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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v22.i1-4.10
pages 1-11

Effects of Autonomic Blockade on Heart Rate Variability after Spinal Cord Injury: A Case Series

Lisa M. Cotie
Department of Kinesiology, Brock University, 500 Glenridge Ave., St. Catharines, ON, L2S 3A1 Canada
Tim St. Amand
Department of Family Medicine, McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8 Canada
Richard McMillan
Department of Physical Medicine and Rehabilitation, Hotel Dieu Shaver Hospital, 541 Glenridge Ave., St. Catharines, ON, L2T 4C2 Canada
Peter Picton
University Health Network, Toronto General Hospital, 190 Elizabeth St., Toronto, ON, M5G 2C4 Canada
David S. Ditor
Department of Kinesiology, Brock University, 500 Glenridge Ave., St. Catharines, ON, L2S 3A1 Canada

ABSTRACT

The purpose of this study was to examine the effects of pharmacological cardiac autonomic blockade on heart rate variability (HRV) in individuals with SCI and compare these effects to age, sex, and weight-matched able-bodied controls. Three males (45.8 years) with incomplete tetraplegia and three male (33.0 years) able-bodied controls underwent 10 min of electrocardiogram recordings before and after beta-blockade (metoprolol tartrate) and cholinergic blockade (atropine sulphate), in both the 0 deg−tilt position and during cardiovascular stress (40 deg head-up tilt, cold pressor, and isometric jaw contraction). The cardiac response to such blockade was determined using power spectral analysis. In the three participants with SCI, atropine sulphate was associated with a 99.9, 98.2, and 99.2% reduction in resting high-frequency (HF) power, while metoprolol tartrate was associated with a 72.5, 73.1, and 39.6% decrease in the low-frequency to high-frequency ratio (LF:HF) during cardiovascular stress. Similar changes were experienced by the able-bodied participants. HF power is a valid estimate of cardiac parasympathetic outflow, and cardiac sympathovagal balance contributes to the LF:HF ratio in individuals with SCI. Large-scale studies on the validity of HRV after SCI are warranted, since such measures may gauge autonomic impairment and subsequent improvement.


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