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2. Prevalence of Cardiovascular Conditions After Traumatic Brain Injury: A Comparison Between the Traumatic Brain Injury Model Systems and the National Health and Nutrition Examination Survey

Author

Pinto, Shanti, Thakur, Bhaskar, Kumar, Raj, Rabinowitz, Amanda, Zafonte, Ross, Walker, William C, Ding, Kan, Driver, Simon, Venkatesan, Umesh, Moralez, Gilbert, Bell, Kathleen, Pinto, Shanti, Thakur, Bhaskar, Kumar, Raj, Rabinowitz, Amanda, Zafonte, Ross, Walker, William C, Ding, Kan, Driver, Simon, Venkatesan, Umesh, Moralez, Gilbert, and Bell, Kathleen

Abstract

BACKGROUND: The purpose of this study is to compare the prevalence of self-reported cardiovascular conditions among individuals with moderate to severe traumatic brain injury (TBI) to a propensity-matched control cohort. METHODS AND RESULTS: A cross-sectional study described self-reported cardiovascular conditions (hypertension, congestive heart failure [CHF], myocardial infarction [MI], and stroke) from participants who completed interviews between January 2015 and March 2020 in 2 harmonized large cohort studies, the TBI Model Systems and the National Health and Nutrition Examination Survey. Mixed-effect logistic regression models were used to compare the prevalence of cardiovascular conditions after 1:1 propensity-score matching based on age, sex, race, ethnicity, body mass index, education level, and smoking status. The final sample was 4690 matched pairs. Individuals with TBI were more likely to report hypertension (odds ratio [OR], 1.18 [95% CI, 1.08-1.28]) and stroke (OR, 1.70 [95% CI, 1.56-1.98]) but less likely to report CHF (OR, 0.81 [95% CI, 0.67-0.99]) or MI (OR, 0.66 [95% CI, 0.55-0.79]). There was no difference in rate of CHF or MI for those ≤50 years old; however, rates of CHF and MI were lower in the TBI group for individuals >50 years old. Over 65% of individuals who died before the first follow-up interview at 1 year post-TBI were >50 years old, and those >50 years old were more likely to die of heart disease than those ≤50 years old (17.6% versus 8.6%). CONCLUSIONS: Individuals with moderate to severe TBI had an increased rate of self-reported hypertension and stroke but lower rate of MI and CHF than uninjured adults, which may be due to survival bias.

Published
2024

12. Cardiac Remodeling In Well-healed Burn Survivors After Six Months Of Unsupervised Progressive Exercise Training

Author

McKenna, Zachary J., primary, Moralez, Gilbert, additional, Romero, Steven A., additional, Hieda, Michinari, additional, Huang, Mu, additional, Cramer, Matthew N., additional, Sarma, Satyam, additional, MacNamara, James P., additional, Jaffery, Manall F., additional, Atkins, Whitley C., additional, Foster, Josh, additional, and Crandall, Craig G., additional

Published
2023
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17. Cardiac remodeling in well-healed burn survivors after 6 months of unsupervised progressive exercise training

Author

McKenna, Zachary J., primary, Moralez, Gilbert, additional, Romero, Steven A., additional, Hieda, Michinari, additional, Huang, Mu, additional, Cramer, Matthew N., additional, Sarma, Satyam, additional, MacNamara, James P., additional, Jaffery, Manall F., additional, Atkins, Whitley C., additional, Foster, Josh, additional, and Crandall, Craig G., additional

Published
2023
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18. Adrenergic control of skeletal muscle blood flow during chronic hypoxia in healthy males

Author

Simpson, Lydia L., primary, Hansen, Alexander B., additional, Moralez, Gilbert, additional, Amin, Sachin B., additional, Hofstaetter, Florian, additional, Gasho, Christopher, additional, Stembridge, Mike, additional, Dawkins, Tony G., additional, Tymko, Michael M., additional, Ainslie, Philip N., additional, Lawley, Justin S., additional, and Hearon, Christopher M., additional

Published
2023
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22. Altered cardiac β1 responsiveness in hyperthermic older adults

