title: Marked exacerbation of orthostatic intolerance after long- vs. short-duration spaceflight in veteran astronauts.
abstract: OBJECTIVE
  The incidence of postflight orthostatic intolerance after short-duration spaceflight is about 20%. However, the incidence after long-duration spaceflight was unknown. The purpose of this study was to test the hypothesis that orthostatic intolerance is more severe after long-duration than after short-duration flight.
  
  
  METHODS
  We performed tilt tests on six astronauts before and after long-duration (129-190 days) spaceflights and compared these data with data obtained during stand tests before and after previous short-duration missions.
  
  
  RESULTS
  Five of the six astronauts studied became presyncopal during tilt testing after long-duration flights. Only one had become presyncopal during stand testing after short-duration flights. We also compared the long-duration flight tilt test data to tilt test data from 20 different astronauts who flew on the short-duration Shuttle missions that delivered and recovered the astronauts to and from the Mir Space Station. Five of these 20 astronauts became presyncopal on landing day. Heart rate responses to tilt were no different between astronauts on long-duration flights and astronauts on short-duration flights, but long-duration subjects had lower stroke volumes and cardiac outputs than short-duration presyncopal subjects, suggesting a possible decrease in cardiac contractile function. One subject had subnormal norepinephrine release with upright posture after the long flight but not after the short flight. Plasma volume losses were not greater after long flights.
  
  
  CONCLUSIONS
  Long-duration spaceflight markedly increases orthostatic intolerance, probably with multiple contributing factors.
authors.affiliation: Space Life Sciences Research Laboratories, NASA, Johnson Space Center, Houston, TX 77058, USA. jmeck@ems.jsc.nasa.gov
authors.forename: J V
authors.initials: JV
authors.lastname: Meck
authors.forename: C J
authors.initials: CJ
authors.lastname: Reyes
authors.forename: S A
authors.initials: SA
authors.lastname: Perez
authors.forename: A L
authors.initials: AL
authors.lastname: Goldberger
authors.forename: M G
authors.initials: MG
authors.lastname: Ziegler
mesh_terms: D000328:Adult; D018480:Astronauts; D001774:Blood Chemical Analysis; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013026:Space Flight; D013997:Time Factors; D014728:Veterans