Diurnal Blood Pressure Variation in Quadriplegic Chronic Spinal Cord Injury Patients

1991 ◽  
Vol 80 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Henry Krum ◽  
William J. Louis ◽  
Douglas J. Brown ◽  
Graham P. Jackman ◽  
Laurence G. Howes
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Ambulatory Monitoring ◽  
Pressure Variation ◽  
Night Time ◽  
Cord Injury ◽  
Blood Pressure Variation ◽  
Neurologically Intact

1. Measurement of blood pressure and heart rate over a 24 h period was peformed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

Autonomic dysreflexia during sperm retrieval in spinal cord injury: influence of lesion level and sildenafil citrate

2005 ◽  
Vol 99 (1) ◽  
pp. 53-58 ◽  
Author(s):  
A. William Sheel ◽  
Andrei V. Krassioukov ◽  
J. Timothy Inglis ◽  
Stacy L. Elliott
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Autonomic Dysreflexia ◽  
Sildenafil Citrate ◽  
Vibratory Stimulation ◽  
Arterial Blood ◽  
Cord Injury ◽  
Penile Vibratory Stimulation

Autonomic dysreflexia (AD) can occur during penile vibratory stimulation in men with spinal cord injury, but this is variable, and the association with lesion level is unclear. The purpose of this study was to characterize the cardiovascular responses to penile vibratory stimulation in men with spinal cord injury. We hypothesized that those with cervical injuries would demonstrate a greater degree of AD compared with men with thoracic injuries. We also questioned whether the rise in blood pressure could be attenuated by sildenafil citrate. Participants were classified as having cervical ( n = 8) or thoracic ( n = 5) injuries. While in a supine position, subjects were instrumented with an ECG, and arterial blood pressure was determined beat by beat. Subjects reported to the laboratory twice and received an oral dose of sildenafil citrate (25–100 mg) or no medication. Penile vibratory stimulation was performed using a handheld vibrator to the point of ejaculation. At ejaculation during the nonmedicated trials, the cervical group had a significant decrease in heart rate (−5–10 beats/min) and increase in mean arterial blood pressure (+70–90 mmHg) relative to resting conditions, whereas the thoracic group had significant increases in both heart rate (+8–15 beats/min) and mean arterial pressure (+25–30 mmHg). Sildenafil citrate had no effect on the change in heart rate or mean arterial pressure in either group. In summary, men with cervical injuries had more pronounced AD during penile vibratory stimulation than men with thoracic injuries. Administration of sildenafil citrate had no effect on heart rate or blood pressure during penile vibratory stimulation in men with spinal cord injury.

scholarly journals Prevalence of Autonomic Dysreflexia in Patients with Spinal Cord Injury above T6

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Eun Sun Lee ◽  
Min Cheol Joo
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Autonomic Dysreflexia ◽  
Therapeutic Interventions ◽  
Pressure Monitoring ◽  
Cord Injury

Objective. To investigate the prevalence of autonomic dysreflexia (AD) using ambulatory blood pressure monitoring (ABPM) and the autonomic dysfunction following spinal cord injury (ADFSCI) questionnaire in patients with spinal cord injury (SCI) above T6.Methods. Twenty-eight patients diagnosed with SCI above T6 were enrolled. ABPM and ADFSCI were utilized to assess AD. Using ABPM, systolic blood pressure (SBP), diastolic blood pressure, and heart rate (HR) were measured at 30-minute intervals. AD was defined as SBP 20 mmHg higher than basal SBP, and the number of AD events was counted. The ADFSCI questionnaire evaluates the severity and frequency of the AD symptoms.Results. According to the ABPM, AD occurred in 26 patients and AD events occurred5.8±4.7times. Average daytime and nighttime SBP were119.9±18.8 mmHg and123.8±21.2 mmHg, respectively, and the nighttime mean SBP appeared to be 4 mmHg higher than daytime mean SBP. These findings suggest the loss of nocturnal BP dipping in SCI patients. ADFSCI results revealed that 16 of the patients evaluated were symptomatic while 12 were asymptomatic.Conclusion. AD following SCI above T6 was highly prevalent and several patients seemed asymptomatic. These results suggest the necessity of proper diagnostic and therapeutic interventions for managing AD.

