Alterations in cardiac autonomic control in spinal cord injury

作者：Biering-Sorensen, Fin^*; Biering-Sorensen, Tor; Liu, Nan; Malmqvist, Lasse; Wecht, Jill Maria; Krassioukov, Andrei

来源：Autonomic Neuroscience-Basic & Clinical, 2018, 209: 4-18.

DOI：10.1016/j.autneu.2017.02.004

• Spinal cord injury
• Autonomic nervous system
• Neurogenic shock
• Autonomic dysreflexia
• Heart rate variability
• Echocardiography

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
42 Diagnosis of autonomic dysreflexia
5. Heart rate/electrocardiography following spinal cord injury
5.1 Acute phase
52 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. I

• 出版日期2018-1
• 单位北京大学