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Leszczynski EC, Schwartz NE, McPeek AC, Currie KD, Ferguson DP, Garland T. Selectively breeding for high voluntary physical activity in female mice does not bestow inherent characteristics that resemble eccentric remodeling of the heart, but the mini-muscle phenotype does. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:205-212. [PMID: 37753423 PMCID: PMC10518799 DOI: 10.1016/j.smhs.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/18/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023] Open
Abstract
Physical activity engagement results in a variety of positive health outcomes, including a reduction in cardiovascular disease risk partially due to eccentric remodeling of the heart. The purpose of this investigation was to determine if four replicate lines of High Runner mice that have been selectively bred for voluntary exercise on wheels have a cardiac phenotype that resembles the outcome of eccentric remodeling. Adult females (average age 55 days) from the 4 High Runner and 4 non-selected control lines were anaesthetized via vaporized isoflurane, then echocardiographic images were collected and analyzed for structural and functional differences. High Runner mice in general had lower ejection fractions compared to control mice lines (2-tailed p = 0.023 6) and tended to have thicker walls of the anterior portion of the left ventricle (p = 0.065). However, a subset of the High Runner individuals, termed mini-muscle mice, had greater ejection fraction (p = 0.000 6), fractional shortening percentage (p < 0.000 1), and ventricular mass at dissection (p < 0.002 7 with body mass as a covariate) compared to non-mini muscle mice. Mice from replicate lines bred for high voluntary exercise did not all have inherent positive cardiac functional or structural characteristics, although a genetically unique subset of mini-muscle individuals did have greater functional cardiac characteristics, which in conjunction with their previously described peripheral aerobic enhancements (e.g., increased capillarity) would partially account for their increased V ˙ O2max.
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Affiliation(s)
| | - Nicole E. Schwartz
- Department of Evolution, Ecology, and Organismal Biology, University of California Riverside, Riverside, CA, USA
| | - Ashley C. McPeek
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | | | - David P. Ferguson
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Theodore Garland
- Department of Evolution, Ecology, and Organismal Biology, University of California Riverside, Riverside, CA, USA
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2
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Maugeri G, Amato A, Sortino M, D Agata V, Musumeci G. The Influence of Exercise on Oxidative Stress after Spinal Cord Injury: A Narrative Review. Antioxidants (Basel) 2023; 12:1401. [PMID: 37507940 PMCID: PMC10376509 DOI: 10.3390/antiox12071401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Spinal cord injury (SCI) is an irreversible disease resulting in partial or total loss of sensory and motor function. The pathophysiology of SCI is characterized by an initial primary injury phase followed by a secondary phase in which reactive oxygen species (ROSs) and associated oxidative stress play hallmark roles. Physical exercise is an indispensable means of promoting psychophysical well-being and improving quality of life. It positively influences the neuromuscular, cardiovascular, respiratory, and immune systems. Moreover, exercise may provide a mechanism to regulate the variation and equilibrium between pro-oxidants and antioxidants. After a brief overview of spinal cord anatomy and the different types of spinal cord injury, the purpose of this review is to investigate the evidence regarding the effect of exercise on oxidative stress among individuals with SCI.
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Affiliation(s)
- Grazia Maugeri
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Alessandra Amato
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Martina Sortino
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Velia D Agata
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
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3
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Ely MR, Schleifer GD, Singh TK, Baggish AL, Taylor JA. Exercise Training Does Not Attenuate Cardiac Atrophy or Loss of Function in Individuals With Acute Spinal Cord Injury: A Pilot Study. Arch Phys Med Rehabil 2023; 104:909-917. [PMID: 36572202 PMCID: PMC10247388 DOI: 10.1016/j.apmr.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the effects of 2 modes of exercise training, upper-body alone, and the addition of electrical stimulation of the lower body, to attenuate cardiac atrophy and loss of function in individuals with acute spinal cord injury (SCI). DESIGN Randomized controlled trial. SETTING Rehabilitation Hospital. PARTICIPANTS Volunteers (N=27; 5 women, 22 men) who were <24 months post SCI. INTERVENTIONS Volunteers completed either 6 months of no structured exercise (Control), arm rowing (AO), or a combination of arm rowing with electrical stimulation of lower body paralyzed muscle (functional electrical stimulation [FES] rowing). MAIN OUTCOME MEASURES Transthoracic echocardiography was performed on each subject prior to and 6 months after the intervention. The relations between time since injury and exercise type to cardiac structure and function were assessed via 2-way repeated-measures analysis of variance and with multilevel linear regression. RESULTS Time since injury was significantly associated with a continuous decline in cardiac structure and systolic function, specifically, a reduction in left ventricular mass (0.197 g/month; P=.049), internal diameter during systole (0.255 mm/month; P<.001), and diastole (0.217 mm/month; P=.019), as well as cardiac output (0.048 L/month, P=.019), and left ventricular percent shortening (0.256 %/month; P=.027). These associations were not differentially affected by exercise (Control vs AO vs FES, P>.05). CONCLUSIONS These results indicate that within the subacute phase of recovery from SCI there is a linear loss of left ventricular cardiac structure and systolic function that is not attenuated by current rehabilitative aerobic exercise practices. Reductions in cardiac structure and function may increase the risk of cardiovascular disease in individuals with SCI and warrants further interventions to prevent cardiac decline.
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Affiliation(s)
- Matthew R Ely
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Cambridge, MA.
| | - Grant D Schleifer
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Cambridge, MA
| | - Tamanna K Singh
- Cardiovascular Performance Program, Harvard Medical School, Cambridge, MA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Harvard Medical School, Cambridge, MA
| | - J Andrew Taylor
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Cambridge, MA
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4
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Balthazaar SJT, Nightingale TE, Currie KD, West CR, Tsang TSM, Walter M, Krassioukov AV. Temporal Changes of Cardiac Structure, Function, and Mechanics During Sub-acute Cervical and Thoracolumbar Spinal Cord Injury in Humans: A Case-Series. Front Cardiovasc Med 2022; 9:881741. [PMID: 35783818 PMCID: PMC9240304 DOI: 10.3389/fcvm.2022.881741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with cervical spinal cord injury (SCI) experience deleterious changes in cardiac structure and function. However, knowledge on when cardiac alterations occur and whether this is dependent upon neurological level of injury remains to be determined. Transthoracic echocardiography was used to assess left ventricular structure, function, and mechanics in 10 male individuals (median age 34 years, lower and upper quartiles 32–50) with cervical (n = 5, c-SCI) or thoracolumbar (n = 5, tl-SCI) motor-complete SCI at 3- and 6-months post-injury. Compared to the 3-month assessment, individuals with c-SCI displayed structural, functional, and mechanical changes during the 6-month assessment, including significant reductions in end diastolic volume [121 mL (104–139) vs. 101 mL (99–133), P = 0.043], stroke volume [75 mL (61–85) vs. 60 mL (58–80), P = 0.042], myocardial contractile velocity (S') [0.11 m/s (0.10–0.13) vs. 0.09 m/s (0.08–0.10), P = 0.043], and peak diastolic longitudinal strain rate [1.29°/s (1.23–1.34) vs. 1.07°/s (0.95–1.15), P = 0.043], and increased early diastolic filling over early myocardial relaxation velocity (E/E') ratio [5.64 (4.71–7.72) vs. 7.48 (6.42–8.42), P = 0.043]. These indices did not significantly change in individuals with tl-SCI between time points. Ejection fraction was different between individuals with c-SCI and tl-SCI at 3 [61% (57–63) vs. 54% (52–55), P < 0.01] and 6 months [58% (57–62) vs. 55% (52–56), P < 0.01], though values were considered normal. These results demonstrate that individuals with c-SCI exhibit significant reductions in cardiac function from 3 to 6 months post-injury, whereas individuals with tl-SCI do not, suggesting the need for early rehabilitation to minimize cardiac consequences in this specific population.
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Affiliation(s)
- Shane J. T. Balthazaar
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Tom E. Nightingale
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Science Research, University of Birmingham, Birmingham, United Kingdom
| | - Katharine D. Currie
- Department of Kinesiology, Michigan State University, East Lansing, MI, United States
| | - Christopher R. West
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, UBC, Vancouver, BC, Canada
| | - Teresa S. M. Tsang
- Department of Cardiology, Vancouver General and UBC Hospitals, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, UBC, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
- *Correspondence: Andrei V. Krassioukov
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5
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Evaluation of the Cardiometabolic Disorders after Spinal Cord Injury in Mice. BIOLOGY 2022; 11:biology11040495. [PMID: 35453695 PMCID: PMC9027794 DOI: 10.3390/biology11040495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022]
Abstract
Changes in cardiometabolic functions contribute to increased morbidity and mortality after chronic spinal cord injury. Despite many advancements in discovering SCI-induced pathologies, the cardiometabolic risks and divergences in severity-related responses have yet to be elucidated. Here, we examined the effects of SCI severity on functional recovery and cardiometabolic functions following moderate (50 kdyn) and severe (75 kdyn) contusions in the thoracic-8 (T8) vertebrae in mice using imaging, morphometric, and molecular analyses. Both severities reduced hindlimbs motor functions, body weight (g), and total body fat (%) at all-time points up to 20 weeks post-injury (PI), while only severe SCI reduced the total body lean (%). Severe SCI increased liver echogenicity starting from 12 weeks PI, with an increase in liver fibrosis in both moderate and severe SCI. Severe SCI mice showed a significant reduction in left ventricular internal diameters and LV volume at 20 weeks PI, associated with increased LV ejection fraction as well as cardiac fibrosis. These cardiometabolic dysfunctions were accompanied by changes in the inflammation profile, varying with the severity of the injury, but not in the lipid profile nor cardiac or hepatic tyrosine hydroxylase innervation changes, suggesting that systemic inflammation may be involved in these SCI-induced health complications.
