CM (Mann-Withney, p$<$0.05).
    
    Results. Compared to BCD-9, at HDT5, RR (CTRL:+17.4\%, CM:+16.6\%) and QTend (CTRL:+3.5\%, CM:+1.7\%) MESOR showed the maximum increment, with RR MESOR then recovering along HDBR (CTRL:+11.4\% at HDT21, CM:-2.2\% at HDT58). Conversely, compared to BCD-9, at R+0 an abrupt decrease was visible both in RR (CTRL:-21.4\%, CM:-27\%) and QTend (CTRL:-9\%, CM:-10.9\%), with a trend to baseline values at R+7. During HDBR, OA decreased in both RR (CM:-43.4\% at HDT21, higher than CTRL:-28.5\%), and QTend (CM up to 48.7\% at HDT58). Post-BR, OA restored to baseline, except for QTend in CTRL at R+0 (+33.2\%). Acrophase was shifted backward during HDBR (CTRL:-3.2\% and CM:-5.3\% at HDT5), and postponed at R+0 compared to BCD-9 (CTRL: RR 4:19AM[4:06;4:42] versus 4:00AM[3:30;4:12]; QTend 4:36AM[4:12;4:54] versus 4:12AM[3:42;4:30]). Circadianity uncoupling between RR and QTend, as difference between acrophases, was found in CTRL at HDT5 (-4'56"[-13'54";1'53"]) compared to BCD-9 (15'57"[8'36";23']), and in CM at HDT58 (-1'[-12';20'36"] versus 0'54"[-5';30'36"]).
    
    Conclusions. 60-days HDBR affects ECG circadian rhythms notwithstanding the nutritional countermeasure, by reducing amplitude and altering acrophase, differently in RR and QTend. The observed changes appeared reversible and within physiologic limits.
    Abstract document

    IAC-19,A1,2,3,x49056.brief.pdf

    Manuscript document

    (absent)