title: Alterations in cardiac autonomic control in spinal cord injury.
abstract: A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries. The objective of this review is to give an update of the current knowledge related to the alterations in cardiac autonomic control following SCI. With this purpose the review includes the following subheadings: 2. Neuro-anatomical plasticity and cardiac control 2.1 Autonomic nervous system and the heart 2.2 Alteration in autonomic control of the heart following spinal cord injury 3. Spinal shock and neurogenic shock 3.1 Pathophysiology of spinal shock 3.2 Pathophysiology of neurogenic shock 4. Autonomic dysreflexia 4.1 Pathophysiology of autonomic dysreflexia 4.2 Diagnosis of autonomic dysreflexia 5. Heart rate/electrocardiography following spinal cord injury 5.1 Acute phase 5.2 Chronic phase 6. Heart rate variability 6.1 Time domain analysis 6.2 Frequency domain analysis 6.3 QT-variability index 6.4 Nonlinear (fractal) indexes 7. Echocardiography 7.1 Changes in cardiac structure following spinal cord injury 7.2 Changes in cardiac function following spinal cord injury 8. International spinal cord injury cardiovascular basic data set and international standards to document the remaining autonomic function in spinal cord injury.
authors.affiliation: Clinic for Spinal Cord Injuries, NeuroScience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: Fin.Biering-Soerensen@regionh.dk.
authors.forename: Fin
authors.initials: F
authors.lastname: Biering-Sørensen
authors.affiliation: Department of Cardiology, Herlev and Gentofte Hospital University of Copenhagen, Kildegårdsvej 28, Post 835, DK-2900 Copenhagen, Denmark; Department of Medicine, Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, USA. Electronic address: tor.biering@gmail.com.
authors.forename: Tor
authors.initials: T
authors.lastname: Biering-Sørensen
authors.affiliation: Department of Rehabilitation Medicine, Peking University Third Hospital, 100191 Beijing, PR China. Electronic address: puth_liunan@outlook.com.
authors.forename: Nan
authors.initials: N
authors.lastname: Liu
authors.affiliation: Rigshospitalet, University of Copenhagen, Blegdamsvej 3, DK-2100 Copenhagen, Denmark. Electronic address: malmqvist.lasse@gmail.com.
authors.forename: Lasse
authors.initials: L
authors.lastname: Malmqvist
authors.affiliation: James J Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, Room 7A-13, 10468 Bronx, NY, USA; Icahn School of Medicine, One Gustave Levy Place, 10029 New York, NY, USA. Electronic address: Jm.wecht@va.gov.
authors.forename: Jill Maria
authors.initials: JM
authors.lastname: Wecht
authors.affiliation: International Collaboration On Repair Discoveries (ICORD), Autonomic Research Unit, ICORD-BSCC, UBC, 818 West 10th Avenue, V5Z 1M9 Vancouver, BC, Canada; Spinal Cord Program, GF Strong Rehabilitation Centre, University of British Columbia, 4255 Laurel St., V5Z 2G9 Vancouver, BC, Canada; Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, ON, Canada. Electronic address: krassioukov@icord.org.
authors.forename: Andrei
authors.initials: A
authors.lastname: Krassioukov
mesh_terms: D000818:Animals; D020211:Autonomic Dysreflexia / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002319:Cardiovascular System / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology; D006801:Humans; D013116:Spinal Cord / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000503:physiopathology*
keywords: Autonomic dysreflexia; Autonomic nervous system; Echocardiography; Heart rate variability; Neurogenic shock; Spinal cord injury