{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:59:43Z","timestamp":1785254383047,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Extraterrestrial environments have an impact on cardiac output, vascular integrity, and endothelial function. This Update Review aims to integrate multi-domain cardiovascular preventive strategies through advanced biomedical and lifestyle interventions in long-duration spaceflight, as well as assessing the adoption of such innovations using Rogers\u2019s Diffusion of Innovations (DOI) theory among spaceflight stakeholders. To conduct this Update Review, we restricted the inclusion criteria to conceptual and interdisciplinary literature in English related to spaceflight in the PubMed, Scopus, and Google Scholar datasets. Articles aligned with the study scope and the relevant keywords about spaceflight, cardiovascular health, and DOI were included. Thematic synthesis was used to integrate the results with the DOI theory and advanced prevention approach on cardiovascular health, with potential benefits in space medicine. Our assessment of current literature suggests that a combined, multi-domain framework for cardiovascular protection in extraterrestrial environments, incorporating lifestyle strategies with complementary biomedical approaches, would be most useful in the pre-Moon or Mars phase. This review underscores how strategic adoption of protective innovations, coupled with a communication model like DOI, can target late adopters and accelerate effective prevention strategies across the aerospace healthcare ecosystem.<\/jats:p>","DOI":"10.3389\/fphys.2026.1890835","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:08:02Z","timestamp":1785251282000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From Earth to orbit: cardiovascular innovation diffusion to space medicine - an updated review incorporating a novel predictive modeling framework"],"prefix":"10.3389","volume":"17","author":[{"given":"Fariba","family":"Yazdanpanah","sequence":"first","affiliation":[{"name":"Department of General Preventive Medicine and Public Health, The University of Texas at Tyler","place":["Tyler, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Yazdanpanah Asmarz","sequence":"additional","affiliation":[{"name":"Center for Education and Research, Federal University of Santa Catarina","place":["Florian\u00f3polis, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1017\/S0029665116000306","article-title":"Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity","volume":"75","author":"Almoosawi","year":"2016","journal-title":"Proc. Nutr. Soc"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10010059","article-title":"The cardiovascular system in space: Focus on in vivo and in vitro studies","volume":"10","author":"Baran","year":"2021","journal-title":"Biomedicines"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1210\/endrev\/bnad019","article-title":"Nicotinamide adenine dinucleotide in aging biology: Potential applications and many unknowns","volume":"44","author":"Bhasin","year":"2023","journal-title":"Endocr Rev."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/cells14020131","article-title":"CRISPR-Cas9 in cardiovascular medicine: Unlocking new potential for treatment","volume":"14","author":"Bonowicz","year":"2025","journal-title":"Cells"},{"key":"B5","unstructured":"Wikipedia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.clnesp.2022.06.010","article-title":"Nutritional entrainment of circadian rhythms under alignment and misalignment: A mechanistic review","volume":"51","author":"Chambers","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.55513","article-title":"Late-life restoration of mitochondrial function reverses cardiac dysfunction in old mice","volume":"9","author":"Chiao","year":"2020","journal-title":"eLife"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxrep.2025.102030","article-title":"Cardiotoxicity prevention in thoracic radiotherapy: The effect of different melatonin doses on the level of oxidation markers -in vivo animal study","volume":"14","author":"Demir","year":"2025","journal-title":"Toxicol. Rep."},{"key":"B9","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/j.0887-378X.2004.00325.x","article-title":"Diffusion of innovations in service organizations: Systematic review and recommendations","volume":"82","author":"Greenhalgh","year":"2004","journal-title":"Milbank Q."},{"key":"B10","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s40779-024-00570-3","article-title":"Cardiovascular adaptations and pathological changes induced by spaceflight: from cellular mechanisms to organ-level impacts","volume":"11","author":"Han","year":"2024","journal-title":"Mil Med. Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1111\/cts.12884","article-title":"Precision medicine, AI, and the future of personalized health care","volume":"14","author":"Johnson","year":"2021","journal-title":"Clin. Transl. Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"0477","DOI":"10.34133\/cbsystems.0477","article-title":"Space physiology and technology: adaptations, countermeasures, and opportunities for wearable systems","volume":"7","author":"Khan","year":"2026","journal-title":"arXiv"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2483163","article-title":"Therapeutic strategies for oxidative stress\u2010related cardiovascular diseases: Removal of excess reactive oxygen species in adult stem cells","volume":"2016","author":"Kim","year":"2016","journal-title":"Oxid. Med. Cell. Longev."},{"key":"B14","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1152\/japplphysiol.00550.2019","article-title":"Arterial structure and function during and after long-duration spaceflight","volume":"129","author":"Lee","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2022.862059","article-title":"From cultured vascular cells to vessels: The cellular and molecular basis of vascular dysfunction in space","volume":"10","author":"Locatelli","year":"2022","journal-title":"Front. Bioeng Biotechnol."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/s17010130","article-title":"Wearable sensors for remote health monitoring","volume":"17","author":"Majumder","year":"2017","journal-title":"Sensors"},{"key":"B17","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1017\/S1092852921000535","article-title":"Space missions: psychological and psychopathological issues","volume":"27","author":"Marazziti","year":"2022","journal-title":"CNS Spectr"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2024.1438089","article-title":"Effects of weightlessness on the cardiovascular system: a systematic review and meta-analysis","volume":"15","author":"Mendes Zambetta","year":"2024","journal-title":"Front. Physiol."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/nu13020387","article-title":"Berry-derived polyphenols in cardiovascular pathologies: Mechanisms of disease and the role of diet and sex","volume":"13","author":"Najjar","year":"2021","journal-title":"Nutrients"},{"key":"B20","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1114\/1.30","article-title":"Influence of gravity on cardiac performance","volume":"26","author":"Pantalos","year":"1998","journal-title":"Ann. Biomed. Eng"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2020.100595","article-title":"The effects of microgravity and space radiation on cardiovascular health: From low-Earth orbit and beyond","volume":"30","author":"Patel","year":"2020","journal-title":"IJC Heart Vasc."},{"key":"B22","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s13728-016-0050-4","article-title":"Exercise in space: the European Space Agency approach to in-flight exercise countermeasures for long-duration missions on ISS","volume":"5","author":"Petersen","year":"2016","journal-title":"Extreme Physiol. Med."},{"key":"B23","first-page":"576","volume-title":"Diffusion of Innovations","author":"Rogers","year":"2003"},{"key":"B24","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.lfs.2019.02.054","article-title":"Protective effect of antioxidant Tempol on cardiac stem cells in chronic pressure overload hypertrophy","volume":"222","author":"Saheera","year":"2019","journal-title":"Life Sci."},{"key":"B25","doi-asserted-by":"publisher","first-page":"34572","DOI":"10.1039\/D1RA06404E","article-title":"Nanotechnology in cardiac stem cell therapy: cell modulation, imaging and gene delivery","volume":"11","author":"Sarathkumar","year":"2021","journal-title":"RSC Adv."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/s23239498","article-title":"The emergence of AI-based wearable sensors for digital health technology: A review","volume":"23","author":"Shajari","year":"2023","journal-title":"Sensors"},{"key":"B27","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1159\/000531466","article-title":"Cardiovascular adaptations of space travel: A systematic review","volume":"148","author":"Sharma","year":"2023","journal-title":"Cardiology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000444","article-title":"Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health: A scientific statement from the American Heart Association","volume":"134","author":"St-Onge","year":"2016","journal-title":"Circulation"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.888319","article-title":"Evidence for the benefits of melatonin in cardiovascular disease","volume":"9","author":"Tobeiha","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1152\/japplphysiol.00950.2006","article-title":"Microgravity-induced changes in aortic stiffness and their role in orthostatic intolerance","volume":"102","author":"Tuday","year":"2007","journal-title":"J. Appl. Physiol."},{"key":"B31","volume-title":"Psychology of Space Exploration: Contemporary Research in Historical Perspective","author":"Vakoch","year":"2011"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1890835\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:08:03Z","timestamp":1785251283000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1890835\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":31,"alternative-id":["10.3389\/fphys.2026.1890835"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2026.1890835","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"1890835"}}