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Fossey MPM, Balthazaar SJT, Squair JW, Williams AM, Poormasjedi-Meibod MS, Nightingale TE, Erskine E, Hayes B, Ahmadian M, Jackson GS, Hunter DV, Currie KD, Tsang TSM, Walter M, Little JP, Ramer MS, Krassioukov AV, West CR. Spinal cord injury impairs cardiac function due to impaired bulbospinal sympathetic control. Nat Commun 2022; 13:1382. [PMID: 35296681 PMCID: PMC8927412 DOI: 10.1038/s41467-022-29066-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 02/20/2022] [Indexed: 02/08/2023] Open
Abstract
Spinal cord injury chronically alters cardiac structure and function and is associated with increased odds for cardiovascular disease. Here, we investigate the cardiac consequences of spinal cord injury on the acute-to-chronic continuum, and the contribution of altered bulbospinal sympathetic control to the decline in cardiac function following spinal cord injury. By combining experimental rat models of spinal cord injury with prospective clinical studies, we demonstrate that spinal cord injury causes a rapid and sustained reduction in left ventricular contractile function that precedes structural changes. In rodents, we experimentally demonstrate that this decline in left ventricular contractile function following spinal cord injury is underpinned by interrupted bulbospinal sympathetic control. In humans, we find that activation of the sympathetic circuitry below the level of spinal cord injury causes an immediate increase in systolic function. Our findings highlight the importance for early interventions to mitigate the cardiac functional decline following spinal cord injury. By combining experimental models with prospective clinical studies, the authors show that spinal cord injury causes a rapid reduction in cardiac function that precedes structural changes, and that the loss of descending sympathetic control is the major cause of reduced cardiac function following spinal cord injury.
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Affiliation(s)
- Mary P M Fossey
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shane J T Balthazaar
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jordan W Squair
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Alexandra M Williams
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Tom E Nightingale
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Trauma Sciences Research, University of Birmingham, Edgabaston, Birmingham, UK
| | - Erin Erskine
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brian Hayes
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Mehdi Ahmadian
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Garett S Jackson
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Diana V Hunter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Katharine D Currie
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Teresa S M Tsang
- Division of Cardiology, University of British Columbia, Vancouver General and University of British Columbia Hospital Echocardiography Department, Vancouver, BC, Canada
| | - Matthias Walter
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Urology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Matt S Ramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Zoology, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. .,Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. .,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. .,GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.
| | - Christopher R West
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. .,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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7
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Flores Á, López-Santos D, García-Alías G. When Spinal Neuromodulation Meets Sensorimotor Rehabilitation: Lessons Learned From Animal Models to Regain Manual Dexterity After a Spinal Cord Injury. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:755963. [PMID: 36188826 PMCID: PMC9397786 DOI: 10.3389/fresc.2021.755963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Electrical neuromodulation has strongly hit the foundations of spinal cord injury and repair. Clinical and experimental studies have demonstrated the ability to neuromodulate and engage spinal cord circuits to recover volitional motor functions lost after the injury. Although the science and technology behind electrical neuromodulation has attracted much of the attention, it cannot be obviated that electrical stimulation must be applied concomitantly to sensorimotor rehabilitation, and one would be very difficult to understand without the other, as both need to be finely tuned to efficiently execute movements. The present review explores the difficulties faced by experimental and clinical neuroscientists when attempting to neuromodulate and rehabilitate manual dexterity in spinal cord injured subjects. From a translational point of view, we will describe the major rehabilitation interventions employed in animal research to promote recovery of forelimb motor function. On the other hand, we will outline some of the state-of-the-art findings when applying electrical neuromodulation to the spinal cord in animal models and human patients, highlighting how evidences from lumbar stimulation are paving the path to cervical neuromodulation.
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Affiliation(s)
- África Flores
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
| | - Diego López-Santos
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
| | - Guillermo García-Alías
- Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
- Institut Guttmann de Neurorehabilitació, Badalona, Spain
- *Correspondence: Guillermo García-Alías
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8
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Soriano JE, Romac R, Squair JW, Barak OF, Sarafis ZK, Lee AH, Coombs GB, Vaseghi B, Grant C, Charbonneau R, Mijacika T, Krassioukov A, Ainslie PN, Larkin-Kaiser KA, Phillips A, Dujic Z. Passive leg cycling increases activity of the cardiorespiratory system in people with tetraplegia. Appl Physiol Nutr Metab 2021; 47:269-277. [PMID: 34739759 DOI: 10.1139/apnm-2021-0523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Individuals with cervical spinal cord injury (SCI) are at an increased risk for cardiovascular disease. Exercise is well-established for preventing cardiovascular disease, however, there are limited straightforward and safe exercise approaches for increasing the activity of the cardiorespiratory system after cervical SCI. The objective of this study was to investigate the cardiorespiratory response to passive leg cycling in people with cervical SCI. Beat-by-beat blood pressure, heart rate, and cerebral blood flow were measured before and throughout 10 minutes of cycling in 11 people with SCI. Femoral artery flow-mediated dilation was also assessed before and immediately after passive cycling. Safety was monitored throughout all study visits. Passive cycling elevated systolic blood pressure (5±2 mmHg), mean arterial pressure (5±3 mmHg), stroke volume (2.4±0.8 mL), heart rate (2±1 beats/min) and cardiac output (0.3±0.07 L/min; all p<0.05). Minute ventilation (0.67±0.23 L/min), tidal volume (70±30 mL) and end-tidal PO2 (2.6±1.23 mmHg) also increased (all p<0.05). Endothelial function was improved immediately after exercise (1.62±0.13%, p<0.01). Passive cycling resulted in one incidence of autonomic dysreflexia. Therefore, passive leg cycling increased the activity of the cardiorespiratory system, improved endothelial function, indicating it may be a beneficial exercise intervention for the cardiovascular and respiratory systems in people with cervical SCI. Novelty: ● Passive leg cycling increases the activity of the cardiorespiratory system and improves markers of cardiovascular health in cervical SCI. ● Passive leg cycling exercise is an effective, low-cost, practical, alternative exercise modality for people with cervical SCI.
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Affiliation(s)
- Jan Elaine Soriano
- University of Calgary, 2129, Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Calgary, Alberta, Canada;
| | - Rinaldo Romac
- Clinical Hospital Center Split, Department of Neurology, Split, Croatia;
| | - Jordan W Squair
- University of Calgary, 2129, Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Calgary, Alberta, Canada.,University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada;
| | - Otto F Barak
- University of Novi Sad, 84981, Faculty of Medicine, Novi Sad, Serbia;
| | - Zoe K Sarafis
- University of British Columbia, Faculty of Medicine , Vancouver, Canada.,ETH Zurich, 27219, Department of Health Sciences and Technology, Zurich, Switzerland;
| | - Amanda Hx Lee
- University of British Columbia, Faculty of Medicine , Vancouver, British Columbia, Canada.,University of British Columbia, Department of Experimental Medicine, Vancouver, British Columbia, Canada;
| | - Geoff B Coombs
- The University of British Columbia Okanagan, 97950, Centre for Heart, Lung, and Vascular Health, Kelowna, British Columbia, Canada;
| | - Bita Vaseghi
- University of Calgary, 2129, Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Calgary, Alberta, Canada.,University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada;
| | - Christopher Grant
- University of Calgary, 2129, Department of Clinical Neurosciences, Calgary, Alberta, Canada;
| | - Rebecca Charbonneau
- University of Calgary, 2129, Department of Clinical Neurosciences, Calgary, Alberta, Canada;
| | - Tanja Mijacika
- University of Split, 74422, Department of Integrative Physiology, Split, Croatia;
| | - Andrei Krassioukov
- University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada.,The University of British Columbia, 8166, Division of Physical Medicine & Rehabilitation, Vancouver, British Columbia, Canada.,G F Strong Rehabilitation Hospital, 103221, Vancouver, British Columbia, Canada;
| | - Philip N Ainslie
- University of British Columbia, Centre for Heart, Lung and Vascular Health, Kelowna, British Columbia, Canada;
| | - Kelly A Larkin-Kaiser
- University of Calgary, Departments of Physiology and Pharmacology, Cardiac Sciences, & Clinical Neurosciences, Calgary, Alberta, Canada;
| | - Aaron Phillips
- University of Calgary, 2129, Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Calgary, Canada, T2N 1N4;
| | - Zeljko Dujic
- University of Split School of Medicine, Department of Integrative Physiology, Split, Splitsko-dalmatinska, Croatia;
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9
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Development of a Spinal Cord Injury Model Permissive to Study the Cardiovascular Effects of Rehabilitation Approaches Designed to Induce Neuroplasticity. BIOLOGY 2021; 10:biology10101006. [PMID: 34681105 PMCID: PMC8533334 DOI: 10.3390/biology10101006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022]
Abstract
Simple Summary People living with high-level spinal cord injury experience worse cardiovascular health than the general population. In most spinal cord injuries, there are some remaining functioning pathways leading from the brain through the spinal cord to the organs and muscles, but not enough to sustain normal levels of function. Recently, therapies that aim to increase the strength of connections in these remaining pathways have shown great potential in restoring walking, hand, and breathing function in the spinal cord injured population. In order to test these therapies for their effects on cardiovascular function, we developed a new type of spinal cord injury rat model that spares enough pathways for these therapies to act upon but still produces measurable reductions in heart and blood vessel function that can be targeted with interventions/treatments. Abstract As primary medical care for spinal cord injury (SCI) has improved over the last decades there are more individuals living with neurologically incomplete (vs. complete) cervical injuries. For these individuals, a number of promising therapies are being actively researched in pre-clinical settings that seek to strengthen the remaining spinal pathways with a view to improve motor function. To date, few, if any, of these interventions have been tested for their effectiveness to improve autonomic and cardiovascular (CV) function. As a first step to testing such therapies, we aimed to develop a model that has sufficient sparing of descending sympathetic pathways for these interventions to target yet induces robust CV impairment. Twenty-six Wistar rats were assigned to SCI (n = 13) or naïve (n = 13) groups. Animals were injured at the T3 spinal segment with 300 kdyn of force. Fourteen days post-SCI, left ventricular (LV) and arterial catheterization was performed to assess in vivo cardiac and hemodynamic function. Spinal cord lesion characteristics along with sparing in catecholaminergic and serotonergic projections were determined via immunohistochemistry. SCI produced a decrease in mean arterial pressure of 17 ± 3 mmHg (p < 0.001) and left ventricular contractility (end-systolic elastance) of 0.7 ± 0.1 mmHg/µL (p < 0.001). Our novel SCI model produced significant decreases in cardiac and hemodynamic function while preserving 33 ± 9% of white matter at the injury epicenter, which we believe makes it a useful pre-clinical model of SCI to study rehabilitation approaches designed to induce neuroplasticity.
