Cardiac parasympathetic activity and ventricular diastolic interactions in individuals with spinal cord injury

Sharif, Hisham; Wainman, Liisa; O’Leary, Deborah D.; Ditor, David S.

doi:10.1038/s41393-018-0224-6

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Such redistribution of blood flow can also be seen when there is cooling of other parts of the head. When an individual's forehead, cheeks or nasal cavities are cooled, MFV in the MCA, blood pressure, RMSSD and total peripheral resistance increase, while heart rate and peripheral skin circulation decrease [1,2,[14][15][16]. Immersion of the head in water increases blood flow in the common carotid artery by 10%-18% [17] and elevates the arterial oxygen saturation after apnea [5].…”

Section: Discussionmentioning

confidence: 99%

Cold stimulation of the oral cavity redistributes blood towards the brain in healthy volunteers

Hensel

2024

Euro J of Neurology

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BackgroundThe aim of this study was to analyze cold stimulation‐induced changes in cerebral and cardiac hemodynamics.MethodsUpon ingestion of an ice cube, the changes in resistance index, mean flow velocity and flow index of the middle cerebral arteries (MCA) were assessed using transcranial Doppler sonography. Extracranial duplex sonography was used to measure the mean flow velocity and resistance index of the right internal carotid artery (ICA). The change in mean arterial pressure, heart rate, root mean square of successive differences (RMSSD) and end‐tidal carbon dioxide pressure were analyzed additionally. These changes were compared to sham stimulation.ResultsCompared with sham stimulation, cooling of the oral cavity resulted in significant changes in cerebral and cardiac hemodynamics. The cold stimulation decreased the resistance index in the MCA (−4.5% ± 5.4%, p < 0.0001) and right ICA (−6.3% ± 15.6%, p = 0.001). This was accompanied by an increase in mean flow velocity (4.1% ± 8.0%, p < 0.0001) and flow index (10.1% ± 43.6%, p = 0.008) in the MCA. The cardiac effects caused an increase in mean arterial pressure (1.8% ± 11.2%, p = 0.017) and RMSSD (55% ± 112%, p = 0.048), while simultaneously decreasing the heart rate (−4.3% ± 9.6%, p = 0.0001).ConclusionCooling of the oral cavity resulted in substantial changes in cerebral and cardiac hemodynamics resulting in a blood flow diversion to the brain.

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Section: Discussionmentioning

confidence: 99%

Cold stimulation of the oral cavity redistributes blood towards the brain in healthy volunteers

Hensel

2024

Euro J of Neurology

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“…Our results also are consistent with those of many previous studies assessing HRV and PWV parameters. However, while the present study used simultaneous measurement of HRV and PWV using an HRV analyzer[ 23 , 24 ], previous studies applied various techniques to simultaneously measure HRV[ 13 , 15 - 17 ] and PWV parameters[ 5 , 19 - 21 ] separately. The SA-3000P HRV analyzer is a non-invasive and quick evaluation tool that can detect cardiovascular complications after SCI, facilitating appropriate early intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Measurable HRV parameters are divided into frequency and time domains. Frequency domain analysis separates HRV into its component rhythms that operate within different frequency ranges: ultra-low frequency (ULF), very-low frequency (VLF), low frequency (LF), and high frequency (HF)[ 12 , 13 ]. The ratio of LF to HF power (LF/HF ratio) estimates the ratio sympathetic to parasympathetic nervous system activity, and the total power (TP) is the sum of the energy in the VLF, LF, and HF bands in short-term recordings[ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, an investigation of obstructive sleep apnea and nocturnal blood pressure (BP), both of which commonly occur in SCI, found no relationship between HRV and obstructive sleep apnea severity or BP as signs of autonomic dysfunction in SCI patients[ 17 ]. Cardiac parasympathetic activity is associated with LV filling at rest and during elevated cardiac vagal tone in healthy individuals but not in SCI patients, whose autonomic function does not influence LV; this observation indicates a lack of connection between parasympathetic and cardiovascular function in SCI patients[ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Altered heart rate variability and pulse-wave velocity after spinal cord injury

Tsou¹,

Shih²,

Lin³

et al. 2022

WJCC

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BACKGROUND Heart rate variability (HRV) and pulse-wave velocity (PWV), indicators of cardiac function, are altered in patients with spinal cord injury (SCI), suggesting that autonomic cardiac function and arterial stiffness may underlie the high risk of cardiovascular complications in these patients. No study has simultaneously investigated HRV and PWV in the same patients. AIM To evaluate cardiovascular complications in SCI patients by comparing HRV and PWV between patients with and without SCI. METHODS In this cross-sectional pilot study, patients with ( n = 60) and without SCI ( n = 60) were recruited from December 7, 2019 to January 21, 2020. Each participant received a five-minute assessment of HRV and the cardiovascular system using the Medicore HRV Analyzer SA-3000P. Differences in HRV and PWV parameters between participants with and without SCI were statistically examined. RESULTS We observed a significant difference between participants with and without SCI with respect to the standard deviation of all normal-to-normal intervals, square root of the mean sum of squared successive risk ratio interval differences, physical stress index, total power, very-low frequency, low frequency, high frequency, and arterial elasticity. CONCLUSION Patients with SCI have weaker sympathetic and parasympathetic activity as well as lower arterial elasticity compared to those without, suggesting that SCI may increase cardiac function loading.

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“…The rise in PNS tone of N. vagus was linked to posttraumatic immunosuppression with enhanced risk of posttraumatic pneumonia [ 94 , 95 , 96 ] and insufficient cardiovascular adaption [ 97 , 98 ]. Similar to TBI, posttraumatic dysregulation of the PNS following TSCI was linked to enhanced immunosuppression [ 99 ], cardiovascular deterioration [ 100 ], and neurogenic bowel disease with consequent malnutrition and dysregulation of microbiota [ 101 ]. Therefore, ANS dysregulation with additive effects on whole systems biology in TSCI patients with concomitant TBI certainly contributes to enhanced morbidity and mortality.…”

Section: Interaction Of Tsci and Tbimentioning

confidence: 99%

Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment

Köhli

Otto

Jahn

et al. 2021

Cells

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Traumatic spinal cord injury (TSCI), commonly caused by high energy trauma in young active patients, is frequently accompanied by traumatic brain injury (TBI). Although combined trauma results in inferior clinical outcomes and a higher mortality rate, the understanding of the pathophysiological interaction of co-occurring TSCI and TBI remains limited. This review provides a detailed overview of the local and systemic alterations due to TSCI and TBI, which severely affect the autonomic and sensory nervous system, immune response, the blood–brain and spinal cord barrier, local perfusion, endocrine homeostasis, posttraumatic metabolism, and circadian rhythm. Because currently developed mesenchymal stem cell (MSC)-based therapeutic strategies for TSCI provide only mild benefit, this review raises awareness of the impact of TSCI–TBI interaction on TSCI pathophysiology and MSC treatment. Therefore, we propose that unravelling the underlying pathophysiology of TSCI with concomitant TBI will reveal promising pharmacological targets and therapeutic strategies for regenerative therapies, further improving MSC therapy.

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Cardiac parasympathetic activity and ventricular diastolic interactions in individuals with spinal cord injury

Cited by 4 publications

References 18 publications

Cold stimulation of the oral cavity redistributes blood towards the brain in healthy volunteers

Cold stimulation of the oral cavity redistributes blood towards the brain in healthy volunteers

Altered heart rate variability and pulse-wave velocity after spinal cord injury

Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment

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