Author

Fischer, Mads, primary, Moralez, Gilbert, additional, Sarma, Satyam, additional, MacNamara, James P., additional, Cramer, Matthew N., additional, Huang, Mu, additional, Romero, Steven A., additional, Hieda, Michinari, additional, Shibasaki, Manabu, additional, Ogoh, Shigehiko, additional, and Crandall, Craig G., additional

Published
2022
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29. Global REACH 2018: increased adrenergic restraint of blood flow preserves coupling of oxygen delivery and demand during exercise at high‐altitude

Author

Hansen, Alexander B., primary, Moralez, Gilbert, additional, Amin, Sachin B., additional, Hofstätter, Florian, additional, Simpson, Lydia L., additional, Gasho, Christopher, additional, Tymko, Michael M., additional, Ainslie, Philip N., additional, Lawley, Justin S., additional, and Hearon, Christopher M., additional

Published
2022
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Author

Fischer, Mads, Moralez, Gilbert, Sarma, Satyam, MacNamara, James P, Cramer, Matthew N, Huang, Mu, Romero, Steven A, Hieda, Michinari, Shibasaki, Manabu, Ogoh, Shigehiko, Crandall, Craig G, Fischer, Mads, Moralez, Gilbert, Sarma, Satyam, MacNamara, James P, Cramer, Matthew N, Huang, Mu, Romero, Steven A, Hieda, Michinari, Shibasaki, Manabu, Ogoh, Shigehiko, and Crandall, Craig G

Published
2022

31. Global Reach 2018: sympathetic neural and hemodynamic responses to submaximal exercise in Andeans with and without chronic mountain sickness

Author

Hansen, Alexander B., primary, Amin, Sachin B., additional, Hofstätter, Florian, additional, Mugele, Hendrik, additional, Simpson, Lydia L., additional, Gasho, Christopher, additional, Dawkins, Tony G., additional, Tymko, Michael M., additional, Ainslie, Philip N., additional, Villafuerte, Francisco C., additional, Hearon, Christopher M., additional, Lawley, Justin S., additional, and Moralez, Gilbert, additional

Published
2022
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36. Spaceflight Bone Atrophy: Problem Solved?

Author

LeBlanc, Adrian, Matsumoto, Toshio, Jones, Jeffrey, Shapiro, Jay, Lang, Thomas, Shackelford, Linda, Smith, Scott M, Evans, Harlan, Spector, Elisabeth, Ploutz-Snyder, Robert, Sibonga, Jean, Keyak, Joyce, Nakumara, Toshitaka, Kohri, Kenjiro, Ohshima, Hiroshi, and Moralez, Gilbert

Subjects
Aerospace Medicine
Published
2015

37. Global REACH 2018: the adaptive phenotype to life with chronic mountain sickness and polycythaemia

Author

Hansen, Alexander B., primary, Moralez, Gilbert, additional, Amin, Sachin B., additional, Simspon, Lydia L., additional, Hofstaetter, Florian, additional, Anholm, James D, additional, Gasho, Christopher, additional, Stembridge, Mike, additional, Dawkins, Tony G., additional, Tymko, Michael M., additional, Ainslie, Philip N., additional, Villafuerte, Francisco, additional, Romero, Steven A., additional, Hearon, Christopher M., additional, and Lawley, Justin S., additional

Published
2021
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38. Thermoregulatory responses with size-matched simulated torso or limb skin grafts

Author

Cramer, Matthew N, Huang, M U, Fischer, Mads, Moralez, Gilbert, Crandall, Craig G, Cramer, Matthew N, Huang, M U, Fischer, Mads, Moralez, Gilbert, and Crandall, Craig G

