Heart rate changes associated with autonomic dysreflexia in daily life of individuals with chronic spinal cord injury.
Journal
Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
09
10
2021
accepted:
30
05
2022
revised:
29
05
2022
pubmed:
11
6
2022
medline:
8
11
2022
entrez:
10
6
2022
Statut:
ppublish
Résumé
Secondary data analysis. To characterize heart rate (HR) changes during autonomic dysreflexia (AD) in daily life for individuals with chronic spinal cord injury (SCI). University-based laboratory/community-based outpatient. Cardiovascular data, previously collected during a 24-h ambulatory surveillance period in individuals with chronic SCI, were assessed. Any systolic blood pressure (SBP) increase ≥20 mmHg from baseline was identified and categorized into confirmed AD (i.e., diarized trigger), unknown (i.e., no diary entry), or unlikely AD (i.e., potential exertion driven SBP increase) groups. SBP-associated HR changes were categorized as unchanged, increased or decreased compared to baseline. Forty-five individuals [8 females, median age and time since injury of 43 years (lower and upper quartiles 36-50) and 17 years (6-23), respectively], were included for analysis. Overall, 797 episodes of SBP increase above AD threshold were identified and classified as confirmed (n = 250, 31.4%), unknown (n = 472, 59.2%) or unlikely (n = 75, 9.4%). The median number of episodes per individual within the 24-h period was 13 (8-28). HR-decrease/increase ratio was 3:1 for confirmed and unknown, and 1.5:1 for unlikely episodes. HR changes resulting in brady-/tachycardia were 34.4%/2.8% for confirmed, 39.6%/3.4% unknown, and 26.7%/9.3% for unlikely episodes, respectively. Our findings suggest that the majority of confirmed AD episodes are associated with a HR decrease. Using wearable-sensors-derived measures of physical activity in future studies could provide a more detailed characterization of HR changes during AD and improve AD identification.
Identifiants
pubmed: 35680988
doi: 10.1038/s41393-022-00820-y
pii: 10.1038/s41393-022-00820-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1030-1036Informations de copyright
© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.
Références
Inskip JA, Lucci VEM, McGrath MS, Willms R, Claydon VE. A community perspective on bowel management and quality of life after spinal cord injury: the influence of autonomic dysreflexia. J Neurotrauma. 2018;35:1091–105.
doi: 10.1089/neu.2017.5343
pubmed: 29239268
pmcid: 5908418
Krassioukov AV. Autonomic dysreflexia: current evidence related to unstable arterial blood pressure control among athletes with spinal cord injury. Clin J Sport Med. 2012;22:39–45.
doi: 10.1097/JSM.0b013e3182420699
pubmed: 22222591
Grigorean VT, Sandu AM, Popescu M, Iacobini MA, Stoian R, Neascu C, et al. Cardiac dysfunctions following spinal cord injury. J Med Life. 2009;2:133–45.
pubmed: 20108532
pmcid: 3018985
Phillips AA, Krassioukov AV. Contemporary cardiovascular concerns after spinal cord injury: mechanisms, maladaptations, and management. J Neurotrauma. 2015;32:1927–42.
doi: 10.1089/neu.2015.3903
pubmed: 25962761
Wan D, Krassioukov AV. Life-threatening outcomes associated with autonomic dysreflexia: a clinical review. J Spinal Cord Med. 2014;37:2–10.
doi: 10.1179/2045772313Y.0000000098
pubmed: 24090418
pmcid: 4066548
Hubli M, Gee CM, Krassioukov AV. Refined assessment of blood pressure instability after spinal cord injury. Am J Hypertens. 2015;28:173–81.
doi: 10.1093/ajh/hpu122
pubmed: 24990527
Eldahan KC, Rabchevsky AG. Autonomic dysreflexia after spinal cord injury: systemic pathophysiology and methods of management. Auton Neurosci. 2019;209:59–70.
doi: 10.1016/j.autneu.2017.05.002
Walter M, Kran SL, Ramirez AL, Rapoport D, Nigro MK, Stothers L, et al. Intradetrusor onabotulinumtoxinA injections ameliorate autonomic dysreflexia while improving lower urinary tract function and urinary incontinence-related quality of life in individuals with cervical and upper thoracic spinal cord injury. J Neurotrauma 2020;37:2023–7.
