INTRODUCTION Space travel imposes significant gravitational and radiation stress on both cellular and systemic physiology, resulting in myriad cardiovascular changes that have not been fully characterized. METHODS We conducted a systematic review of the cellular and clinical adaptations of the cardiovascular system after exposure to real or simulated space travel in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed and Cochrane databases were searched in June 2021 for all peer-reviewed articles published since 1950 related to the following search terms entered in separate pairs: "cardiology and space" and "cardiology and astronaut." Only cellular and clinical studies in English concerning the investigation of cardiology and space were included. RESULTS Eighteen studies were identified, comprising 14 clinical and 4 cellular investigations. On the genetic level, pluripotent stem cells in humans and cardiomyocytes in mice displayed increased beat irregularity, with clinical studies revealing a persistent increase in heart rate after space travel. Further cardiovascular adaptations included a higher frequency of orthostatic tachycardia but no evidence of orthostatic hypotension, after return to sea level. Hemoglobin concentration was also consistently decreased after return to Earth. No consistent change in systolic or diastolic blood pressure or any clinically significant arrhythmias were observed during or after space travel. CONCLUSION Changes in oxygen carrying capacity, blood pressure, and post-flight orthostatic tachycardia may serve as reasons to further screen for pre-existing anemic and hypotensive conditions among astronauts.

中文翻译：

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太空旅行的心血管适应：系统回顾。

简介 太空旅行对细胞和全身生理学施加了显着的重力和辐射应力，导致了无数尚未完全表征的心血管变化。方法 我们根据系统评价和荟萃分析指南的首选报告项目，对经历真实或模拟太空旅行后心血管系统的细胞和临床适应进行了系统评价。2021 年 6 月，对 PubMed 和 Cochrane 数据库进行了检索，查找自 1950 年以来发表的所有同行评审文章，这些文章与以下单独对输入的搜索词相关：“心脏病学和太空”和“心脏病学和宇航员”。仅包括有关心脏病学和空间研究的英语细胞和临床研究。结果 确定了 18 项研究，其中包括 14 项临床研究和 4 项细胞研究。在基因水平上，人类的多能干细胞和小鼠的心肌细胞显示出心跳不规则性增加，临床研究表明太空旅行后心率持续增加。返回海平面后，进一步的心血管适应包括更高频率的直立性心动过速，但没有证据表明直立性低血压。返回地球后，血红蛋白浓度也持续下降。在太空旅行期间或之后没有观察到收缩压或舒张压的一致变化或任何临床上显着的心律失常。结论 携氧能力、血压和飞行后直立性心动过速的变化可能是进一步筛查宇航员先前存在的贫血和低血压状况的原因。