Abstract

Skin grafting following a burn injury attenuates/abolishes sweat production within grafted areas. It is presently unknown whether the thermoregulatory consequences of skin grafting depend on anatomical location.Purpose: To test the hypothesis that a simulated burn injury on the torso will be no more or less detrimental to core temperature control than on the limbs during uncompensable exercise-heat stress.Methods: Nine non-burned individuals (7 males, 2 females) completed the protocol. On separate occasions, burn injuries of identical surface area (0.45 ± 0.08 m2 or 24.4% ± 4.4% of total body surface area) were simulated on the torso or the arms/legs using an absorbent, vapor-impermeable material that impedes sweat evaporation in those regions. Participants performed 60 min of treadmill walking at 5.3 km·h-1 and a 4.1% ± 0.8% grade, targeting 6 W·kg-1 of metabolic heat production in 40.1°C ± 0.2°C and 19.6% ± 0.6% relative humidity conditions. Rectal temperature, heart rate, and perceptual responses were measured.Results: Rectal temperature increased to a similar extent with simulated injuries on the torso and limbs (condition-by-time interaction: P = 0.86), with a final rectal temperature 0.9 ± 0.3°C above baseline in both conditions. No differences in heart rate, perceived exertion, or thermal sensation were observed between conditions (condition-by-time interactions: P ≥ 0.50).Conclusion: During uncompensable exercise-heat stress, sized-matched simulated burn injuries on the torso or limbs evoke comparable core temperature, heart rate, and perceptual responses, suggesting that the risk of exertional heat illness in such environmental conditions is independent of injury location.

Published
2021

40. Update of the Bisphosphonate ISS Flight Experiment

Author

LeBlanc, Adrian, Matsumoto, Toshio, Jones, Jeffrey, Shapiro, Jay, Lang, Thomas, Shackelford, Linda, Smith, Scott M, Evans, Harlan, Spector, Elisabeth, Ploutz-Snyder, Robert, Sibonga, Jean, Keyak, Joyce, Nakamura, Toshitaka, Kohri, Kenjiro, Ohshima, Hiroshi, and Moralez, Gilbert

Subjects
Aerospace Medicine
Abstract

The bisphosphonate study is an international collaboration between the NASA and JAXA space agencies to investigate the potential value of antiresorptive drugs to mitigate the well-established bone changes associated with long-duration spaceflight. Our hypothesis is that an antiresorptive drug in combination with in-flight exercise will ameliorate bone loss and hypercalcuria during long-duration spaceflight. We have completed data analysis for 7 crewmembers treated with alendronate during flight and 3 of 10 controls without treatment. We previously reported the pre/postflight changes in bone density and the pre versus in-flight changes in various biomarkers in crewmembers taking alendronate during flight. The purpose of this report is to compare these results with the 12- month follow-up data. The table below presents these data as a percentage change from baseline either immediately postflight or in-flight (biochemical markers) with a 1-year follow-up.

Published
2014

41. Bisphosphonate ISS Flight Experiment

Author

LeBlanc, Adrian, Matsumoto, Toshio, Jones, Jeffrey, Shapiro, Jay, Lang, Thomas, Shackleford, Linda, Smith, Scott M, Evans, Harlan, Spector, Elizabeth, Ploutz-Snyder, Robert, Sibonga, Jean, Keyak, Joyce, Nakamura, Toshitaka, Kohri, Kenjiro, Ohshima, Hiroshi, and Moralez, Gilbert

Subjects
Aerospace Medicine
Abstract

The bisphosphonate study is a collaborative effort between the NASA and JAXA space agencies to investigate the potential for antiresorptive drugs to mitigate bone changes associated with long-duration spaceflight. Elevated bone resorption is a hallmark of human spaceflight and bed rest (common zero-G analog). We tested whether an antiresorptive drug in combination with in-flight exercise would ameliorate bone loss and hypercalcuria during longduration spaceflight. Measurements include DXA, QCT, pQCT, and urine and blood biomarkers. We have completed analysis of 7 crewmembers treated with alendronate during flight and the immediate postflight (R+<2 week) data collection in 5 of 10 controls without treatment. Both groups used the advanced resistive exercise device (ARED) during their missions. We previously reported the pre/postflight results of crew taking alendronate during flight (Osteoporosis Int. 24:2105-2114, 2013). The purpose of this report is to present the 12-month follow-up data in the treated astronauts and to compare these results with preliminary data from untreated crewmembers exercising with ARED (ARED control) or without ARED (Pre-ARED control). Results: the table presents DXA and QCT BMD expressed as percentage change from preflight in the control astronauts (18 Pre-ARED and the current 5 ARED-1-year data not yet available) and the 7 treated subjects. As shown previously the combination of exercise plus antiresorptive is effective in preventing bone loss during flight. Bone measures for treated subjects, 1 year after return from space remain at or near baseline values. Except in one region, the treated group maintained or gained bone 1 year after flight. Biomarker data are not currently available for either control group and therefore not presented. However, data from other studies with or without ARED show elevated bone resorption and urinary Ca excretion while bisphosphonate treated subjects show decreases during flight. Comparing the two control groups suggests significant but incomplete improvement in maintaining BMD using the newer exercise protocols compared to earlier resistive exercise protocols. Quantitative characterization of this improvement requires additional measurements in the ARED control group that we are currently collecting. In conclusion, these results indicate that an antiresorptive may be an effective adjunct to exercise during long-duration spaceflight.

