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Sympathetic nervous system activity and cardiovascular homeostasis during head-up tilt in patients with spinal cord injuries

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Abstract

The relationship between sympathetic nervous system activity and cardiovascular responses to head-up tilt in patients with spinal cord injuries and in able-bodied subjects was studied. Twenty-seven adults, nine in each of the three groups (tetraplegia, paraplegia, and able-bodied subjects) were tilted 70°, head up, for 12 minutes after 20 minutes supine rest. Differences between steady-state measurements of mean arterial pressure, stroke volume, and sympathetic nervous system activity were estimated in both positions. Sympathetic nervous system activity was reflected by the low-frequency peak of the blood pressure variability spectrum. From supine rest to head-up tilt, low-frequency power increased in able-bodies subjects (median, 0.42 mm Hg2, p=0.003), which was different (p=0.015) from patients with tetraplegia and paraplegia (−0.15 and −0.10 mm Hg2, respectively). Stroke volume and mean arterial pressure decreased in patients with tetraplegia (−40% and −9 mm Hg, respectively; p=0.008, both variables) more than in ablebodied subjects (−33%, 11 mm Hg, respectively) or patients with paraplegia (−24%, 8 mm Hg, respectively). Results indicated increased sympathetic nervous system activity during head-up tilt in able-bodied subjects, but not in patients with paraplegia or tetraplegia, whereas patients with tetraplegia, but not paraplegia, showed poorer cardiovascular homeostasis than able-bodied subjects. This suggests that patients with paraplegia maintained cardiovascular homeostasis during head-up tilt without increased sympathetic nervous system activity.

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Authors and Affiliations

  1. Department of Physiology 237, University of Nijmegen, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands

    Sibrand Houtman M.Sc. & Berend Oeseburg M.D. Ph.D.

  2. Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada

    Richard L. Hughson Ph.D. & Maria T. E. Hopman M.D., Ph.D.

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  1. Sibrand Houtman M.Sc.
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  2. Berend Oeseburg M.D. Ph.D.
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  3. Richard L. Hughson Ph.D.
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  4. Maria T. E. Hopman M.D., Ph.D.
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Correspondence to Sibrand Houtman M.Sc..

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Houtman, S., Oeseburg, B., Hughson, R.L. et al. Sympathetic nervous system activity and cardiovascular homeostasis during head-up tilt in patients with spinal cord injuries. Clinical Autonomic Research 10, 207–212 (2000). https://doi.org/10.1007/BF02291358

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  • DOI: https://doi.org/10.1007/BF02291358

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