Cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injuries
Hill, Mattias LU
; Jörgensen, Sophie
LU
; Engström, Gunnar
LU
; Persson, Margaretha
LU
; Platonov, Pyotr G
LU
; Hamrefors, Viktor
LU
and Lexell, Jan
LU
(2025)
In Journal of Spinal Cord Medicine
48(3).
p.447-460
- Abstract
OBJECTIVES: To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.
DESIGN: Population-based cross-sectional study with matched controls.
SETTING: Outpatient SCI unit in Southern Sweden.
PARTICIPANTS: Twenty-five individuals (20% women, mean age 58 years and mean time since injury 28 years, NLI C2-T6, American Spinal Injury Association Impairment Scale A-C) from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched controls were obtained from the... (More)
OBJECTIVES: To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.
DESIGN: Population-based cross-sectional study with matched controls.
SETTING: Outpatient SCI unit in Southern Sweden.
PARTICIPANTS: Twenty-five individuals (20% women, mean age 58 years and mean time since injury 28 years, NLI C2-T6, American Spinal Injury Association Impairment Scale A-C) from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched controls were obtained from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) at a ratio of 5:1.
INTERVENTIONS: Not applicable.
OUTCOME MEASURES: 24 h electrocardiography and deep breathing tests. 24 h ambulatory blood pressure (BP) monitoring and orthostatic BP tests.
RESULTS: In individuals with SCI compared with controls, heart rate variability (24h mean SD of the normal-to-normal interval 112 ms vs 145 ms, P < 0.001) and diastolic orthostatic BP increase (2.0 and 9.4 mmHg, P < 0.001), were significantly lower, whereas BP variability was significantly higher (24h mean systolic SD
BP 17.8 mmHg vs 15.7 mmHg, P = 0.029). Circadian patterns of heart rate variability and BP (lack of nocturnal dip) were significantly different among the individuals with SCI than controls. Higher NLI was significantly (P < 0.05) correlated with impairments to various cardiovascular autonomic function variables.
CONCLUSIONS: This exploratory study indicates that cardiovascular autonomic function is impaired in middle-aged people with long-term cervical and upper thoracic SCI compared with the general non-SCI population, and more pronounced with a higher NLI. Future research is needed to understand the pathophysiological mechanisms underlying these impairments, and the prognostic significance for individuals with SCI.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03515122.
(Less)
- author
- Hill, Mattias
LU
; Jörgensen, Sophie
LU
; Engström, Gunnar
LU
; Persson, Margaretha
LU
; Platonov, Pyotr G
LU
; Hamrefors, Viktor
LU
and Lexell, Jan
LU
- organization
-
- Rehabilitation and Sustainable Health (research group)
- Rehabilitation medicine (research group)
- Cardiovascular Research - Epidemiology (research group)
- EpiHealth: Epidemiology for Health
- Internal Medicine - Epidemiology (research group)
- Electrocardiology Research Group - CIEL (research group)
- Cardiology
- EXODIAB: Excellence of Diabetes Research in Sweden
- Cardiovascular Research - Hypertension (research group)
- MultiPark: Multidisciplinary research focused on Parkinson's disease
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Spinal Cord Medicine
- volume
- 48
- issue
- 3
- pages
- 447 - 460
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:39392470
- scopus:85206251063
- ISSN
- 2045-7723
- DOI
- 10.1080/10790268.2024.2403791
- language
- English
- LU publication?
- yes
- id
- dffabe98-ea56-4837-8551-e87e78836f40
- date added to LUP
- 2024-11-14 23:32:58
- date last changed
- 2025-10-18 10:00:06
@article{dffabe98-ea56-4837-8551-e87e78836f40,
abstract = {{<p>OBJECTIVES: To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.</p><p>DESIGN: Population-based cross-sectional study with matched controls.</p><p>SETTING: Outpatient SCI unit in Southern Sweden.</p><p>PARTICIPANTS: Twenty-five individuals (20% women, mean age 58 years and mean time since injury 28 years, NLI C2-T6, American Spinal Injury Association Impairment Scale A-C) from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched controls were obtained from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) at a ratio of 5:1.</p><p>INTERVENTIONS: Not applicable.</p><p>OUTCOME MEASURES: 24 h electrocardiography and deep breathing tests. 24 h ambulatory blood pressure (BP) monitoring and orthostatic BP tests.</p><p>RESULTS: In individuals with SCI compared with controls, heart rate variability (24h mean SD of the normal-to-normal interval 112 ms vs 145 ms, P < 0.001) and diastolic orthostatic BP increase (2.0 and 9.4 mmHg, P < 0.001), were significantly lower, whereas BP variability was significantly higher (24h mean systolic SD<br>
BP 17.8 mmHg vs 15.7 mmHg, P = 0.029). Circadian patterns of heart rate variability and BP (lack of nocturnal dip) were significantly different among the individuals with SCI than controls. Higher NLI was significantly (P < 0.05) correlated with impairments to various cardiovascular autonomic function variables.<br>
</p><p>CONCLUSIONS: This exploratory study indicates that cardiovascular autonomic function is impaired in middle-aged people with long-term cervical and upper thoracic SCI compared with the general non-SCI population, and more pronounced with a higher NLI. Future research is needed to understand the pathophysiological mechanisms underlying these impairments, and the prognostic significance for individuals with SCI.</p><p>TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03515122.</p>}},
author = {{Hill, Mattias and Jörgensen, Sophie and Engström, Gunnar and Persson, Margaretha and Platonov, Pyotr G and Hamrefors, Viktor and Lexell, Jan}},
issn = {{2045-7723}},
language = {{eng}},
number = {{3}},
pages = {{447--460}},
publisher = {{Taylor & Francis}},
series = {{Journal of Spinal Cord Medicine}},
title = {{Cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injuries}},
url = {{http://dx.doi.org/10.1080/10790268.2024.2403791}},
doi = {{10.1080/10790268.2024.2403791}},
volume = {{48}},
year = {{2025}},
}