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10
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Hayes BD, Fossey MPM, Poormasjedi-Meibod MS, Erskine E, Soriano JE, Scott B, Rosentreter R, Granville DJ, Phillips AA, West CR. Experimental high thoracic spinal cord injury impairs the cardiac and cerebrovascular response to orthostatic challenge in rats. Am J Physiol Heart Circ Physiol 2021; 321:H716-H727. [PMID: 34448635 DOI: 10.1152/ajpheart.00239.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022]
Abstract
Spinal cord injury (SCI) impairs the cardiovascular responses to postural challenge, leading to the development of orthostatic hypotension (OH). Here, we apply lower body negative pressure (LBNP) to rodents with high-level SCI to demonstrate the usefulness of LBNP as a model for experimental OH studies, and to explore the effect of simulated OH on cardiovascular and cerebrovascular function following SCI. Male Wistar rats (n = 34) were subjected to a sham or T3-SCI surgery and survived into the chronic period postinjury (i.e., 8 wk). Cardiac function was tracked via ultrasound pre- to post-SCI to demonstrate the clinical utility of our model. At study termination, we conducted left-ventricular (LV) catheterization and insonated the middle cerebral artery to investigate the hemodynamic, cardiac, and cerebrovascular response to a mild dose of LBNP that is sufficient to mimic clinically defined OH in rats with T3-SCI but not sham animals. In response to mimicked OH, there was a greater decline in stroke volume, cardiac output, maximal LV pressure, and blood pressure in SCI compared with sham (P < 0.034), whereas heart rate was increased in sham but decreased in SCI (P < 0.029). SCI animals also had an exaggerated reduction in peak, minimum and mean middle cerebral artery flow, for a given change in blood pressure, in response to LBNP (P < 0.033), implying impaired dynamic cerebral autoregulation. Using a preclinical SCI model of OH, we demonstrate that complete high thoracic SCI impairs the cardiac response to OH and disrupts dynamic cerebral autoregulation.NEW & NOTEWORTHY This is the first use of LBNP to interrogate the cardiac and cerebrovascular responses to simulated OH in a preclinical study of SCI. Here, we demonstrate the utility of our simulated OH model and use it to demonstrate that SCI impairs the cardiac response to simulated OH and disrupts dynamic cerebrovascular autoregulation.
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Affiliation(s)
- Brian D Hayes
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary Pauline Mona Fossey
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Erin Erskine
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jan Elaine Soriano
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Berkeley Scott
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ryan Rosentreter
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David J Granville
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christopher R West
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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11
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Ely MR, Singh TK, Baggish AL, Taylor JA. Reductions in Cardiac Structure and Function 24 Months After Spinal Cord Injury: A Cross-Sectional Study. Arch Phys Med Rehabil 2021; 102:1490-1498. [PMID: 33556347 PMCID: PMC8339187 DOI: 10.1016/j.apmr.2021.01.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/11/2020] [Accepted: 01/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the alterations in cardiac structure and function that occur in the months after spinal cord injury (SCI). STUDY DESIGN Cross-sectional SETTING: Rehabilitation Hospital PARTICIPANTS: Volunteers (N=29; 4 women, 25 men) between 3 and 24 months after SCI. MAIN OUTCOME MEASURES Transthoracic echocardiography was performed on each volunteer. The relationships between time since injury and neurologic and sensory levels of injury to cardiac structure and function were assessed via multiple linear regression. RESULTS Time since injury was most strongly associated with reductions in left ventricular end diastolic volume (r2=0.156; P=.034), end systolic volume (r2=0.141; P=.045), and mass (r2=0.138; P=.047). These structural changes were paralleled by reduced stroke volume (r2=0.143; P=.043) and cardiac output (r2=0.317; P=<.001). The reductions in left ventricular structure and systolic function were not differentially affected by neurologic or sensory levels of injury (P=.084-.921). CONCLUSIONS These results suggest progressive reductions in left ventricular structure and systolic function between 3 and 24 months after SCI that occur independent of neurologic and sensory levels of injury.
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Affiliation(s)
- Matthew R Ely
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, United States.
| | - Tamanna K Singh
- Cardiovascular Performance Program, Harvard Medical School, Cambridge, Massachusetts, United States
| | - Aaron L Baggish
- Cardiovascular Performance Program, Harvard Medical School, Cambridge, Massachusetts, United States
| | - J Andrew Taylor
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, United States
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12
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Harman KA, DeVeau KM, Squair JW, West CR, Krassioukov AV, Magnuson DSK. Effects of early exercise training on the severity of autonomic dysreflexia following incomplete spinal cord injury in rodents. Physiol Rep 2021; 9:e14969. [PMID: 34337884 PMCID: PMC8327165 DOI: 10.14814/phy2.14969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/04/2022] Open
Abstract
Hemodynamic instability and cardiovascular (CV) dysfunction are hallmarks of patients living with cervical and high thoracic spinal cord injuries (SCI). Individuals experience bouts of autonomic dysreflexia (AD) and persistent hypotension which hamper the activities of daily living. Despite the widespread use of exercise training to improve health and CV function after SCI, little is known about how different training modalities impact hemodynamic stability and severity of AD in a model of incomplete SCI. In this study, we used implantable telemetry devices to assess animals with T2 contusions following 3.5 weeks of exercise training initiated 8 days post-injury: passive hindlimb cycling (T2-CYC, n = 5) or active forelimb swimming (T2-SW, n = 6). Uninjured and non-exercised SCI control groups were also included (CON, n = 6; T2-CON, n = 7; T10-CON, n = 6). Five weeks post-injury, both T2-CON and T2-CYC presented with resting hypotension compared to uninjured CON and T10-CON groups; no differences were noted in resting blood pressure in T2-SW versus CON and T10-CON. Furthermore, pressor responses to colorectal distention (AD) were larger in all T2-injured groups compared to T10-CON, and were not attenuated by either form of exercise training. Interestingly, when T2-injured animals were re-stratified based on terminal BBB scores (regardless of training group), animals with limited hindlimb recovery (T2-LOW, n = 7) had more severe AD responses. Our results suggest that the spontaneous recovery of locomotor and autonomic function after severe but incomplete T2 SCI also influences the severity of AD, and that short periods (3.5 weeks) of passive hindlimb cycling or active forelimb swimming are ineffective in this model.
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Affiliation(s)
- Kathryn A. Harman
- Department of Health & Sport SciencesUniversity of LouisvilleLouisvilleKYUSA
- Kentucky Spinal Cord Injury Research CenterUniversity of LouisvilleLouisvilleKYUSA
| | - Kathryn M. DeVeau
- Department of Anatomy and Cell BiologyGeorge Washington UniversityWashingtonD.C.USA
| | - Jordan W. Squair
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
| | - Christopher R. West
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
| | - Andrei V. Krassioukov
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
- GF Strong Rehabilitation CentreVancouver Health AuthorityVancouverCanada
| | - David S. K. Magnuson
- Kentucky Spinal Cord Injury Research CenterUniversity of LouisvilleLouisvilleKYUSA
- Department of Neurological SurgeryUniversity of LouisvilleLouisvilleKYUSA
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13
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Effects of 16-Form Wheelchair Tai Chi on the Autonomic Nervous System among Patients with Spinal Cord Injury. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6626603. [PMID: 33354221 PMCID: PMC7737450 DOI: 10.1155/2020/6626603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/04/2020] [Accepted: 11/17/2020] [Indexed: 11/21/2022]
Abstract
Objective This study aims to investigate the effects of 16-form Wheelchair Tai Chi (WCTC16) on the autonomic nervous system among patients with spinal cord injury (SCI). Methods Twenty patients with chronic complete thoracic SCI were recruited. Equivital life monitoring system was used to record and analyze heart rate variability (HRV) of patients for five minutes before and after five consecutive sets of WCTC16, respectively. The analysis of HRV in the time domain included RR intervals, the standard deviation of all normal RR intervals (SDNN), and the root mean square of the differences between adjacent NN intervals (RMSSD). The analysis of HRV in the frequency domain included total power (TP), which could be divided into very-low-frequency area (VLFP), low-frequency area (LFP), and high-frequency area (HFP). The LF/HF ratio as well as the normalized units of LFP (LFPnu) and HFP (HFPnu) reflected the sympathovagal balance. Results There was no significant difference in RR interval, SDNN, RMSSD, TP, HEP, VLFP, and LFP of SCI patients before and after WCTC16 exercise (P > 0.05). LFPnu and HF peak decreased, while HFPnu and LF/HF increased in SCI patients after WCTC16 exercise. The differences were statistically significant (P < 0.001). Conclusion WCTC16 can enhance vagal activity and decrease sympathetic activity so that patients with chronic complete thoracic SCI can achieve the balanced sympathovagal tone.
