Document Detail


Baroreflex function following spinal cord injury.
MedLine Citation:
PMID:  22897489     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Significant cardiovascular and autonomic dysfunction occurs after spinal cord injury (SCI). It is now recognized that cardiovascular disease is a leading cause of morbidity and mortality in SCI. Patients with SCI may also suffer severe orthostatic hypotension and autonomic dysreflexia. Baroreflex sensitivity (i.e., the capability of the autonomic nervous system to detect and respond efficaciously to acute changes in blood pressure) has been recognized as having predictive value for cardiovascular events as well as playing a role in effective short-term regulation of blood pressure. The purpose of this paper is to review the mechanisms underlying effective baroreflex function, describe the techniques available to measure baroreflex function, and summarize the literature examining baroreflex function after SCI. Finally, we describe the potential mechanisms responsible for baroreflex dysfunction after SCI and propose future avenues for research. Briefly, although cardiovagal baroreflex function is reduced markedly in those with high level lesions (above the 6th thoracic level) the reduction appears partially mitigated in those with low lesion levels. Although no studies have examined the sympathetic arm of the baroreflex in those with SCI, despite this being arguably more important to blood pressure regulation than the cardio-vagal baroreflex, nine articles have examined sympathetic responses to orthostatic challenges; these findings are reviewed. Future studies are needed to describe whether dysfunctional baroreflex sensitivity after SCI is due to arterial stiffening or a neural component. Further, measurement of forearm vascular conductance and/or muscle sympathetic nerve activity is required to directly evaluate of the sensitivity of the sympathetic arm of the baroreflex in those with SCI.
Authors:
Aaron A Phillips; Andrei V Krassioukov; Phil Ainslie; Darren E R Warburton
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-16
Journal Detail:
Title:  Journal of neurotrauma     Volume:  -     ISSN:  1557-9042     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University of British Columbia, Experimental Medicine, Rm. 205, Unit II Osborne Centre, 6108 Thunderbird Blvd, Vancouver, British Columbia, Canada, V6T2C3, 6048221337; aaphill@interchange.ubc.ca.
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