scholarly journals Normative Blood Pressure and Heart Rate in Pediatric Spinal Cord Injury

2013 ◽  
Vol 19 (2) ◽  
pp. 87-95 ◽  
Author(s):  
Miriam Hwang ◽  
Kathy Zebracki ◽  
Randal Betz ◽  
M.J. Mulcahey ◽  
Lawrence Vogel
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Cord Injury ◽  
Pediatric Spinal Cord Injury

The association of resting state heart rate variability and 24-hour blood pressure variability in spinal cord injury

2016 ◽  
Vol 361 ◽  
pp. 52-59 ◽  
Author(s):  
Julian F. Thayer ◽  
John J. Sollers ◽  
Annika Clamor ◽  
Julian Koenig ◽  
Kristofer J. Hagglund
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Heart Rate Variability ◽  
Resting State ◽  
Blood Pressure Variability ◽  
Cord Injury

Cardiovascular responses to vaginocervical stimulation in the spinal cord-transected rat

1997 ◽  
Vol 273 (4) ◽  
pp. R1361-R1366 ◽  
Author(s):  
Giorgio R. Sansone ◽  
Ralph Bianca ◽  
Rafael Cueva-Rolón ◽  
Lisbeth E. Gómez ◽  
Barry R. Komisaruk
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Cardiovascular Responses ◽  
Spinal Cord Transection ◽  
Autonomic Dysreflexia ◽  
Control Group ◽  
Cord Injury ◽  
Sh Group

The present study ascertained whether increases in heart rate (HR) and systolic blood pressure (SBP) produced by vaginocervical stimulation (VS; 500 g force) persist in the unanesthetized rat after chronic spinal cord transection at selected levels. Three groups were used: spinal cord transection at T7 ( n = 10) or L5 ( n = 10) or a sham-operated control group (Sh, n = 10). In the Sh group, VS increased significantly both HR, by 95 ± 14.3 beats/min (bpm) (22 ± 3.7% above baseline), and BP, by 37 ± 5.7 mmHg (37 ± 7.7% above baseline), confirming earlier findings. In the T7 group, VS significantly decreased HR by 107 ± 21.4 bpm (27 ± 4.1% below baseline) and increased BP by 41.3 ± 12.9 mmHg (32 ± 8.3% above baseline). In response to VS, HR increased in every rat in the Sh group and decreased in every rat in the T7 group. In the L5 group, VS failed to significantly affect HR or BP. In the present study, specific levels of spinal cord transection produced differential HR and BP responses to VS in the rat. A model is presented addressing the component responses of autonomic dysreflexia that can occur, contingent on the level of spinal cord injury, in women during parturition or sexual intercourse.

Sympathovagal balance of the heart in subjects with spinal cord injury

1997 ◽  
Vol 272 (2) ◽  
pp. H835-H842 ◽  
Author(s):  
D. R. Grimm ◽  
R. E. De Meersman ◽  
P. L. Almenoff ◽  
A. M. Spungen ◽  
W. A. Bauman
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
High Frequency ◽  
Low Frequency ◽  
Sympathovagal Balance ◽  
Fast Fourier Transform Algorithm ◽  
Cord Injury ◽  
Spectral Components

This study investigated the effect of abnormal autonomic cardiovascular function on heart rate variability (HRV) in individuals classified into four groups: complete quadriplegia, incomplete quadriplegia, low paraplegia, and non-spinal cord injury (SCI) controls. Measurements were collected at baseline and during provocative maneuvers. Spectral analysis using a fast-Fourier transform algorithm revealed two spectral components of HRV, termed low frequency (LF) and high frequency (HF); the LF-to-HF ratio (estimate of sympathovagal balance) was also calculated. Each group of subjects with quadriplegia exhibited significantly lower spectral components for both baseline and composite provocative measures compared with the non-SCI controls (P < 0.05). In addition, the group with paraplegia demonstrated significantly lower HF baseline and LF composite levels than controls (P < 0.05). No differences were observed among all groups for the LF-to-HF ratio. This consistency in the LF-to-HF ratio suggests that the two autonomic divisions that regulate the cardiovascular system maintain homeostasis even when one component is severely compromised. This is supported by the additional findings of decreased parasympathetic activity in the two groups with quadriplegia and the absence of significant differences among any of the four groups at rest in either heart rate or blood pressure.

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