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14
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Williams AM, Manouchehri N, Erskine E, Tauh K, So K, Shortt K, Webster M, Fisk S, Billingsley A, Munro A, Tigchelaar S, Streijger F, Kim KT, Kwon BK, West CR. Cardio-centric hemodynamic management improves spinal cord oxygenation and mitigates hemorrhage in acute spinal cord injury. Nat Commun 2020; 11:5209. [PMID: 33060602 PMCID: PMC7562705 DOI: 10.1038/s41467-020-18905-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 09/14/2020] [Indexed: 12/29/2022] Open
Abstract
Chronic high-thoracic and cervical spinal cord injury (SCI) results in a complex phenotype of cardiovascular consequences, including impaired left ventricular (LV) contractility. Here, we aim to determine whether such dysfunction manifests immediately post-injury, and if so, whether correcting impaired contractility can improve spinal cord oxygenation (SCO2), blood flow (SCBF) and metabolism. Using a porcine model of T2 SCI, we assess LV end-systolic elastance (contractility) via invasive pressure-volume catheterization, monitor intraparenchymal SCO2 and SCBF with fiberoptic oxygen sensors and laser-Doppler flowmetry, respectively, and quantify spinal cord metabolites with microdialysis. We demonstrate that high-thoracic SCI acutely impairs cardiac contractility and substantially reduces SCO2 and SCBF within the first hours post-injury. Utilizing the same model, we next show that augmenting LV contractility with the β-agonist dobutamine increases SCO2 and SCBF more effectively than vasopressor therapy, whilst also mitigating increased anaerobic metabolism and hemorrhage in the injured cord. Finally, in pigs with T2 SCI survived for 12 weeks post-injury, we confirm that acute hemodynamic management with dobutamine appears to preserve cardiac function and improve hemodynamic outcomes in the chronic setting. Our data support that cardio-centric hemodynamic management represents an advantageous alternative to the current clinical standard of vasopressor therapy for acute traumatic SCI.
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Affiliation(s)
- Alexandra M Williams
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Neda Manouchehri
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Erin Erskine
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Keerit Tauh
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Kitty So
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Katelyn Shortt
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Megan Webster
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Shera Fisk
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Avril Billingsley
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Alex Munro
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Seth Tigchelaar
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Femke Streijger
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Kyoung-Tae Kim
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Neurosurgery, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Brian K Kwon
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - Christopher R West
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada. .,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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15
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Järve A, Qadri F, Todiras M, Schmolke S, Bader M. Angiotensin-II receptor type Ia does not contribute to cardiac atrophy following high-thoracic spinal cord injury in mice. Exp Physiol 2020; 105:1316-1325. [PMID: 32515106 DOI: 10.1113/ep088378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 06/03/2020] [Indexed: 12/27/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the role of the renin-angiotensin system with angiotensin II acting via its receptor AT1a in spinal cord injury-induced cardiac atrophy? What is the main finding and its importance? Knockout of AT1a did not protect mice that had undergone thoracic level 4 transection from cardiac atrophy. There were no histopathological signs but there was reduced load-dependent left ventricular function (lower stroke volume and cardiac output) with preserved ejection fraction. ABSTRACT Spinal cord injury (SCI) leads to cardiac atrophy often accompanied by functional deficits. The renin-angiotensin system (RAS) with angiotensin II (AngII) signalling via its receptor AT1a might contribute to cardiac atrophy post-SCI. We performed spinal cord transection at thoracic level T4 (T4-Tx) or sham-operation in female wild-type mice (WT, n = 27) and mice deficient in AT1a (Agtr1a-/- , n = 27). Echocardiography (0, 7, 21 and 28 days post-SCI) and histology and gene expression analyses at 1 and 2 months post-SCI were performed. We found cardiac atrophy post-SCI: reduced heart weight, reduced estimated left ventricular mass in Agtr1a-/- , and reduced cardiomyocyte diameter in WT mice. Although, the latter as well as stroke volume (SV) and cardiac output (CO) were reduced in Agtr1a-/- mice already at baseline, cardiomyocyte diameter was even smaller in injured Agtr1a-/- mice compared to injured WT mice. SV and CO were reduced in WT mice post-SCI. Ejection fraction and fractional shortening were preserved post-SCI in both genotypes. There were no histological signs of fibrosis and pathology in the cardiac sections of either genotype post-SCI. Gene expression of Agtr1a showed a trend for up-regulation at 2 months post-SCI; angiotensinogen was up-regulated at 2 month post-SCI in both genotypes. AngII receptor type 2 (Agtr2) was up- and down-regulated at 1 and 2 months post-SCI in WT mice, respectively, and Ang-(1-7) receptor (Mas) at 1 and 2 months post-SCI. Atrogin-1/MAFbx and MuRF1, atrophy markers, were not significantly up-regulated post-SCI. Our data show that lack of AT1a does not protect from cardiac atrophy post-SCI.
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Affiliation(s)
- Anne Järve
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Fatimunnisa Qadri
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Mihail Todiras
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,Nicolae Testemițanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Shirley Schmolke
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Michael Bader
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute for Biology, University of Lübeck, Lübeck, Germany
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16
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Järve A, Qadri F, Todiras M, Schmolke S, Alenina N, Bader M. Angiotensin-(1-7) Receptor Mas Deficiency Does Not Exacerbate Cardiac Atrophy Following High-Level Spinal Cord Injury in Mice. Front Physiol 2020; 11:203. [PMID: 32226394 PMCID: PMC7080696 DOI: 10.3389/fphys.2020.00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/21/2020] [Indexed: 11/13/2022] Open
Abstract
Experimental spinal cord injury (SCI) causes a morphological and functional deterioration of the heart, in which the renin–angiotensin system (RAS) might play a role. The recently discovered non-canonical axis of RAS with angiotensin-(1–7) and its receptor Mas, which is associated with cardioprotection could be essential to prevent damage to the heart following SCI. We investigated the cardiac consequences of SCI and the role of Mas in female wild-type (WT, n = 22) and mice deficient of Mas (Mas–/–, n = 25) which underwent spinal cord transection at thoracic level T4 (T4-Tx) or sham-operation by echocardiography (0, 7, 21, and 28 days post-SCI), histology and gene expression analysis at 1 or 2 months post-SCI. We found left ventricular mass reduction with preserved ejection fraction (EF) and fractional shortening in WT as well as Mas–/– mice. Cardiac output was reduced in Mas–/– mice, whereas stroke volume (SV) was reduced in WT T4-Tx mice. Echocardiographic indices did not differ between the genotypes. Smaller heart weight (HW) and smaller cardiomyocyte diameter at 1 month post-SCI compared to sham mice was independent of genotype. The muscle-specific E3 ubiquitin ligases Atrogin-1/MAFbx and MuRF1 were upregulated or showed a trend for upregulation in WT mice at 2 months post-SCI, respectively. Angiotensinogen gene expression was upregulated at 1 month post-SCI and angiotensin II receptor type 2 downregulated at 2 month post-SCI in Mas–/– mice. Mas was downregulated post-SCI. Cardiac atrophy following SCI, not exacerbated by lack of Mas, is a physiological reaction as there were no signs of cardiac pathology and dysfunction.
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Affiliation(s)
- Anne Järve
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany.,Partner Site Berlin, German Center for Cardiovascular Research, Berlin, Germany
| | - Fatimunnisa Qadri
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany
| | - Mihail Todiras
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany.,Nicolae Testemiţanu State University of Medicine and Pharmacy, Chişinãu, Moldova
| | - Shirley Schmolke
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany
| | - Natalia Alenina
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany.,Partner Site Berlin, German Center for Cardiovascular Research, Berlin, Germany
| | - Michael Bader
- Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers, Berlin, Germany.,Partner Site Berlin, German Center for Cardiovascular Research, Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute for Biology, University of Lübeck, Lübeck, Germany
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17
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Ghnenis AB, Burns DT, Osimanjiang W, He G, Bushman JS. A Long-Term Pilot Study on Sex and Spinal Cord Injury Shows Sexual Dimorphism in Functional Recovery and Cardio-Metabolic Responses. Sci Rep 2020; 10:2762. [PMID: 32066802 PMCID: PMC7026076 DOI: 10.1038/s41598-020-59628-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/28/2020] [Indexed: 12/25/2022] Open
Abstract
More than a quarter of a million individuals in the US live with spinal cord injury (SCI). SCI disrupts neural circuitry to vital organs in the body. Despite severe incidences of long-term peripheral complications from SCI, the cardio-metabolic consequences and divergences in sex-related responses are not well described. We examined the effects of SCI on functional recovery, cardiac structure and function, body composition, and glucose metabolism on adult female and male Sprague Dawley (SD) rats. SCI was induced at T10 via contusion. Measured outcomes include behavioral assessment, body weight, dual-energy X-ray absorptiometry (DEXA) for body composition, echocardiography for cardiac structure and function, intraperitoneal glucose tolerance test (IPGTT) for glucose metabolism, insulin tolerance test (ITT), and histology of cardiac structure at the endpoint. There was a decrease in body fat percentage in both sexes, with SCI females disproportionately affected in percent body fat change. Left ventricular internal diameter during systole (LVIDs) was decreased in SCI females more than in SCI males. No significant differences in glucose metabolism were observed up to 20 weeks post-injury (PI). These data show significant cardio-metabolic differences as a consequence of SCI and, furthermore, that sex is an underlying factor in these differences.
