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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2002 June;38(2):73-87
The cardiovascular system in individuals with spinal cord injury
Occhi E., Pedrini D., Brambilla M.
From the Spinal Unit E. Morelli Hospital, Sondalo (Sondrio)
Spinal cord injury (SCI) with resultant paraplegia and tetraplegia is often associated with significant alterations of the cardiovascular (CV) system due to the loss of sympathetic control, immobility and hormonal-metabolic dysregulation. The main alterations related to sympathetic dysfunction are: low resting blood pressure, reflex bradycardia, orthostatic hypotension, peripheral edema, reduced venous return, altered response to physical exercise, autonomic dysreflexia and, rarely, cardiac arrest. These alterations occur in patients with tetraplegia or high paraplegia as a consequence of the loss of supraspinal control of the sympathetic nervous system directed to the heart and cervico-thoracic vessels. Immobility and hormonal-metabolic dysregulation are responsible for a series of complications such as deep vein thrombosis (sometimes complicated by pulmonary embolism), obesity, altered lipid profile, hypertension and atherosclerosis. All these complications reduce the exercise capacity of many individuals with SCI and are responsible for a high mortality rate from CV disease. Regular aerobic physical exercise, in some cases associated with FES ergometry program, diet and periodic check up of CV system, seem to improve CV fitness and reduce complications.