Rapid and Extensive Arterial Adaptations After Spinal Cord Injury

Groot, P. C. de; Bleeker, Michiel W. P.; Kuppevelt, Dirk H. van; Woude, Lucas H V van der; Hopman, Maria T. E.

doi:10.1016/j.apmr.2006.01.022

Cited by 79 publications

(93 citation statements)

References 45 publications

(67 reference statements)

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“…These findings do not correspond with the previous results of a decrease in cross-sectional area of the popliteal and femoral vein (Arbeille et al 1999(Arbeille et al , 2001) and the common result of a decreased venous volume variation after bed rest (Bleeker et al , 2005aChrist et al 2001;Louisy et al 1997). The arterial vascular system also presented diameter reductions after deconditioning (Bleeker et al 2005a, b;De Groot et al 2006), but these changes over time were remarkably larger than previously shown in the venous vascular system. This difference in diameter response suggests that the venous and arterial vascular systems are susceptible to different stimuli, when exposed to deconditioning.…”

Section: Discussioncontrasting

confidence: 54%

The effect of bed rest and an exercise countermeasure on leg venous function

et al. 2008

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This study was performed to assess the effect of resistive vibration exercise during bed rest deconditioning on venous vascular dimension and function, as measured with ultrasound in the popliteal vein. Sixteen men were assigned to bed rest (BR-Ctrl) or bed rest with resistive vibration exercise (BR-RVE). Before and at 25 and 52 days of bed rest, popliteal vein diameter was measured at increasing cuff pressures. Venous capacitance and compliance were calculated from the pressure-volume curve. After 52 days of bed rest, BR-Ctrl showed no change in baseline popliteal vein diameter or compliance, while venous capacitance decreased. Resistive vibration exercise had no effect on the response in venous diameter, capacitance or compliance to 52 days of bed rest. The decline in venous capacitance due to long-term bed rest is not effectively counteracted by resistive vibration exercise, indicating that an alternative factor during bed rest deconditioning is responsible for venous changes.

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Section: Discussioncontrasting

confidence: 54%

The effect of bed rest and an exercise countermeasure on leg venous function

et al. 2008

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“…Acute alterations are mediated primarily by changes in sympathetic activity to the smooth muscle, whereas chronic changes are mediated primarily by changes in blood flow and pressure, which alters shear stress and consequently the number of smooth muscle cells in vessel walls. 48 Remodeling of peripheral arteries in paralyzed limbs occurs soon after SCI; within weeks there is a significant reduction in systemic blood volume 49 and a consequent inward remodeling of the arterial wall, 50 such that the diameter of the common femoral artery is 30-50% smaller [51][52][53][54] and resting blood flow in the leg is 30-40% lower than in AB individuals. 54,55 Compared with the inactive lower limbs, the active upper limb vasculature is relatively well preserved.…”

Section: Conduit Arterial Function After Sci Structural Adaptationsmentioning

confidence: 99%

Peripheral vascular function in spinal cord injury: a systematic review

et al. 2012

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Background: During the past 20 years, significant advances in patient care have resulted in individuals with spinal cord injury (SCI) living longer than before. As lifespan increases, cardiovascular complications are emerging as the leading cause of mortality in this population, and individuals with SCI develop cardiovascular disease at younger ages than their able-bodied counterparts. To address this increasing clinical challenge, several recent studies investigated the central cardiovascular adaptations that occur following SCI. However, a somewhat less recognized component of cardiovascular dysfunction in this population is the peripheral vascular adaptations that also occur as a result of SCI. Study design: Literature review.Objective: To present a comprehensive overview of changes in arterial structure and function, which occur after SCI. Setting: Canada. Methods: A systematic literature review was conducted to extract studies that incorporated measures of arterial structure or function after SCI in animals or humans. Results: Individuals with SCI exhibit vascular dysfunction below the lesion that is characterized by a reduction in conduit artery diameter and blood flow, increased shear rate and leg vascular resistance, and adrenoceptor hyper-responsiveness. There is also recent alarming evidence for central arterial stiffening in individuals with SCI. Conclusion: Although physical deconditioning is the primary candidate responsible for the maladaptive remodeling of the peripheral vasculature after SCI, there is emerging evidence that blood pressure oscillations, such as those occurring in the large majority of individuals with SCI, also exacerbates vascular dysfunction in this population.

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“…Arterial remodeling has been shown to occur rapidly following SCI, 19 resulting in decreased arterial diameter 19,20 and increased arterial stiffness. 13,14,21 Elevated artery stiffness assessed using aPWV is associated with a 68% increased risk of CVD events and mortality in able-bodied subjects.…”

Section: Discussionmentioning

confidence: 99%

Applanation tonometry: a reliable technique to assess aortic pulse wave velocity in spinal cord injury

2014

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Study design: Within-subject repeated measures. Objectives: To determine the intra-and inter-tester reliability of aortic pulse wave velocity (aPWV) measurements collected using applanation tonometry in individuals with spinal cord injury (SCI). Setting: Inpatient Rehabilitation Centre and outpatient Clinic in Vancouver, BC, Canada. Methods: Fifteen men and three women with traumatic SCI (age: 46 ± 16 years; C3-L1; American Spinal Injury Association Impairment Scale A-D; 2-284 months post injury) participated in two testing sessions separated by an average of 2 days. During each testing session, aPWV measurements were collected in the supine position following 10 min of rest. Arterial blood pressure waveforms were collected simultaneously by two trained raters at the carotid and femoral arterial sites using applanation tonometry. Heart rate was continuously measured using a single-lead electrocardiogram, whereas brachial blood pressures were measured at 5-min intervals using an automated device. Results: Intra-and inter-tester aPWV measurements demonstrated almost perfect reliability with intraclass correlation coefficients of 0.91 and 0.98 (Po0.001), and coefficients of variation of 5.9% and 3.4%, respectively. The smallest detectable differences (SDDs) for intra-and inter-tester measurements were 0.9 m s À1 and 0.6 m s À1 , respectively. There were no significant differences in heart rate or blood pressure between intra-and inter-testing sessions. Conclusion: Applanation tonometry measurements of aPWV are reliable in individuals with SCI. In addition, the SDDs were smaller than a clinically relevant value, suggesting that this measurement is suitable for repeated measures study designs in SCI. Spinal Cord (2014) 52, 272-275; doi:10.1038/sc.2013.176; published online 21 January 2014 Keywords: arterial stiffness; blood pressure; cardiovascular diseases; reliability INTRODUCTION Cardiovascular disease (CVD) is a leading cause of mortality in individuals living with spinal cord injury (SCI), 1,2 with the incidence of CVD occurring at earlier ages compared with able-bodied individuals. 2 In able-bodied individuals, CVD risk is attributed to non-modifiable factors such as age and gender, and modifiable factors including blood pressure, blood lipid profile, smoking status, physical activity status, body composition and diabetes management. 3 Although individuals with SCI typically present with one or more modifiable risk factors, 2,4 there is evidence to suggest that these risk factors alone may not fully explain the increased risk of CVD in this population. 5 Consequently, future investigations need to examine alternative and non-traditional CVD risk factors for individuals with SCI.Aortic pulse wave velocity (aPWV), which describes the speed of the arterial pressure waveform between the carotid and femoral arterial sites, is considered the gold-standard assessment of arterial stiffness. 6 In able-bodied individuals, elevated aPWV, indicative of increased arterial stiffness, is associated with an increased risk of C...

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Rapid and Extensive Arterial Adaptations After Spinal Cord Injury

Cited by 79 publications

References 45 publications

The effect of bed rest and an exercise countermeasure on leg venous function

The effect of bed rest and an exercise countermeasure on leg venous function

Peripheral vascular function in spinal cord injury: a systematic review

Applanation tonometry: a reliable technique to assess aortic pulse wave velocity in spinal cord injury

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