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Affiliation(s)
- Adel B Ghnenis
- University of Wyoming School of Pharmacy, 1000 East University Avenue, Department 3375, Laramie, WY, 82071, USA
| | - Daniel T Burns
- University of Wyoming School of Pharmacy, 1000 East University Avenue, Department 3375, Laramie, WY, 82071, USA
| | - Wupu Osimanjiang
- University of Wyoming School of Pharmacy, 1000 East University Avenue, Department 3375, Laramie, WY, 82071, USA
| | - Guanglong He
- University of Wyoming School of Pharmacy, 1000 East University Avenue, Department 3375, Laramie, WY, 82071, USA
| | - Jared S Bushman
- University of Wyoming School of Pharmacy, 1000 East University Avenue, Department 3375, Laramie, WY, 82071, USA.
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18
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Harman KA, States G, Wade A, Stepp C, Wainwright G, DeVeau K, King N, Shum-Siu A, Magnuson DSK. Temporal analysis of cardiovascular control and function following incomplete T3 and T10 spinal cord injury in rodents. Physiol Rep 2019; 6:e13634. [PMID: 29595874 PMCID: PMC5875543 DOI: 10.14814/phy2.13634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/05/2018] [Indexed: 11/24/2022] Open
Abstract
Spinal cord injury (SCI) is a devastating condition that results in whole‐body dysfunction, notably cardiovascular (CV) disruption and disease. Injury‐induced destruction of autonomic pathways in conjunction with a progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Despite the wide use of exercise training as a therapeutic option to reduce CV dysfunction, little is known about the acute hemodynamic responses to the exercise itself. We investigated CV responses to an exercise challenge (swimming) following both high and low thoracic contusion to determine if the CV system is able to respond appropriately to the challenge of swimming. Blood pressure (BP) telemetry and echocardiography were used to track the progression of dysfunction in rodents with T3 and T10 SCI (n = 8 each) for 10 weeks postcontusion. At 1 week postinjury, all animals displayed a drastic decline in heart rate (HR) during the exercise challenge, likely a consequence of neurogenic shock. Furthermore, over time, all groups developed a progressive inability to maintain BP within a narrow range during the exercise challenge despite displaying normal hemodynamic parameters at rest. Echocardiography of T10 animals revealed no persistent signs of cardiac dysfunction; T3 animals exhibited a transient decline in systolic function that returned to preinjury levels by 10 weeks postinjury. Novel evidence provided here illustrates that incomplete injuries produce hemodynamic instability that only becomes apparent during an exercise challenge. Further, this dysfunction lasts into the chronic phase of disease progression despite significant recovery of hindlimb locomotion and cardiac function.
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Affiliation(s)
- Kathryn A Harman
- Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky.,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Gregory States
- Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky.,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Abigail Wade
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Biomedical Engineering, University of Louisville, Louisville, Kentucky
| | - Chad Stepp
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Biomedical Engineering, University of Louisville, Louisville, Kentucky
| | - Grace Wainwright
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Biomedical Engineering, University of Louisville, Louisville, Kentucky
| | - Kathryn DeVeau
- Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky.,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Nicholas King
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Biomedical Engineering, University of Louisville, Louisville, Kentucky
| | - Alice Shum-Siu
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - David S K Magnuson
- Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky.,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Biomedical Engineering, University of Louisville, Louisville, Kentucky
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19
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Krassioukov AV, Currie KD, Hubli M, Nightingale TE, Alrashidi AA, Ramer L, Eng JJ, Ginis KAM, MacDonald MJ, Hicks A, Ditor D, Oh P, Verrier MC, Craven BC. Effects of exercise interventions on cardiovascular health in individuals with chronic, motor complete spinal cord injury: protocol for a randomised controlled trial [Cardiovascular Health/Outcomes: Improvements Created by Exercise and education in SCI (CHOICES) Study]. BMJ Open 2019; 9:e023540. [PMID: 30612110 PMCID: PMC6326283 DOI: 10.1136/bmjopen-2018-023540] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Recent studies demonstrate that cardiovascular diseases and associated complications are the leading cause of morbidity and mortality in individuals with spinal cord injury (SCI). Abnormal arterial stiffness, defined by a carotid-to-femoral pulse wave velocity (cfPWV) ≥10 m/s, is a recognised risk factor for heart disease in individuals with SCI. There is a paucity of studies assessing the efficacy of conventional training modalities on arterial stiffness and other cardiovascular outcomes in this population. Therefore, this study aims to compare the efficacy of arm cycle ergometry training (ACET) and body weight-supported treadmill training (BWSTT) on reducing arterial stiffness in individuals with chronic motor complete, high-level (above the sixth thoracic segment) SCI. METHODS AND ANALYSIS This is a multicentre, randomised, controlled, clinical trial. Eligible participants will be randomly assigned (1:1) into either ACET or BWSTT groups. Sixty participants with chronic (>1 year) SCI will be recruited from three sites in Canada (Vancouver, Toronto and Hamilton). Participants in each group will exercise three times per week up to 30 min and 60 min for ACET and BWSTT, respectively, over the period of 6 months. The primary outcome measure will be change in arterial stiffness (cfPWV) from baseline. Secondary outcome measures will include comprehensive assessments of: (1) cardiovascular parameters, (2) autonomic function, (3) body composition, (4) blood haematological and metabolic profiles, (5) cardiorespiratory fitness and (6) quality of life (QOL) and physical activity outcomes. Outcome measures will be assessed at baseline, 3 months, 6 months and 12 months (only QOL and physical activity outcomes). Statistical analyses will apply linear-mixed modelling to determine the training (time), group (ACET vs BWSTT) and interaction (time × group) effects on all outcomes. ETHICS AND DISSEMINATION Ethical approval was obtained from all three participating sites. Primary and secondary outcome data will be submitted for publication in peer-reviewed journals and widely disseminated. TRIAL REGISTRATION NUMBER NCT01718977; Pre-results. TRIAL STATUS Recruitment for this study began on January 2013 and the first participant was randomized on April 2013. Recruitment stopped on October 2018.
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Affiliation(s)
- Andrei V Krassioukov
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Katharine D Currie
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Michèle Hubli
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Balgrist University Hospital, University of Zurich, Zurich, Swaziland
| | - Tom E Nightingale
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Abdullah A Alrashidi
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Physical Therapy Department, King Fahd Medical City, Riyadh, Saudi Arabia
| | - Leanne Ramer
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Janice J Eng
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathleen A Martin Ginis
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Southern Medical Program, School of Health & Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Audrey Hicks
- Spinal Cord Injury Centre, McMaster University, Hamilton, Ontario, Canada
| | - Dave Ditor
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Paul Oh
- Department of Medicine University Health Network, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Molly C Verrier
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Beverly Catharine Craven
- Department of Medicine University Health Network, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
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20
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Poormasjedi-Meibod MS, Mansouri M, Fossey M, Squair JW, Liu J, McNeill JH, West CR. Experimental Spinal Cord Injury Causes Left-Ventricular Atrophy and Is Associated with an Upregulation of Proteolytic Pathways. J Neurotrauma 2018; 36:950-961. [PMID: 29877162 DOI: 10.1089/neu.2017.5624] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) causes autonomic dysfunction, altered neurohumoral control, profound hemodynamic changes, and an increased risk of heart disease. In this prospective study, we investigated the cardiac consequences of chronic experimental SCI in rats by combining cutting edge in vivo techniques (magnetic resonance imaging [MRI] and left-ventricular [LV] pressure-volume catheterization) with histological and molecular assessments. Twelve weeks post-SCI, MRI-derived structural indices and in vivo LV catheterization-derived functional indices indicated the presence of LV atrophy (LV mass in Control vs. SCI = 525 ± 38.8 vs. 413 ± 28.6 mg, respectively; p = 0.0009), reduced ventricular volumes (left-ventricular end-diastolic volume in Control vs. SCI = 364 ± 44 vs. 221 ± 35 μL, respectively; p = 0.0004), and contractile dysfunction (end-systolic pressure-volume relationship in Control vs. SCI = 1.31 ± 0.31 vs. 0.76 ± 0.11 mm Hg/μL, respectively; p = 0.0045). Cardiac atrophy and contractile dysfunction in SCI were accompanied by significantly lower blood pressure, reduced circulatory norepinephrine, and increased angiotensin II. At the cellular level, we found the presence of reduced cardiomyocyte size and increased expression of angiotensin II type 1 receptors and transforming growth factor-beta receptors (TGF-β receptor 1 and 2) post-SCI. Importantly, we found more than a two-fold increase in muscle ring finger-1 and Beclin-1 protein level following SCI, indicating the upregulation of the ubiquitin-proteasome system and autophagy-lysosomal machinery. Our data provide novel evidence that SCI-induced cardiomyocyte atrophy and systolic cardiac dysfunction are accompanied by an upregulation of proteolytic pathways, the activation of which is likely due to loss of trophic support from the sympathetic nervous system, neuromechanical unloading, and altered neurohumoral pathways.
