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. 2024 Jun 21:15:1351985.
doi: 10.3389/fphys.2024.1351985. eCollection 2024.

Computational modeling of heart failure in microgravity transitions

Stefan L Wilson  1 , Klaus-Martin Schulte  1 , Anne Steins  1 , Russell L Gruen  1 , Emma M Tucker  1 , Lex M van Loon  1
Affiliations

Computational modeling of heart failure in microgravity transitions

Stefan L Wilson et al. Front Physiol. .

Abstract

The space tourism industry is growing due to advances in rocket technology. Privatised space travel exposes non-professional astronauts with health profiles comprising underlying conditions to microgravity. Prior research has typically focused on the effects of microgravity on human physiology in healthy astronauts, and little is known how the effects of microgravity may play out in the pathophysiology of underlying medical conditions, such as heart failure. This study used an established, controlled lumped mathematical model of the cardiopulmonary system to simulate the effects of entry into microgravity in the setting of heart failure with both, reduced and preserved ejection fraction. We find that exposure to microgravity eventuates an increased cardiac output, and in patients with heart failure there is an unwanted increase in left atrial pressure, indicating an elevated risk for development of pulmonary oedema. This model gives insight into the risks of space flight for people with heart failure, and the impact this may have on mission success in space tourism.

Keywords: cardiovascular; digital twin; mathematical model (MM); physiology; space medicine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Schematic overview of the 21-compartment cardiovascular model. Reproduced from van Loon et al., 2022, licensed under CC BY 4.0 International. Left panel (A): Anatomic model. Dashed square indicates the intrathoracic pressure. Right panel (B): Hydraulic circuit model. The orange circles with numbers are elastic elements with a pre and post resistance in blue and annotated with Roman numbers. The cardiac compartments are illustrated with red circles and represent time-variant elastances, together with their valves (green single triangles). The dashed rectangle outlines the intrathoracic compartments, and the brown wide-dashed line with round arrowheads indicates the lymphatic flow from the lower and upper body to the super vena cava. The green and red apple indicate gravity and its direction (green = added, red = subtracted).
FIGURE 2
FIGURE 2
Pressure-volume loops of the left intraventricular compartment. A healthy astronaut (‘normal’, blue line) to heart failure with reduced (HFrEF, red line) and preserved (HFpEF, green line) ejection fraction under Earth’s gravitational conditions (1G) in the supine position (t = 80 s).
FIGURE 3
FIGURE 3
Haemodynamic responses occurring during entry into microgravity under different conditions. Top panel; healthy adult. Middle panel: Heart failure with reduced ejection fraction (HFrEF). Bottom panel: Heart failure with preserved ejection fraction (HFpEF). Line colours: dashed line = start microgravity transition, red = mean arterial blood pressure, dashed green = heart rate, black = cardiac output, and blue = left atrial pressure.
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The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

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