Published
2014

44. Low‐dose ketamine affects blood pressure, but not muscle sympathetic nerve activity, during progressive central hypovolemia without altering tolerance

Author

Huang, Mu, primary, Watso, Joseph C., additional, Moralez, Gilbert, additional, Cramer, Matthew N., additional, Hendrix, Joseph M., additional, Yoo, Jeung‐Ki, additional, Badrov, Mark B., additional, Fu, Qi, additional, Hinojosa‐Laborde, Carmen, additional, and Crandall, Craig G., additional

Published
2020
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47. Mechanisms of sympathetic restraint in human skeletal muscle during exercise: role of α-adrenergic and nonadrenergic mechanisms

Author

Hansen, Alexander B., primary, Moralez, Gilbert, additional, Romero, Steven A., additional, Gasho, Christopher, additional, Tymko, Michael M., additional, Ainslie, Philip N., additional, Hofstätter, Florian, additional, Rainer, Simon L., additional, Lawley, Justin S., additional, and Hearon, Christopher M., additional

Published
2020
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49. Effect of centrally acting angiotensin converting enzyme inhibitor on the exercise‐induced increases in muscle sympathetic nerve activity

Author

Moralez, Gilbert, Jouett, Noah P., Tian, Jun, Zimmerman, Matthew C., Bhella, Paul, and Raven, Peter B.

Subjects
Sympathetic Nervous System, Angiotensin II, Angiotensin-Converting Enzyme Inhibitors, Baroreflex, Exercise
Abstract

KEY POINTS: The arterial baroreflex's operating point pressure is reset upwards and rightwards from rest in direct relation to the increases in dynamic exercise intensity. The intraneural pathways and signalling mechanisms that lead to upwards and rightwards resetting of the operating point pressure, and hence the increases in central sympathetic outflow during exercise, remain to be identified. We tested the hypothesis that the central production of angiotensin II during dynamic exercise mediates the increases in sympathetic outflow and, therefore, the arterial baroreflex operating point pressure resetting during acute and prolonged dynamic exercise. The results identify that perindopril, a centrally acting angiotensin converting enzyme inhibitor, markedly attenuates the central sympathetic outflow during acute and prolonged dynamic exercise. ABSTRACT: We tested the hypothesis that the signalling mechanisms associated with the dynamic exercise intensity related increases in muscle sympathetic nerve activity (MSNA) and arterial baroreflex resetting during exercise are located within the central nervous system. Participants performed three randomly ordered trials of 70° upright back‐supported dynamic leg cycling after ingestion of placebo and two different lipid soluble angiotensin converting enzyme inhibitors (ACEi): perindopril (high lipid solubility), captopril (low lipid solubility). Repeated measurements of whole venous blood (n = 8), MSNA (n = 7) and arterial blood pressures (n = 14) were obtained at rest and during an acute (SS1) and prolonged (SS2) bout of steady state dynamic exercise. Arterial baroreflex function curves were modelled at rest and during exercise. Peripheral venous superoxide concentrations measured by electron spin resonance spectroscopy were elevated during exercise and were not altered by ACEi at rest (P ≥ 0.4) or during exercise (P ≥ 0.3). Baseline MSNA and mean arterial pressure were unchanged at rest (P ≥ 0.1; P ≥ 0.8, respectively). However, during both SS1 and SS2, the centrally acting ACEi perindopril attenuated MSNA compared to captopril and the placebo (P

Published
2018

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