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Affiliation(s)
- Malihe-Sadat Poormasjedi-Meibod
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.,2 School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maral Mansouri
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada
| | - Mary Fossey
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.,2 School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan W Squair
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.,3 MD/PhD Training Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jie Liu
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada
| | - John H McNeill
- 4 Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher R West
- 1 International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.,2 School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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21
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Squair JW, DeVeau KM, Harman KA, Poormasjedi-Meibod MS, Hayes B, Liu J, Magnuson DS, Krassioukov AV, West CR. Spinal Cord Injury Causes Systolic Dysfunction and Cardiomyocyte Atrophy. J Neurotrauma 2018; 35:424-434. [PMID: 28599602 PMCID: PMC9836687 DOI: 10.1089/neu.2017.4984] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Individuals with spinal cord injury (SCI) have been shown to exhibit systolic, and to a lesser extent, diastolic cardiac dysfunction. However, previous reports of cardiac dysfunction in this population are confounded by the changing loading conditions after SCI and as such, whether cardiac dysfunction per se is present is still unknown. Therefore, our aim was to establish if load-independent cardiac dysfunction is present after SCI, to understand the functional cardiac response to SCI, and to explore the changes within the cellular milieu of the myocardium. Here, we applied in vivo echocardiography and left-ventricular (LV) pressure-volume catheterization with dobutamine infusions to our Wistar rodent model of cardiac dysfunction 5 weeks following high (T2) thoracic contusion SCI, while also examining the morphological and transcriptional alterations of cardiomyocytes. We found that SCI significantly impairs systolic function independent of loading conditions (end-systolic elastance in control: 1.35 ± 0.15; SCI: 0.65 ± 0.19 mm Hg/μL). The reduction in contractile indices is accompanied by a reduction in width and length of cardiomyocytes as well as alterations in the LV extracellular matrix. Importantly, we demonstrate that the reduction in the rate (dP/dtmax) of LV pressure rise can be offset with beta-adrenergic stimulation, thereby experimentally implicating the loss of descending sympatho-excitatory control of the heart as a principle cause of LV dysfunction in SCI. Our data provide evidence that SCI induces systolic cardiac dysfunction independent of loading conditions and concomitant cardiomyocyte atrophy that may be underpinned by changes in the genes regulating the cardiac extracellular matrix.
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Affiliation(s)
- Jordan W. Squair
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- MD/PhD Training Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn M. DeVeau
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky
| | - Kathryn A. Harman
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky
| | - Malihe-Sadat Poormasjedi-Meibod
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Hayes
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jie Liu
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
| | - David S.K. Magnuson
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Health Authority, Vancouver, British Columbia, Canada
| | - Christopher R. West
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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22
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Squair JW, Liu J, Tetzlaff W, Krassioukov AV, West CR. Spinal cord injury-induced cardiomyocyte atrophy and impaired cardiac function are severity dependent. Exp Physiol 2018; 103:179-189. [PMID: 29235182 DOI: 10.1113/ep086549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 11/13/2017] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does the severity of spinal cord injury affect left ventricular mechanics, function and the underlying cardiomyocyte morphology? What is the main finding and its importance? Here, we show that severe, but not moderate, spinal cord injury causes cardiomyocyte atrophy, altered left ventricular mechanics and impaired cardiac function. The principal aim of the present study was to assess how the severity of spinal cord injury (SCI) affects left ventricular (LV) mechanics, function and underlying cardiomyocyte morphology. Here, we used different severities of T3 spinal cord contusions (MODERATE, 200 kdyn contusion; SEVERE, 400 kdyn contusion; SHAM) and combined standard echocardiography with speckle tracking analyses to investigate in vivo cardiac function and deformation (contractility) after experimental SCI in the Wistar rat. In addition, we investigated changes in the intrinsic structure of cardiac myocytes ex vivo. We demonstrate that SEVERE SCI induces a characteristic decline in LV chamber size and a reduction in in vivo LV deformation (i.e. radial strain) throughout the entire systolic portion of the cardiac cycle [25.6 ± 3.0 versus 44.5 ± 8.1% (Pre-injury); P = 0.0029]. SEVERE SCI also caused structural changes in cardiomyocytes, including decreased length [115.6 ± 7.63 versus 125.8 ± 6.75 μm (SHAM); P = 0.0458], decreased width [7.78 ± 0.71 versus 10.78 ± 1.08 μm (SHAM); P = 0.0015] and an increase in the length/width ratio [14.88 ± 0.66 versus 11.74 ± 0.89 (SHAM); P = 0.0018], which was significantly correlated with LV flow-generating capacity after SCI (i.e. stroke volume, R2 = 0.659; P = 0.0013). Rats with MODERATE SCI exhibited no changes in any metric versus SHAM. This is the first study to demonstrate that the severity of SCI determines the course of changes in the intrinsic structure of cardiomyocytes, which are directly related to contractile function of the LV.
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Affiliation(s)
- Jordan W Squair
- International Collaboration of Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,MD/PhD Training Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jie Liu
- International Collaboration of Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Wolfram Tetzlaff
- International Collaboration of Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Zoology, Faculty of Science, University of British Columbia, Vancouver, BC, Canada.,Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V Krassioukov
- International Collaboration of Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Centre, Vancouver Health Authority, University of British Columbia, Vancouver, BC, Canada
| | - Christopher R West
- International Collaboration of Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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23
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Biering-Sørensen F, Biering-Sørensen T, Liu N, Malmqvist L, Wecht JM, Krassioukov A. Alterations in cardiac autonomic control in spinal cord injury. Auton Neurosci 2018; 209:4-18. [DOI: 10.1016/j.autneu.2017.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 01/30/2017] [Accepted: 02/14/2017] [Indexed: 01/22/2023]
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24
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DeVeau KM, Harman KA, Squair JW, Krassioukov AV, Magnuson DSK, West CR. A comparison of passive hindlimb cycling and active upper-limb exercise provides new insights into systolic dysfunction after spinal cord injury. Am J Physiol Heart Circ Physiol 2017; 313:H861-H870. [PMID: 28710067 PMCID: PMC9925118 DOI: 10.1152/ajpheart.00046.2017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/05/2017] [Accepted: 07/12/2017] [Indexed: 12/24/2022]
Abstract
Active upper-limb and passive lower-limb exercise are two interventions used in the spinal cord injury (SCI) population. Although the global cardiac responses have been previously studied, it is unclear how either exercise influences contractile cardiac function. Here, the cardiac contractile and volumetric responses to upper-limb (swim) and passive lower-limb exercise were investigated in rodents with a severe high-thoracic SCI. Animals were divided into control (CON), SCI no exercise (NO-EX), SCI passive hindlimb cycling (PHLC), or SCI swim (SWIM) groups. Severe contusion SCI was administered at the T2 level. PHLC and SWIM interventions began on day 8 postinjury and lasted 25 days. Echocardiography and dobutamine stress echocardiography were performed before and after injury. Cardiac contractile indexes were assessed in vivo at study termination via a left ventricular pressure-volume conductance catheter. Stroke volume was reduced after SCI (91 µl in the NO-EX group vs. 188 µl in the CON group, P < 0.05) and was reversed at study termination in the PHLC (167 µl) but not SWIM (90 µl) group. Rates of contraction were reduced in NO-EX versus CON groups (6,079 vs. 9,225 mmHg, respectively, P < 0.05) and were unchanged by PHLC and SWIM training. Similarly, end-systolic elastance was reduced in the NO-EX versus CON groups (0.67 vs. 1.37 mmHg/µl, respectively, P < 0.05) and was unchanged by PHLC or SWIM training. Dobutamine infusion normalized all pressure indexes in each SCI group (all P < 0.05). In conclusion, PHLC improves flow-derived cardiac indexes, whereas SWIM training displayed no cardiobeneficial effect. Pressure-derived deficits were corrected only with dobutamine, suggesting that reduced β-adrenergic stimulation is principally responsible for the impaired cardiac contractile function after SCI.NEW & NOTEWORTHY This is the first direct comparison between the cardiac changes elicited by active upper-limb or passive lower-limb exercise after spinal cord injury. Here, we demonstrate that lower-limb exercise positively influences flow-derived cardiac indexes, whereas upper-limb exercise does not. Furthermore, neither intervention corrects the cardiac contractile dysfunction associated with spinal cord injury.
