The Influence of Corticosteroids on Heart Rate Variablity in Acute Cervical Spinal Cord Injury

Abstract

SUMMARY -Heart rate variability (HRV) gives information on the sympathetic-parasympathetic autonomic balance. Th e aim of the study was to analyze sympathovagal balance after acute spinal cord injury (SCI), demonstrated by linear measures in time and frequency domain of HRV and to analyze the eff ect of corticosteroids on HRV parameters in SCI. Th e study included 40 tetraplegic patients with acute SCI and 40 healthy subjects as control group. In the SCI group, 29 patients received and 11 patients did not receive corticosteroid therapy. All patients underwent 24-hour Holter monitoring for evaluation of HRV. Cardiac autonomic balance was evaluated by analysis of HRV in time and frequency domain. Sympathovagal balance (LF/HF) was signifi cantly reduced in the groups of acute SCI patients, both with and without corticosteroid therapy, as compared with controls. However, there was no statistically signifi cant diff erence between the two SCI groups (1.74 (0524) with and 1.75 (0534) without corticosteroid therapy). Th is study showed the sympathovagal balance to be altered in the acute phase of cervical spinal cord trauma. Finally, there was no eff ect of corticosteroid therapy on HRV parameters in SCI patients.

Cardiac autonomic modulation in response to postural transition during a virtual reality task in individuals with spinal cord injury: A cross-sectional study

“…However, this group (SCI that practiced VR task) was the only one that presented a higher increase in the sympathovagal balance (LF/HF ratio) when changing position from sitting to orthostatism (i.e., this change means an increase in sympathetic activity that represents a more normal ANS adaptation). These results are important for rehabilitation considering that SCI individuals present lower sympathetic dominance [ 16 , 18 , 21 , 58 ] and a VR task could represent a possibility to improve ANS activity.…”

“…It is known that individuals with SCI present reduced HRV and decreased resting heart rate, however, the parasympathetic and sympathetic nervous system profiles need to be more deeply explored [12,[16][17][18][19]. Studies of HRV in SCI are limited and few describe the behavior of the autonomic nervous system (ANS) in postural changes, especially in relation to orthostatism [20][21][22].…”

Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit

“…Since pharmacological treatment (such as the administration of catecholamine) and intervention (such as deepness of sedation) were similar, we hypothesize that eventual differences between non-COVID-19 and COVID-19 patients are due to the autonomic control. The COVID-19 and non-COVID-19 groups differed in regard to the administration of steroids; however, since HP variability indexes are expected to be negligibly affected by corticosteroids [41], the impact on conclusions of the administration of the steroids is limited. As a matter of fact, the σ 2 HP and σ 2 SAP did not vary across populations (i.e., non-COVID-19 and COVID-19 groups) and experimental conditions (i.e., REST and MHUT), and this conclusion held even when the markers were made more specific by assessing the magnitude of variations in frequency bands typical of the vagal and sympathetic controls (i.e., HF HP and LF SAP ) [22][23][24][25]36,37].…”