Monitoring Astronaut Health:�Homeostasis of the Habitat

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

What’s missing here?

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Homeostasis of the Habitat

• The first priority in extraterrestrial existence is maintaining a safe environment for man in the ultimate most hostile environment of space.

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• To monitor and regulate conditions in the vessel habitat the most definitive (death defining) measure are of vital signs.

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• The most basic biometric of vitality is the heart beat.

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• This essential information should be shared with the vessel and crew to ensure homeostasis.

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Astronaut Selection

• Rigorous Physical

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• Strenuous Mental

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• Teamwork Intensive

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• HRV

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Homeostasis and Dynamic Equilibrium

• Homeostasis is the property of a system that regulates its internal environment and tends to maintain a stable, relatively constant condition of properties; the balance of things.

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• Homeostasis is a biologic equivalent of Dynamic Equilibrium.

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• Much has been done in respect to monitoring Clinical Aspects of Crew Health (Apollo, Mir, Space Lab).

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• Homeostasis is best expressed by the status of the Autonomic Nervous System (ANS) which can be determined from analysis of the variability of the heart beat (HRV) using the heart as a sensor of the ANS.

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

The Autonomic Nervous System

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

• It is Axiomatic that Autonomic Nervous System (ANS) function represents the state of homeostasis.

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• The ANS is divided (a dichotomy) into the:
• Sympathetic Limb
• Parasympathetic Limb- Vagal nerves
• At rest both are tonically active with the Vagal effects dominant.

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Schema of the Electric Activation of Heart Chambers and their Visualization on ECG

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

The Heartbeat by EKG

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

RR Interval

Diastole

QT Interval

Repolarization

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Depolarization

Systole

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Heart Rate Variability (HRV)

• HRV has been a corner stone analysis of ANS function; the ‘gold standard’ of vital signs.
• Currently the standard method of analysis is of the R-R interval, a single series of data.
• This allows distinguishing intrinsic (cardiac) vs. extrinsic (ANS) aspects of homeostasis.

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Current Methods of HRV Analysis

• Algebraic- Time Domain (standard statistical methods).
• Advanced Calculus- Frequency Domain (spectral analysis)
• Non-Linear Dynamics- Phase plane plot, Poincare section,

return map, Mandelbrot set.

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Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Retrograde Relation: RR/QT- �A New Dimension for HRV

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

• A novel and unique method using two simultaneous signals from the heart beat, RR and QT intervals.

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• The variability of the RR/QT exhibit coupled dynamics that are highly sensitive to initial conditions, is ergodic in nature, non-linear, and deterministic.

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• Fractal dimensions are recognized allowing the use of chaotic theory to determine the ENTROPY (Shannon) of the ANS via HRV.

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Non-Linear Dynamics, Chaos, and Fractal Physiology

• Visualization of the RR/QT relationship using Dynamical Systems mathematics including Chaos theory.

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• Deterministic, predictive.

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• Allows the use of the Lyapunov numerical method (exponent) as an adjunct to the graphical analysis of state space; entropy.

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

What We Can Learn/Future Studies

• Correlation of HRV with the status of the ANS in individuals and the crew.

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• Recognize and influence neuropsychological status of individuals and crew.

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• Real time integration of visual and auditory signals to and from individuals, crew, and vessel; feedback and mirroring. I’d like to hear HRV.

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• Correlation to the microbiota.

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• Correlation to reproduction.

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Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

50MB/24 Hours

Conclusion:

• Heart Rate Variability (HRV) analysis remains useful in selecting individuals entering a hostile environment.

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• Current computational tools, Information Technology, allows embedding many dimensions into and with HRV as a singular non-invasive, wireless biometric to monitor the Autonomic Nervous System (ANS), homeostasis, and entropy.

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• Future applications include methods of maintaining and developing health and wellness under conditions of continuous stress including other worldly.

Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Bibliography

1. Hawkins, W.R. and Zieglschmid, J.F.;

Clinical Aspects of Crew Health Biomedical Results of Apollo, Section II Chapter 1.

2. Beckers, F., et al; Non-Linear heart Rate Control in Orthostatic Tolerant Cosmonauts After Short Duration

Spaceflight; Microgravity- Space and Technology; Vol 19, #’s 5-6, Sept. 2007.

3. The Physiologic Society

Valsalva’s Manoeuvre: Physiology in Space

The Journal of Physiology (2002), 538.1. pp. 309-320

4. Cardiovascular Oscillations; IEEE Engineering In Medicine and Biology; Vol. 28, No. 6; Nov./Dec., 2009.

5. Malik, M. and Camm, A.J.

Heart Rate Variability

Future Publishing Company, Inc., 19995

6. Brassingthwaighte, J.B., Liebovitchy, L.S, and West, B.J.

Fractal Physiology

Oxford University Press, 1994

7. McCraty, R., Atkinson, M., Tomasino, D., Stuppy, W.

Analysis of Twenty-Four Hour Heart Rate Variability in Patients with Panic Disorder, Biological Psychology 56:

(2001), pg. 131-150

6. Jonckheere, E., Stuppy W., Callahan, T.

Return Time of Heart Dynamics. 4th European Congress for Medical and Biomedical Engineering 2008,

(eMBEC 2008, http://mbec2008.be/), Nov. 23-7,

Antwerp, Belgium, Contribution Session 30, Mathematical Biology.

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Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Bibliography, cont.

7. Jonckheere et. al.

Method and System for Dynamical Systems Modeling of Electrocardiogram Data

United States Patent US 8,041,4173.

8. Denton, T., et. al.

Fascinating Rhythm: A Primer on Chaos Theory and its Application to Cardiology.

American Heart Journal, Vol. 120, No. 6, pg.1419-1440, December, 1990.

9. Shannon, C. E.

A Mathematical Theory of Communication

Bell System Technical Jol., 27(3): 379-423; 1948.

10. McCraty, R., Atkinson, M., Tomasino, D., Stuppy, W.

Analysis of Twenty-Four Hour Heart Rate Variability in Patients with Panic Disorder, Biological Psychology 56:

(2001), pg. 131-150.

11. Learning, J.L. and Guha-Sapir

Natural Disasters, Armed Conflict, and Public Health.

New England Jol. Of Medicine, 369:19, pp.1836-1841; Nov. 7, 2013.

12. Stuppy, William P.- Stuppymd.com.

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Health and Well Being

William P. Stuppy, MD

ASTE 527, 17 Dec. 2013

Monitoring Astronaut Health William P. Stuppy, MD ASTE 527, 8 Oct. 2013

The end.

Questions?