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Affiliation(s)
- Kathryn M. DeVeau
- 1International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; ,2Kentucky Spinal Cord Injury Research Institute, University of Louisville, Louisville, Kentucky;
| | - Kathryn A. Harman
- 1International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; ,2Kentucky Spinal Cord Injury Research Institute, University of Louisville, Louisville, Kentucky;
| | - Jordan W. Squair
- 1International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; ,3MD/PhD Training Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;
| | - Andrei V. Krassioukov
- 4Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ,5GF Strong Rehabilitation Centre, Vancouver Health Authority, Vancouver, British Columbia, Canada; and
| | - David S. K. Magnuson
- 2Kentucky Spinal Cord Injury Research Institute, University of Louisville, Louisville, Kentucky;
| | - Christopher R. West
- 1International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; ,6School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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25
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Silva FS, Bortolin RH, Araújo DN, Marques DE, Lima JPM, Rezende AA, Vieira WH, Silva NB, Medeiros KC, Ackermann PW, Abreu BJ, Dias FA. Exercise training ameliorates matrix metalloproteinases 2 and 9 messenger RNA expression and mitigates adverse left ventricular remodeling in streptozotocin-induced diabetic rats. Cardiovasc Pathol 2017; 29:37-44. [DOI: 10.1016/j.carpath.2017.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/30/2017] [Accepted: 05/16/2017] [Indexed: 01/22/2023] Open
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Abstract
Over the past 10 years, our team has attended numerous Paralympic games and International Paralympic Committee (IPC)-sanctioned events where we have accumulated the largest data set to date from elite athletes with spinal cord injury (SCI). This empirical evidence has allowed us to address critical questions related to health and athletic performance in these incredibly medically complex individuals. Namely, does autonomic function influence performance? Can we account for this with the present sport classification? How can we prevent the doping practice of self-inducing life-threatening episodes of hypertension to improve performance (termed "boosting")? How does extremely high participation in routine upper-body wheelchair exercise impact cardiovascular and cerebrovascular disease risk? Is it possible to improve the sport classification to level the playing field between athletes with and without autonomic dysfunction? Herein, we will narratively address these questions, and provide our perspective on future directions and recommendations moving forward. Our extensive clinical experience and comprehensive dataset suggest preserved autonomic function is critical for elite performance. We will explore how an easy-to-execute test may be able to predict which individuals are most likely to develop autonomic dysfunctions that may negatively affect their health and performance. We also will evaluate the possibility that a level playing field may be even more difficult to establish than once thought, considering the importance of not only voluntary movement to performance, but also autonomic function. Finally, we also will discuss new changes in screening guidelines at Rio to assess the occurrence of boosting, which is a banned practice by the IPC.
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Affiliation(s)
- Aaron A Phillips
- 1 International Collaboration on Repair Discoveries, University of British Columbia , Vancouver, British Columbia, Canada
| | - Jordan W Squair
- 1 International Collaboration on Repair Discoveries, University of British Columbia , Vancouver, British Columbia, Canada .,2 MD/PhD Training Program, University of British Columbia , Vancouver, British Columbia, Canada
| | - Andrei V Krassioukov
- 1 International Collaboration on Repair Discoveries, University of British Columbia , Vancouver, British Columbia, Canada .,3 Department of Medicine, University of British Columbia , Vancouver, British Columbia, Canada .,4 GF Strong Rehabilitation Centre, Vancouver Health Authority, University of British Columbia , Vancouver, British Columbia, Canada
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27
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Squair JW, West CR, Popok D, Assinck P, Liu J, Tetzlaff W, Krassioukov AV. High Thoracic Contusion Model for the Investigation of Cardiovascular Function after Spinal Cord Injury. J Neurotrauma 2017; 34:671-684. [DOI: 10.1089/neu.2016.4518] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jordan W. Squair
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- MD/PhD Training Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher R. West
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Popok
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Peggy Assinck
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jie Liu
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Wolfram Tetzlaff
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Zoology, Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Health Authority, Vancouver, British Columbia, Canada
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28
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Popok DW, West CR, McCracken L, Krassioukov AV. Effects of early and delayed initiation of exercise training on cardiac and haemodynamic function after spinal cord injury. Exp Physiol 2017; 102:154-163. [DOI: 10.1113/ep085978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/28/2016] [Indexed: 11/08/2022]
Affiliation(s)
- David W. Popok
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver BC Canada
| | - Christopher R. West
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver BC Canada
- School of Kinesiology; Faculty of Education; University of British Columbia; Vancouver BC Canada
| | - Laura McCracken
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver BC Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver BC Canada
- Faculty of Medicine; Division of Physical Medicine and Rehabilitation; University of British Columbia; Vancouver BC Canada
- GF Strong Rehabilitation Centre; Vancouver Coastal Health; Vancouver BC Canada
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29
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Assessing kinematics and kinetics of functional electrical stimulation rowing. J Biomech 2017; 53:120-126. [PMID: 28104245 DOI: 10.1016/j.jbiomech.2017.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 11/22/2022]
Abstract
Hybrid functional electrical stimulation (FES) rowing has positive effects on cardiovascular fitness, producing significantly greater aerobic power than either upper body or FES exercise alone. However, there is minimal information on the kinematics, kinetics, and mechanical efficiency of FES-rowing in the spinal cord injured (SCI) population. This study examined the biomechanics of FES-rowing to determine how motions, forces, and aerobic demand change with increasing intensity. Six individuals with SCI and six able-bodied subjects performed a progressive aerobic capacity rowing test. Differences in kinematics (motion profiles), kinetics (forces produced by the feet and arms), external mechanical work, and mechanical efficiency (work produced/volume of oxygen consumed) were compared in able-bodied rowing vs. SCI FES-rowing at three comparable subpeak workloads. With increasing exercise intensity (measured as wattage), able-bodied rowing increased stroke rate by decreasing recovery time, while FES-rowing maintained a constant stroke rate, with no change in drive or recovery times. While able-bodied rowers increased leg and arm forces with increasing intensity, FES-rowers used only their arms to achieve a higher intensity with a constant and relatively low contribution of the legs. Oxygen consumption increased in both groups, but more so in able-bodied rowers, resulting in able-bodied rowers having twice the mechanical efficiency of FES-rowers. Our results suggest that despite its ability to allow for whole body exercise, the total force output achievable with FES-rowing results in only modest loading of the legs that affects overall rowing performance and that may limit forces applied to bone.
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30
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Nardone R, Orioli A, Golaszewski S, Brigo F, Sebastianelli L, Höller Y, Frey V, Trinka E. Passive cycling in neurorehabilitation after spinal cord injury: A review. J Spinal Cord Med 2017; 40:8-16. [PMID: 27841091 PMCID: PMC5376131 DOI: 10.1080/10790268.2016.1248524] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
CONTEXT/OBJECTIVE Passive cycling (PC) may represent a potential alternative neurorehabilitation program for patients who are too weak or medically unstable to repeatedly practice active movements. We review here the most important animal and human studies addressing PC after spinal cord injury (SCI). METHODS A MEDLINE search was performed using following terms: "passive", "cycling", "pedaling", "pedalling","spinal cord injury". RESULTS Experimental studies revealed that PC modulated spinal reflex and reduced spasticity. PC also reduced autonomic dysreflexia and elicited cardio-protective effects. Increased levels of mRNA for brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and neurotrophin-4 were found. In contrast, human studies failed to show an effect of PC on spasticity reduction and did not support its application for prevention of cardiovascular disease-related secondary complications. CONCLUSION Available evidence to support the use of PC as standard treatment in patients with SCI is still rather limited. Since it is conceivable that PC motion could elicit sensory inputs to activate cortical structures and induce cortical plasticity changes leading to improved lower limb motor performance, further carefully designed prospective studies in subjects with SCI are needed.
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Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria,Department of Neurology, Franz Tappeiner Hospital, Merano, Italy,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria,Correspondence to: Raffaele Nardone, Department of Neurology – “F. Tappeiner” Hospital – Meran/o, Via Rossini, 5, 39012 Meran/o (BZ) – Italy. E-mail address:
| | - Andrea Orioli
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
| | - Stefan Golaszewski
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy,Department of Neurological and Movement Sciences. Section of Clinical Neurology, University of Verona, Italy
| | | | - Yvonne Höller
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Vanessa Frey
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
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31
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Challenging cardiac function post-spinal cord injury with dobutamine. Auton Neurosci 2016; 209:19-24. [PMID: 28065654 DOI: 10.1016/j.autneu.2016.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/28/2016] [Accepted: 12/13/2016] [Indexed: 12/29/2022]
Abstract
There is general consensus that spinal cord injuries (SCI) above T6 result in altered sympathetic control of the heart, which negatively influences cardiac structure and function. To by-pass disrupted circuitry and investigate cardiac responses under enhanced sympathetic activity we utilized dobutamine (DOB) stress echocardiography. Animals were divided into a T2, 25g-cm contusive SCI (SCI) or an uninjured control (CON) group. Echocardiography was performed pre-SCI and at 1, 2 and 6weeks post-SCI. Increasing doses of DOB (5, 10 & 20μg/min/kg) were infused intravenously pre-SCI and at 1 and 6weeks post-SCI. Parasternal-short axis images were used to compare group differences in systolic function and track changes in response to SCI and DOB over time. One week post-SCI, stroke volume (SV), end diastolic volume (EDV), cardiac output (CO) and ejection fraction (EF) were all reduced compared to CON and these deficits persisted to 6weeks. We also found an increase in collagen deposition at 6weeks post SCI. Pre-SCI, DOB elicited a decrease in EDV and increases in CO, EF and HR but not SV. At 6weeks following SCI, in addition to increases in CO, EF and HR, DOB also induced increases in SV. This is the first report, to our knowledge, of DOB responses in a contusive SCI model with persistent cardiac impairments. The return of CO to pre-SCI levels and the substantial increase in SV at low DOB dosages shows that impaired descending control of the heart is directly contributing to reduced resting SV after SCI.
