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Clinical Autonomic Research

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01-04-2021 | Research Article

The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training

Authors: Ryan Solinsky, Isabelle Vivodtzev, J. W. Hamner, J. Andrew Taylor

Published in: Clinical Autonomic Research | Issue 2/2021

Abstract

Purpose

To define differences in heart rate and blood pressure variability (HRV/BPV) after spinal cord injury (SCI) compared with uninjured controls, and to determine whether variabilities are impacted by whole-body exercise after SCI.

Methods

Individuals with SCI (n = 40), aged 18–40, and uninjured age/sex-matched controls (n = 22) had HRV and BPV determined during supine paced (0.25 Hz) breathing. Spectral and cross-spectral values were derived for fluctuations at low (LF 0.05–0.15 Hz) and high (HF 0.20–0.30 Hz) frequencies. Thirty-two individuals with SCI further underwent either 6 months of whole-body exercise training (n = 17) or a control intervention (n = 15).

Results

Individuals with SCI had injuries graded A–C in severity, neurological levels of injury C1–T10. LF and HF HRV and LF BPV were significantly lower in individuals with SCI (p = 0.008–0.002), though HF BPV was similar. The LF cross-spectrum demonstrated similar phase and gain relationships between groups. The HF phase relationship between pressure and heart rate differed markedly: individuals with SCI demonstrated a −11.7 ± 3.4° phase lag (241 ± 70 ms feedback mechanism of pressure into heart rate), whereas uninjured controls demonstrated a +21.5 ± 10.8° phase lead (443 ± 224 ms feedforward mechanism of heart rate into pressure, p = 0.007). Whole-body exercise increased mean VO_2peak by 2.09 ml/kg, whereas HRV, BPV, and their cross-spectral relationships were not significantly altered relative to the control intervention after SCI.

Conclusion

After SCI, marked frequency-specific differences exist in the relationship between heart rate and blood pressure variabilities. The high-frequency cross-spectral relationship indicates that a feedback mechanism of blood pressure into heart rate may predominate in this range.

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Title: The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training
Authors: Ryan Solinsky
Isabelle Vivodtzev
J. W. Hamner
J. Andrew Taylor
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Published in: Clinical Autonomic Research / Issue 2/2021
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-020-00677-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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