Response of Ventricular Repolarization to Simulated Microgravity Measured by Periodic Repolarization Dynamics Using Phase-Rectified Signal Averaging

Head-Down Bed Rest (HDBR) microgravity simulation induces cardiovascular deconditioning, including effects on ventricular repolarization. The index of Periodic Repolarization Dynamics (PRD) was developed to quantify low-frequency oscillations of cardiac repolarization. In this study, PRD was quantified by Phase Rectified Signal Averaging (PRD PRSA ) and Continuous Wavelet Transform (PRD CWT ) methods. PRD was analyzed in ECGs from 22 volunteers at rest and during orthostatic Tilt-Table Test (TTT) performed before and after -6° 60-days HDBR. Significant correlation was found between PRD measured by PRSA and CWT (Pearson’s ρ = 0.93, p < 10 ^-54 and Kendall’s τ = 0.79 p < 10 ^-38 ). A highly significant increase was found when PRD PRSA values were measured at POST-HDBR with respect to PRE-HDBR in the tilt phase: 1.40 [1.10] deg and 0.97 [0.90] deg (median [IQR]), p = 0.008, respectively. PRD PRSA also increased significantly in the tilt phase with respect to baseline, both at POST-HDBR (0.90 [0.57] deg, p = 0.003) and at PRE-HDBR (0.75 [0.45] deg, p = 0.011). PRD, either measured with PRSA or with CWT, is able to measure changes in ventricular repolarization induced by microgravity simulation as well as following sympathetic provocation.