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West CR, Squair JW, McCracken L, Currie KD, Somvanshi R, Yuen V, Phillips AA, Kumar U, McNeill JH, Krassioukov AV. Cardiac Consequences of Autonomic Dysreflexia in Spinal Cord Injury. Hypertension 2016; 68:1281-1289. [PMID: 27698067 DOI: 10.1161/hypertensionaha.116.07919] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 09/08/2016] [Indexed: 12/12/2022]
Abstract
Autonomic dysreflexia (AD), which describes episodic hypertension, is highly prevalent in people with spinal cord injury (SCI). In non-SCI, primary hypertension depresses cardiac contractile reserve via β-adrenergic mechanisms. In this study, we investigated whether AD contributes to the impairment in cardiac contractile function that accompanies SCI. We induced SCI in rodents and stratified them into sham, SCI, or SCI plus repetitive induction of AD. At 6-week post-SCI, we assessed cardiac function using in vivo (speckle-tracking echocardiography), ex vivo (working heart), and molecular approaches (Western blot). We also provide unique translational insight by comparing the relationship between the number of daily AD events and cardiac function in 14 individuals with cervical SCI. We found SCI and SCI plus repetitive induction of AD exhibited a reduction in left ventricular dimensions at 6-week post-SCI versus preinjury (P<0.049). Compared with sham, SCI exhibited a reduction in peak radial strain along with a down and rightward shift in the Starling curve (P<0.037), both of which were further depressed in SCI plus repetitive induction of AD (P<0.042). In response to β-adrenergic stimulation, SCI plus repetitive induction of AD exhibited an attenuated increase in contractile indices (P<0.001), despite no differences in β-receptor expression within the left ventricle. Our clinical data confirm our experimental findings by demonstrating significant associations between the number of daily AD events and markers of systolic and diastolic function along with left ventricular mechanics. Here, we provide the first evidence from a translational perspective that AD exerts insidious effects on cardiac function in rodents and humans with SCI.
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Affiliation(s)
- Christopher R West
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Jordan W Squair
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Laura McCracken
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Katharine D Currie
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Rishi Somvanshi
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Violet Yuen
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Aaron A Phillips
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Ujendra Kumar
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - John H McNeill
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K)
| | - Andrei V Krassioukov
- From the International Collaboration on Repair Discoveries (C.R.W., J.W.S., L.M., K.D.C., A.A.P., A.V.K), School of Kinesiology, Faculty of Education (C.R.W., L.M.), MD-PhD Training Program, Faculty of Medicine (J.W.S.), Faculty of Pharmaceutical Sciences (R.S., V.Y., U.K., J.H.M.), and Faculty of Medicine, Division of Physical Medicine and Rehabilitation (A.V.K), University of British Columbia, Vancouver, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, ON, Canada (K.D.C.); and GF Strong Rehabilitation Centre, Vancouver Coastal Health, BC, Canada (A.V.K).
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Sandrow-Feinberg HR, Houlé JD. Exercise after spinal cord injury as an agent for neuroprotection, regeneration and rehabilitation. Brain Res 2015; 1619:12-21. [PMID: 25866284 PMCID: PMC4540698 DOI: 10.1016/j.brainres.2015.03.052] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 12/17/2022]
Abstract
Spinal cord injury (SCI) is a traumatic event from which there is limited recovery of function, despite the best efforts of many investigators to devise realistic therapeutic treatments. Partly this is due to the multifaceted nature of SCI, where there is considerable disarray and dysfunction secondary to the initial injury. Contributing to this secondary degeneration is neurotoxicity, vascular dysfunction, glial scarring, neuroinflammation, apoptosis and demyelination. It seems logical that addressing the need for neuroprotection, regeneration and rehabilitation will require different treatment strategies that may be applied at varied stages of the post-injury response. Here we focus on a single strategy, exercise/physical training, which appears to have multiple applications and benefits for an acute or chronic SCI. Exercise has been demonstrated to be advantageous at cellular and biochemical levels, as well as being of benefit for the whole animal or human subject. Data from our lab and others will be discussed to further elucidate the many positive aspects of implementing exercise following injury and to suggest that rehabilitation is not the sole target of a training regimen following SCI. This article is part of a Special Issue entitled SI: Spinal cord injury.
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Affiliation(s)
- Harra R Sandrow-Feinberg
- Department of Neurobiology and Anatomy, Spinal Cord Research Center, Drexel University College of Medicine, 2900 Queen Lane, PA 19129, Philadelphia, United States
| | - John D Houlé
- Department of Neurobiology and Anatomy, Spinal Cord Research Center, Drexel University College of Medicine, 2900 Queen Lane, PA 19129, Philadelphia, United States.
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Phillips AA, Krassioukov AV. Contemporary Cardiovascular Concerns after Spinal Cord Injury: Mechanisms, Maladaptations, and Management. J Neurotrauma 2015; 32:1927-42. [PMID: 25962761 DOI: 10.1089/neu.2015.3903] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Cardiovascular (CV) issues after spinal cord injury (SCI) are of paramount importance considering they are the leading cause of death in this population. Disruption of autonomic pathways leads to a highly unstable CV system, with impaired blood pressure (BP) and heart rate regulation. In addition to low resting BP, on a daily basis the majority of those with SCI suffer from transient episodes of aberrantly low and high BP (termed orthostatic hypotension and autonomic dysreflexia, respectively). In fact, autonomic issues, including resolution of autonomic dysreflexia, are frequently ranked by individuals with high-level SCI to be of greater priority than walking again. Owing to a combination of these autonomic disturbances and a myriad of lifestyle factors, the pernicious process of CV disease is accelerated post-SCI. Unfortunately, these secondary consequences of SCI are only beginning to receive appropriate clinical attention. Immediately after high-level SCI, major CV abnormalities present in the form of neurogenic shock. After subsiding, new issues related to BP instability arise, including orthostatic hypotension and autonomic dysreflexia. This review describes autonomic control over the CV system before injury and the mechanisms underlying CV abnormalities post-SCI, while also detailing the end-organ consequences, including those of the heart, as well as the systemic and cerebral vasculature. The tertiary impact of CV dysfunction will also be discussed, such as the potential impediment of rehabilitation, and impaired cognitive function. In the recent past, our understanding of autonomic dysfunctions post-SCI has been greatly enhanced; however, it is vital to further develop our understanding of the long-term consequences of these conditions, which will equip us to better manage CV disease morbidity and mortality in this population.
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Affiliation(s)
- Aaron A Phillips
- 1 Center for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia , Kelowna, British Columbia, Canada .,2 Experimental Medicine Program, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia, Canada .,3 International Collaboration on Repair Discoveries (ICORD), University of British Columbia , Vancouver, British Columbia, Canada
| | - Andrei V Krassioukov
- 2 Experimental Medicine Program, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia, Canada .,3 International Collaboration on Repair Discoveries (ICORD), University of British Columbia , Vancouver, British Columbia, Canada .,4 Department of Physical Medicine and Rehabilitation, University of British Columbia , Vancouver, British Columbia, Canada
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Wecht JM, La Fountaine MF, Handrakis JP, West CR, Phillips A, Ditor DS, Sharif H, Bauman WA, Krassioukov AV. Autonomic Nervous System Dysfunction Following Spinal Cord Injury: Cardiovascular, Cerebrovascular, and Thermoregulatory Effects. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0093-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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West CR, Crawford MA, Laher I, Ramer MS, Krassioukov AV. Passive Hind-Limb Cycling Reduces the Severity of Autonomic Dysreflexia After Experimental Spinal Cord Injury. Neurorehabil Neural Repair 2015; 30:317-27. [DOI: 10.1177/1545968315593807] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Spinal cord injury (SCI) induces alterations in cardio-autonomic control of which autonomic dysreflexia (AD), a condition characterized by life-threatening hypertension, is arguably the most insidious. Passive hind-limb cycling represents a low-cost therapeutic intervention with demonstrable cardiovascular, sensory, and motor benefits. Objective. To investigate the effect of passive hind-limb cycling on AD in rodents with T3 SCI. Methods. Forty-five male Wistar rats were evenly assigned to either uninjured control (CON), SCI, or SCI plus hind-limb cycling exercise (SCI-EX). At the end of the experimental period (day 32), rats were randomly assigned to stream 1 (n = 24) or stream 2 (n = 21). Stream 1 rats were assessed for AD severity (pressor response to colorectal distension) and were then perfused for tissue dissection and immunohistochemistry. Stream 2 rats underwent excision of the superior mesenteric artery for in vitro myography assessments. Results. From 2 weeks post-SCI onwards, SCI-EX rats exhibited a significant reduction in the pressor response to colorectal distension versus SCI ( P < .001). Reduced AD severity in SCI-EX rats was accompanied by a prevention of the SCI-induced increase in density of CGRP+ afferents in the dorsal horn ( P = .001). Conversely, both SCI and SCI-EX rats exhibited a similar degree of mesenteric endothelial dysfunction and α-adrenoceptor hypersensitivity versus CON. Conclusion. Passive hind-limb cycling reduces the severity of AD in SCI, and is correlated with changes in primary afferent morphology, but has limited effects on the peripheral vasculature.
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Affiliation(s)
| | - Mark A. Crawford
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Ismail Laher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Matt S. Ramer
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei V. Krassioukov
- University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Health Authority, British Columbia, Canada
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West CR, Popok D, Crawford MA, Krassioukov AV. Characterizing the Temporal Development of Cardiovascular Dysfunction in Response to Spinal Cord Injury. J Neurotrauma 2015; 32:922-30. [DOI: 10.1089/neu.2014.3722] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Christopher R. West
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Popok
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark A. Crawford
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Health Authority, Vancouver, British Columbia, Canada
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Lujan HL, Dicarlo SE. Increasing venous return as a strategy to prevent or reverse cardiac dysfunction following spinal cord injury. J Physiol 2014; 592:1727-8. [PMID: 24737897 DOI: 10.1113/jphysiol.2014.272666] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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39
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Malmqvist L, Biering-Sørensen T, Bartholdy K, Krassioukov A, Welling KL, Svendsen JH, Kruse A, Hansen B, Biering-Sørensen F. Assessment of autonomic function after acute spinal cord injury using heart rate variability analyses. Spinal Cord 2014; 53:54-8. [DOI: 10.1038/sc.2014.195] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/12/2014] [Accepted: 09/29/2014] [Indexed: 11/09/2022]
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