Kathleen Rosendahl-Garcia, BS, FASE, RDCS, RVT

The spring and summer of 2009 were very busy on the International Space Station (ISS). There were international crews of astronauts and cosmonauts on Expedition 18, an Endeavour Shuttle docked to ISS (STS-127), and then an ISS crew exchange with Expedition 19. With the arrival of Expedition 20/21, six astronauts and cosmonauts, Canadian, Japanese, American, and Russian, were living and working on the ISS.

This translated into a very busy time for us in Space Medicine. The team I work with is comprised of three physician investigators, a team of engineers and managers, and myself. In Advanced Projects, a division of Space Medicine, I am a sonographer and scientist who also performs various types of ultrasound scanning, including echocardiography, coordinates studies, and analyzes all ultrasound data.

During the summer of 2009 our team was conducting a research/technical study in collaboration with Russian partners investigating the ability of ultrasound to detect physiological effects of a Russian-made countermeasure called the “braslet”. The experiment compared ultrasound data taken before and after exposure to the Russian Braslet device used to counter the negative effects of early space adaptation. We were using remote guidance ultrasound to allow our team on the ground to acquire data from astronauts. We had great success acquiring images, but many factors influenced image quality and consistency of the data, including human factor elements (called ergonomics back on Earth), individual astronaut skill in performance, and time. There were challenges getting that perfect apical view on axis consistently. It seems this is a universal problem both on Earth and in space. This experiment also was the first study to utilize tissue Doppler during spaceflight and is the most consistent data point with the highest fidelity between subjects and operators.

On one session the series of data was completed in record time, thanks to the great skill of the astronaut operator, and for the first time our team could acquire “secondary objectives,” or what you could wish for if you just had the time. We asked the operator to acquire tissue Doppler from the right ventricle at the tricuspid annulus. The signal was beautiful and consistent, even with the subject and operator floating in a microgravity environment. We included this parameter for the remainder of the experiment.

Some operators did not have perfect apical views; therefore the angle was not optimal and this affected the velocity. While I was analyzing the Doppler images in the lab it was clear that we were on to something. The time intervals were shorter after exposure to the braslet, and time intervals (isovolumetric relaxation times) are not affected by angle.

With this data I calculated the myocardial performance, or Tei Index, on all the crew before and after the braslet, and found that the Tei index dropped after the application of the braslet without any significant change to heart rate. With the help of ASE member Dr. Karthikeyan Ananth, I was able to make sense of the data.

Abstracts for the Aerospace Medical Association were due by mid October 2009 for the 2010 meeting. My colleague, Dr. Douglas Hamilton, suggested that I be first author on the abstract, so I accepted the offer and completed and submitted it. I was able to include one author astronaut, Dr. Michael Barratt, while he was still on his mission on the ISS.

In February I received an email from the Aerospace Medical Association from Dr. Jeff Young, who wanted to submit my abstract for the Aerospace Medical Association Young Investigator Award. I gladly accepted the offer, but needed to complete the manuscript by the first of March, a short time frame. I was able to complete the manuscript, and with my team of wonderful scientists, the full article, “Right Ventricular Tissue Doppler in Space Flight,” was formatted and submitted to the Aerospace Medical Association for consideration.

There were 92 applicants for the AsMA Young Investigator award in 2010; 90 had PhDs and post-doctorate work; many were practicing physicians in space medicine. Only I and one other investigator were “technical”. In early May I was prepared to defend the manuscript with a presentation and interviews by senior members from the aerospace community at the international AsMA meeting in Phoenix Arizona.

I was interviewed twice on each aspect of the research that went into the paper and I presented to the AsMA members on the paper’s concepts; I was questioned about the validity of tissue Doppler from the right heart and why it was necessary for flight medicine to understand the concept. There was little background data on this concept, so it was my challenge to try to explain while on the stage, a frightening endeavor to say the least.

At the awards ceremony the top ten nominees were announced and their research described. Then the top three qualifiers were announced and my name was called.

Dr. Young took the podium and announced my name; I was awarded “Young Investigator of the Year 2010,” the first time it was ever awarded to a technical applicant. Today I am still amazed with the recognition from the aerospace community. I was given a plaque, a check, and a textbook on space medicine written by Drs. Michael Barrett and Sam Pool. My final manuscript will be assigned to the AsMA journal for publication sometime this year or early next year.

I could not have achieved this alone. I am fortunate to work with a great team, including Dr. Doug Hamilton, an internal medicine physician with a PhD in cardiovascular physiology and a Masters degree in electrical engineering; Dr. Ashot Sargsyan, a radiologist and ultrasound specialist in space medicine; Project Manager Dr. Doug Ebert; and Dr. Scott Dulchavsky, chair of surgery at Henry Ford Hospital in Detroit. I would also like to thank Dr. Mary Freire de Carvalho for providing her statistical expertise to the manuscript.