doi: 10.1089/neu.2020.7115
pubmed: 32631152
pmcid: 7470218
Solinsky R, Kirshblum SC, Burns SP. Exploring detailed characteristics of autonomic dysreflexia. J Spinal Cord Med. 2018;41:549–55.
doi: 10.1080/10790268.2017.1360434
pubmed: 28784041
Kewalramani LS. Autonomic dysreflexia in traumatic myelopathy. Am J Phys Med. 1980;59:1–21.
pubmed: 6986791
Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34:535–46.
doi: 10.1179/204577211X13207446293695
pubmed: 22330108
pmcid: 3232636
Hubli M, Krassioukov AV. Ambulatory blood pressure monitoring in spinal cord injury: clinical practicability. J Neurotrauma. 2013;31:789–97.
doi: 10.1089/neu.2013.3148
Krassioukov AV, Biering-Sorensen F, Donovan W, Kennelly M, Kirshblum S, Krogh K, et al. International standards to document remaining autonomic function after spinal cord injury (ISAFSCI), first edition 2012. Top Spinal Cord Inj Rehabil. 2012;18:282–96.
doi: 10.1310/sci1803-282
pubmed: 23460763
Karlsson AK. Autonomic dysreflexia. Spinal Cord. 1999;37:383–91.
doi: 10.1038/sj.sc.3100867
pubmed: 10432257
Biering-Sørensen F, Biering-Sørensen T, Liu N, Malmqvist L, Wecht JM, Krassioukov AV. Alterations in cardiac autonomic control in spinal cord injury. Auton Neurosci Basic Clin. 2018;209:4–18.
doi: 10.1016/j.autneu.2017.02.004
West CR, Mills P, Krassioukov AV. Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis. Spinal Cord. 2012;50:484–92.
doi: 10.1038/sc.2012.17
pubmed: 22391687
Lindan R, Joiner E, Freehafer AA, Hazel C. Incidence and clinical features of autonomic dysreflexia in patients with spinal cord injury. Paraplegia. 1980;18:285–92.
pubmed: 7443280
Hector SM, Biering-Srøensen T, Krassioukov AV, Biering-Srøensen F. Cardiac arrhythmias associated with spinal cord injury. J Spinal Cord Med. 2013;36:591–9.
doi: 10.1179/2045772313Y.0000000114
pubmed: 24090076
pmcid: 3831320
Solinsky R, Linsenmeyer TA. Anxiety masquerading as autonomic dysreflexia. J Spinal Cord Med. 2019;42:639–42.
doi: 10.1080/10790268.2018.1518763
pubmed: 30199346
Jackson CR, Acland R. Knowledge of autonomic dysreflexia in the emergency department. Emerg Med J. 2011;28:866–9.
doi: 10.1136/emj.2009.085159
pubmed: 20947918
Mcgillivray CF, Hitzig SL, Craven BC, Tonack MI, Krassioukov AV. Evaluating knowledge of autonomic dysreflexia among individuals with spinal cord injury and their families. J Spinal Cord Med. 2009;32:54–62.
doi: 10.1080/10790268.2009.11760753
pubmed: 19264050
pmcid: 2647501
Walter M, Knüpfer SC, Cragg JJ, Leitner L, Schneider MP, Mehnert U, et al. Prediction of autonomic dysreflexia during urodynamics: a prospective cohort study. BMC Med. 2018;16:1–11.
doi: 10.1186/s12916-018-1040-8
Huang YH, Bih LI, Liao JM, Chen SL, Chou LW, Lin PH. Blood pressure and age associated with silent autonomic dysreflexia during urodynamic examinations in patients with spinal cord injury. Spinal Cord. 2013;51:401–5.
doi: 10.1038/sc.2012.155
pubmed: 23229618
Nightingale TE, Rouse PC, Thompson D, Bilzon JLJ. Measurement of physical activity and energy expenditure in wheelchair users: methods, considerations and future directions. Sport Med Open. 2017;3:10.
doi: 10.1186/s40798-017-0077-0