• Top Spinal Cord Inj Rehabil · Jan 2013

    Cardiovascular function in individuals with incomplete spinal cord injury: a systematic review.

    • Christopher R West, Austin Bellantoni, and Andrei V Krassioukov.
    • International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada.

    BackgroundThere is a clear relationship between the neurological level of spinal cord injury (SCI) and cardiovascular function; however, the relationship between completeness of injury and cardiovascular function is less straightforward. Traditionally completeness of injury has referred to neurological (motor/sensory) completeness. Recently, a number of studies have started to investigate autonomic completeness of injury.ObjectiveTo investigate the relationships between cardiovascular function and neurological and autonomic completeness of injury.MethodsA literature search was conducted in November 2012 through MEDLINE, Embase, and CINAHL. Twenty-one studies were included in this review.ResultsIn acute SCI, there is no clear consensus about whether resting heart rate (HR), blood pressure (BP), or prevalence of BP abnormalities differs between neurologically complete and incomplete SCI. In chronic SCI, there is limited evidence that there is less prevalence of autonomic dysreflexia and improved heart rate variability in response to provocation in neurologically incomplete SCI; however, resting HR and BP appear similar between neurologically complete and incomplete SCI. There is growing evidence that BP and HR at rest and during orthostasis is enhanced in autonomically incomplete SCI. Numerous studies report that neurological completeness does not agree with autonomic completeness of injury.ConclusionsFor acute SCI, there is no clear consensus whether cardiovascular function differs between complete and incomplete. For chronic SCI, the studies to date suggest that autonomic completeness of SCI is more strongly related to cardiovascular function than neurological completeness of injury. Thus, clinicians and scientists should account for autonomic completeness of injury when assessing cardiovascular function in SCI.

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