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

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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 VO2peak 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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Funding

Support for this study was provided by NIH Grants R01HL117037 and ACL NIDILRR Grant 90SI5021-01.

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Authors and Affiliations

  1. Cardiovascular Research Laboratory, Spaulding Rehabilitation Hospital, Cambridge, MA, USA

    Ryan Solinsky, Isabelle Vivodtzev, J. W. Hamner & J. Andrew Taylor

  2. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA

    Ryan Solinsky & J. Andrew Taylor

  3. Spaulding Research Institute, Boston, MA, USA

    Ryan Solinsky & J. Andrew Taylor

Authors
  1. Ryan Solinsky
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  2. Isabelle Vivodtzev
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  3. J. W. Hamner
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  4. J. Andrew Taylor
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Corresponding author

Correspondence to Ryan Solinsky.

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Solinsky, R., Vivodtzev, I., Hamner, J.W. et al. The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training. Clin Auton Res 31, 293–301 (2021). https://doi.org/10.1007/s10286-020-00677-2

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  • DOI: https://doi.org/10.1007/s10286-020-00677-2

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