Abstract
Study design
Cohort cross-sectional study.
Objective
To investigate the relationship between cardiac vagal activity and left ventricular filling at rest and during vagal stimulation, via the cold face test (CFT), in individuals with spinal cord injury (SCI).
Setting
University-based laboratory at Brock University, St. Catharines, ON, Canada.
Methods
A total of 12 able-bodied (age: 40 ± 8.5 years) and 13 SCI individuals (age: 41 ± 8.5 years; C4-T6; AIS: A–D) were recruited. Cardiac parasympathetic activity was assessed via heart rate variability (HRV) while LV filling was assessed by conventional echocardiography. All indices of HRV and diastolic function were obtained at rest and during cardiac vagal stimulation via the CFT.
Results
At baseline, the able-bodied group demonstrated strong positive correlations between HRV and early diastolic filling; however, such correlations were absent in the SCI group. The CFT resulted in elevated HRV with concomitant bradycardia in the able-bodied group, while the SCI group experienced no change in HRV or heart rate during the CFT. Able-bodied individuals showed a positive correlation between the change in HRV and the change in LV diastole during the CFT, which was attributed to increased cardiac vagal tone and not the change in heart rate, however, no relationships were observed in the SCI group.
Conclusion
In able-bodied individuals, cardiac parasympathetic activity is associated with LV filling at rest and during elevated cardiac vagal tone. After SCI, there is a discord between vagal and LV diastolic activity, where changes in autonomic function do not influence LV filling, suggesting a disconnect between parasympathetic and cardiac function.
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Acknowledgements
Author contributions
HS was responsible for concept, study design, recruitment, data collection, data analysis and manuscript writing. LW was responsible for subject recruitment, data collection and manuscript revision. DO and DD were responsible for study design, manuscript writing and approval of final product.
Funding
This study was funded by the Ontario Neurotrauma Foundation, Toronto, Ontario (Grant No. 2011-ONF-RHI-MT-894). This funding source had no involvement in the preparation of this article and there is no relationship with industry.
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Sharif, H., Wainman, L., O’Leary, D. et al. Cardiac parasympathetic activity and ventricular diastolic interactions in individuals with spinal cord injury. Spinal Cord 57, 419–426 (2019). https://doi.org/10.1038/s41393-018-0224-6
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DOI: https://doi.org/10.1038/s41393-018-0224-6
