Why the study?
Does chronic spinal cord injury alter the incidence of cardiac dysrhythmias and autonomic nervous system function compared to controls?
Does chronic spinal cord injury alter the incidence of cardiac dysrhythmias and autonomic nervous system function compared to controls?
Chronic complete cervical spinal cord injury disrupts autonomic modulation but does not cause major arrhythmias requiring treatment.
Indicates autonomic impairment without excess ectopics in chronic quadriplegia; leaves open whether reduced HRV predicts events in spinal cord injury.
The purpose of this study is to evaluate chronic spinal cord injury (SCI) patients for the incidence of cardiac dysrhythmias and the level of autonomic nervous system (ANS) dysfunction using 24-hour Holter recordings and long-term time-domain and frequency-domain heart rate variability (HRV) analysis. There was no difference be tween groups for the frequency of ventricular or supraventricular ectopics, minimal and mean heart rate, and the longest RR intervals. Maximum heart rate was lower in the quadriplegic group compared with controls (124.1 ± 11.2 vs. 139.4 ± 10.9, p < 0.05). Frequency-domain spectral analysis of high, low, total frequency powers, and ratio LF/HF showed no significant difference between groups. On time-domain analy sis SDANN (94.5 ± 26.4 vs. 131.1 ± 15.1, p < 0.0 1) and SDNN (110.1 ± 29.2 vs. 143.6 ± 19. 1, p < 0.05) were significantly lower in quadriplegics compared with controls. SDANN (74.0 ± 17.9 vs. 115.0 ± 14.2 p < 0.01) and SDNN ( 90.2 ± 21.1 vs. 130.0 ± 22.0 p < 0.05) were significantly lower in complete quadriplegics com pared with incomplete quadriplegics. When the effect of wake (07-22)-sleep (23-07) cycle on frequency-domain parameters were assessed, HF (12.38 ± 5.1 vs. 21.18 ± 8.05, p = 0.001) and TP (35.93 ± 10.5 vs. 45.68 ± 12.68, p = 0.004) showed the physiologic increase during sleep in controls, but was unchanged in quadriplegics (10.48 ± 5.39 vs. 13.35 ± 8.03, p = 0.205 and 30.67 ± 10.61 vs. 37.01 ± 17.59, p = 0.208, respectively). In paraplegics a blunted increase in HF (14.61 ± 7.69 vs. 19.85 ± 14.13, p = 0.09) and TP (38.5 ± 12.77 vs. 47.13 ± 23.08, p = 0.08) was observed. LF showed no significant change in the three groups. Heart rate circadian rhythm was preserved in all three groups (p < 0.01). We concluded that chronic complete cer vical SCI may disrupt modulatory sympathetic flow and downregulates parasympa thetic activity but causes no major arrhythmias needing treatment.
No takes yet. Share an insight, caveat, or question.
Demirel et al. (1999) studied this question.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: