Key result
Spinal cord injury above T5 is linked to greater cardiac autonomic dysfunction versus below-T5 injuries.
Why the study?
Spinal cord injury at cervical and upper thoracic levels impairs cardiovascular autonomic regulation, but heart rate variability differences by injury level during hospitalization are not well characterized.
Does the level of spinal cord injury (above vs below T5) affect heart rate variability and autonomic adaptive capacity in response to postural changes during hospitalization?
Cross-Sectional (n=33)
No
Does the level of spinal cord injury (above vs below T5) affect heart rate variability and autonomic adaptive capacity in response to postural changes during hospitalization?
Absolute Event Rate: 735% vs 839%
p-value: p=0.025
Patients with spinal cord injury above T5 demonstrate greater cardiac autonomic dysfunction and reduced adaptive capacity during postural changes compared to those with lower injuries, emphasizing the need for targeted hemodynamic monitoring.
May warrant closer autonomic monitoring in acute high-level SCI; leaves open prospective validation for risk stratification.
Introduction: Spinal cord injury (SCI), especially at cervical and upper thoracic levels, impairs cardiovascular autonomic regulation, resulting in changes in heart rate (HR) and responses to postural stimuli. Heart rate variability (HRV) is a noninvasive method used to assess this modulation. Objective: To analyze HRV in adult patients with spinal cord injury during hospital hospitalization, comparing individuals with injuries above and below the T5 level in different body positions. Methods: This was a cross-sectional observational study conducted in the wards of an Emergency Hospital in Goiás, Brazil, including individuals aged ≥18 years of both sexes diagnosed with spinal cord injury. HRV was recorded using a Polar H10 heart rate monitor in the supine position at 0° and with head-of-bed elevation to 60°, for 5 minutes in each position. Data were analyzed using Kubios HRV software. The following parameters were assessed: mean RR interval, mean HR, RMSSD, SDNN, LF/HF ratio, and the non-linear index DFA α1. Participants were stratified according to the level of injury (above and below T5). Statistical analysis was performed using IBM SPSS Statistics 26, applying the Wilcoxon and Mann–Whitney U tests, with p < 0.05 considered statistically significant. Results: A total of 33 individuals participated in the study, predominantly male, with a mean age of 35 ± 14 years. In the supine position (0°), patients with injuries above T5 showed significantly reduced mean RR intervals (p = 0.025), higher mean HR (p = 0.026), and lower autonomic complexity assessed by DFA α1 (p = 0.041) compared with those injured below T5. During head-of-bed elevation to 60°, these differences persisted for mean RR (p = 0.013) and mean HR (p = 0.014), and were associated with a significant change in the LF/HF ratio (p = 0.030) and a more pronounced reduction in DFA α1 (p = 0.005), indicating lower autonomic adaptability in individuals with higher-level injuries. Conclusion: Patients with spinal cord injury above T5 exhibit greater cardiac autonomic dysfunction and reduced adaptive capacity in response to postural changes during hospital hospitalization.
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Gonçalves et al. (2026) conducted a cross-sectional in Spinal cord injury (n=33). Spinal cord injury above T5 vs. Spinal cord injury below T5 was evaluated on Mean RR interval in the supine position (0°) in milliseconds (p=0.025). Patients with spinal cord injury above T5 exhibited significantly greater cardiac autonomic dysfunction, including reduced mean RR intervals and lower autonomic complexity, compared to those with injuries below T5.
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