Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9680-9692
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9680
Altered heart rate variability and pulse-wave velocity after spinal cord injury
Hsi-Kai Tsou, Kuan-Chung Shih, Yueh-Chiang Lin, Yi-Ming Li, Hsiao-Yu Chen
Hsi-Kai Tsou, Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung 404, Taiwan
Hsi-Kai Tsou, Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County 356, Taiwan
Hsi-Kai Tsou, College of Health, National Taichung University of Science and Technology, Taichung 403, Taiwan
Hsi-Kai Tsou, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
Kuan-Chung Shih, Research Assistant, The Rong Sing Medical Foundation, Taichung 404, Taiwan
Yueh-Chiang Lin, Research Assistant, Neurological Institute, Taichung Veterans General Hospital, Taichung 404, Taiwan
Yi-Ming Li, Research Assistant, Department of Nursing, National Taichung University of Science and Technology, Taichung 403, Taiwan
Yi-Ming Li, Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei 106, Taiwan
Hsiao-Yu Chen, Department of Nursing, National Taichung University of Science and Technology, Taichung 403, Taiwan
Author contributions: Tsou HK and Chen HY contributed to study conception and design; Tsou HK, Chen HY, Shih KC, Lin YC and Li YM contributed to data collection; Tsou HK, Chen HY and Shih KC did data analysis and interpretation; Tsou HK, Chen HY and Shih KC contributed to drafting of the article; Tsou HK and Chen HY did the critical revision of the article.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of Taichung Jen-Ai Hospital (JAHIRB-108-73). All participants provided signed informed consent prior to participating in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hsiao-Yu Chen, PhD, RN, Department of Nursing, National Taichung University of Science and Technology, No. 193 Sanmin Road, West District, Taichung 403, Taiwan. hychen64@nutc.edu.tw
Received: April 6, 2022
Peer-review started: April 6, 2022
First decision: June 16, 2022
Revised: July 14, 2022
Accepted: August 15, 2022
Article in press: August 15, 2022
Published online: September 26, 2022
Processing time: 157 Days and 16.7 Hours
ARTICLE HIGHLIGHTS
Research background

While a clear correlation has been established between spinal cord injury and cardiovascular disorders, the underlying mechanism is not fully understood. Heart rate variability (HRV) and pulse-wave velocity (PWV), indicators of cardiac function, are altered in patients with spinal cord injury, implicating autonomic cardiac function and arterial stiffness in this mechanism.

Research motivation

While studies have independently assessed HRV or PWV in patients with spinal cord injury, simultaneous assessment to gain a broader view of their cardiovascular condition has not been reported.

Research objectives

The study objective is to elucidate the mechanism underlying cardiovascular complications in spinal cord injury (SCI) patients

Research methods

Short-term HRV and PWV parameters were compared between patients with and without spinal cord injury. All assessments were made using the Medicore HRV Analyzer SA-3000P, which measures HRV time and frequency domain parameters and uses acceleration plethysmography to measure PWV.

Research results

Factors that differed significantly between participants with and without spinal cord injury included the standard deviation of all normal-to-normal intervals, square root of the mean sum of squared successive RR interval differences, physical stress index, total power, very-low frequency, low frequency, high frequency, and arterial elasticity.

Research conclusions

Patients with spinal cord injury have weaker sympathetic and parasympathetic activity as well as lower arterial elasticity compared to those without, suggesting that SCI may increase cardiac function loading.

Research perspectives

Further investigation is needed using multi-center, cohort-matched studies with continuous assessment of HRV and PWV. This non-invasive assessment could be integrated into care programs for SCI patients as an indicator of the need for measures to reduce stress and increase vitality.