Presentation on internal jugular vein flow in microgravity, 2021 NASA HRP Investigators Workshop

This 3-minute presentation features work on internal jugular vein flow in microgravity using the Dartmouth Craniovascular model. It was presented at the 2021 NASA Human Research Program Investigators’ Workshop. The model outputs correctly predicted reduced jugular vein flow in microgravity as was measured in astronauts on the ISS in 2019.

The Importance of Tissue Weight and Tissue Compressive Forces in Human Spaceflight

Abstract
The fluid shift and loss of hydrostatic forces that occur upon entering microgravity are often presented as key stimuli for some of physiological changes in space. Less often discussed is the effect of tissue weight. Tissue weight and tissue compressive forces are important, and often overlooked, contributors to the physiological changes that occur in space, and need to be considered when trying to understand the cardiovascular, cerebrovascular, and ocular effects of microgravity. The weight of tissues generates compressive forces that act on the walls of veins and venules. Upon entering microgravity, tissues no longer have any weight, and so any tissue compressive forces produced by the tissues are lost, removing compressive forces from the vessel walls. This likely increases vascular capacity, and allows the same amount of blood to be contained at a lower pressure within these structures. This would reduce mean circulatory filling pressure—an important component of central venous pressure (CVP). This is likely a main contributor to the reduced central and peripheral venous pressures seen when these pressures are measured directly in space. Similarly, tissue weight can affect the compliance of other organs. Studies during Gx (front to back) centrifugation show that the heart deforms with increased gravity, and that the size of the cardiac chambers decreases. The left ventricle becomes stiffer with transverse acceleration. If all gravitational forces were removed, the heart may become less stiff, which could also contribute to reduced venous pressures in space. This compliance effect could apply to tissues throughout the body, including the eye and cerebrovascular system.

But, the effects of gravity on the cardiovascular system and eye are complex, and require integrated study. In our group, we have used numerical modeling combined with physiological measurements to build a model of the eye and cerebrovascular system that includes the effects of tissue weight. The model is able to reproduce the known cardiovascular effects of modifying tissue weight (increased supine intracranial pressures with obesity, lower central venous pressures in microgravity compared to a supine baseline on Earth) and provides insight into the effect of microgravity on intracranial and intraocular pressures. The model offers a new way to develop hypotheses about how microgravity exposure may affect the eye.


ESSENTIAL PARAMETERS FOR MODELING SPACE-INDUCED VISUAL CHANGES

Abstract
Upon entering microgravity, the hydrostatic pressure of fluids within the body is reduced to effectively zero. In addition, tissues no longer have any weight and tissue compressive forces are lost. These changes have effects on pressures throughout the vascular system and produce a headward fluid shift, potentially leading to one of the unique effects of microgravity-induced visual changes in astronauts. Given the complexity of the effect of gravity on the cardiovascular system and the eye, our group has developed a numerical model that incorporates the effects of weightlessness, including the effects of modifying tissue weight. To our knowledge, this is the first to consider the effects of tissue weight and likely provides a new way of understanding tissue-weight related effects. But, a sensitivity analysis has not been done on the model. A sensitivity analysis, an exploration of the effects of changing tissue weight in the model, and an examination of the effects of a proposed countermeasure (lower body negative pressure (LBNP)) were done in this project. From the sensitivity analysis, we find that the model is stable over wide range of inputs. One interesting result from the sensitivity analysis is that venous plexus diameter has an important effect on intraocular pressure (IOP) and intracranial pressure (ICP) in microgravity. This may be significant since the size of venous drainage pathways are often significantly different between the eye showing microgravity changes compared to the unaffected eye. Altering tissue weight in the model showed that heavier individuals likely have larger decreases in ICP upon entering microgravity, which contradicts hypotheses suggesting that elevated ICP is related to the visual changes. Visual changes are more common in heavier individuals and if elevated ICP were an important cause then it should increase more in heavier individuals. From the model, the proposed countermeasure Lower Body Negative Pressure might not work as expected. These results offer insight not only to the effect of microgravity on visual problems, but also to other tissue-weight related conditions on earth, such as idiopathic intracranial hypertension and increased supine intracranial pressures with obesity.