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Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis.
MedLine Citation:
PMID:  22391687     Owner:  NLM     Status:  Publisher    
Background:Although motor and sensory deficits following spinal cord injury (SCI) are well known, there are still contrasting reports on how SCI affects baseline cardiovascular (CV) parameters and other autonomic functions.Study design:Meta-analysis is performed.Objectives:To examine the effect of injury level on supine and seated CV function in individuals with SCI.Methods:A total of 98 studies representing 1968 individuals were retrieved for analysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were abstracted from the studies and compared between four groups according to the neurological lesion level, cervical (C) SCI (C4-C8), high-thoracic (HT) SCI (T1-T6), low-thoracic lumbar (LTL) SCI (below T6) and able-bodied (AB) controls.Results:In the supine position, SBP, DBP and HR were lower in C compared with HT, LTL and AB (all P<0.04). In the seated position, SBP and DBP were significantly lower in C compared with LTL and AB (all P<0.003) and HR was significantly lower in C compared with LTL only (P=0.01). A final finding was that C exhibited a lower resting SBP in the seated compared with the supine position (P<0.001).Conclusion:Individuals with SCI exhibit a lesion-dependent impairment in resting CV function, whereby those with the highest injury had the greatest degree of CV dysfunction. A further finding was that individuals with a C injury exhibited a lower resting SBP in the seated vs supine position. Thus, clinicians and researchers should consider lesion level and body position when measuring and interpreting CV parameters in individuals with SCI.Spinal Cord advance online publication, 6 March 2012; doi:10.1038/sc.2012.17.
C R West; P Mills; A V Krassioukov
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-06
Journal Detail:
Title:  Spinal cord     Volume:  -     ISSN:  1476-5624     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, British Columbia, Canada.
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