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Am J Physiol Regul Integr Comp Physiol 277: R1084-R1090, 1999;
0363-6119/99 $5.00
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Vol. 277, Issue 4, R1084-R1090, October 1999

Contributions of MSNA and stroke volume to orthostatic intolerance following bed rest

J. K. Shoemaker1, C. S. Hogeman1, and L. I. Sinoway1,2

1 Section of Cardiology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey 17033; and 2 Lebanon Veterans Affairs Medical Center, Lebanon, Pennsylvania 17042

We examined whether the altered orthostatic tolerance following 14 days of head-down tilt bed rest (HDBR) was related to inadequate sympathetic outflow or to excessive reductions in cardiac output during a 10- to 15-min head-up tilt (HUT) test. Heart rate, blood pressure (BP, Finapres), muscle sympathetic nerve activity (MSNA, microneurography), and stroke volume blood velocity (SVV, Doppler ultrasound) were assessed during supine 30° (5 min) and 60° (5-10 min) HUT positions in 15 individuals who successfully completed the pre-HDBR test without evidence of orthostatic intolerance. Subjects were classified as being orthostatically tolerant (OT, n = 9) or intolerant (OI, n = 6) following the post-HDBR test. MSNA, BP, and SVV during supine and HUT postures were not altered in the OT group. Hypotension during 60° HUT in the post-bed rest test for the OI group (P < 0.05) was associated with a blunted increase in MSNA (P < 0.05). SVV was reduced following HDBR in the OI group (main effect of HDBR, P < 0.02). The data support the hypothesis that bed rest-induced orthostatic intolerance is related to an inadequate increase in sympathetic discharge that cannot compensate for a greater postural reduction in stroke volume.

Doppler ultrasound; head-up tilt; muscle sympathetic nerve activity; presyncope


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