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Hemodynamic responses to head-up tilt after spinal cord injury support a role for the mid-thoracic spinal cord in cardiovascular regulation.
MedLine Citation:
PMID:  20714335     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background:Data showing a role for the mid-thoracic spinal cord (SC) in the control of hemodynamic changes is scarce despite existing evidence for its involvement in autonomic regulation.Study design:On the basis of the open label prospective series comparing three groups.Objective:To determine whether the mid-thoracic SC has a role in hemodynamic regulation during head-up tilt (HUT).Setting:Spinal Research Laboratory, Loewenstein Rehabilitation Hospital.Methods:A total of 13 healthy control subjects, 10 patients with T(4)-T(6) paraplegia and 11 with C(4)-C(7) tetraplegia were examined during supine rest and during HUT. Heart rate (HR), blood pressure (BP), HR spectral components (lower frequency fluctuation (LF), higher frequency fluctuations (HF) and LF/HF) and cerebral blood flow velocity (CBFV) were continuously measured or calculated.Results:BP response to HUT differed among these groups (P<0.02). During HUT, BP decreased markedly in the tetraplegia group (from a mean value of 81.65 to 67.69 mm Hg), and increased in the control groups (from 92.89 to 95.44 mm Hg) and in the T(4)-T(6) paraplegia group (from 96.24 to 97.86 mm Hg). Significant correlation was found in the control and tetraplegia groups between increases in HR LF/HF and HR at HUT (r>0.7; P<0.01). No such correlation was found in the paraplegia group. HUT effect on HR and CBFV was significant in all groups (P<0.001), but group differences were statistically non-significant.Conclusion:Findings were generally compatible with those of comparable previously published studies, but they also support a role for the mid-thoracic SC in hemodynamic regulation, which should be considered in clinical setting and in research.
Authors:
V Bluvshtein; A D Korczyn; S Akselrod; I Pinhas; I Gelernter; A Catz
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Publication Detail:
Type:  Journal Article     Date:  2010-08-17
Journal Detail:
Title:  Spinal cord : the official journal of the International Medical Society of Paraplegia     Volume:  49     ISSN:  1476-5624     ISO Abbreviation:  Spinal Cord     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  IM    
Affiliation:
1] Department of Spinal Rehabiliation, Loewenstein Rehabilitation Hospital, Raanana, Israel [2] Departments of Rehabilitation and Physiology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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