124 results match your criteria: "Cardiovascular Concerns in Spinal Cord Injury"

Spinal cord injury and risk of overall and type specific cardiovascular diseases: A meta-analysis.

PLoS One

October 2024

Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

Background: Cardiovascular disease (CVD) is a growing concern among people with spinal cord injury (SCI). This meta-analysis aims to explore the risk of overall CVD and specific types of cardiovascular events among SCI patients.

Methods: This meta-analysis is registered on PROSPERO (CRD CRD42024537888).

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Article Synopsis
  • Osteotomy procedures help correct kyphosis and improve spinal alignment but raise concerns about potential injury to the aorta during surgery.
  • A study involved 16 patients with ankylosing spondylitis undergoing a two-level osteotomy, using aortic CT scans and 3D models to analyze structural changes.
  • Post-surgery findings showed that the aorta's length increased, curvature decreased, but transverse diameter remained stable; however, blood flow velocity, blood pressure, and wall shear stress all significantly decreased.
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  • The study investigated the safety of high-moderate and low-moderate systemic hypothermia during circulatory arrest in patients with acute DeBakey I aortic dissection, focusing on spinal cord protection.
  • Over 1,700 patients were analyzed, showing that those in the nonmalperfusion subgroup experienced lower in-hospital mortality and kidney injury rates with high-moderate hypothermia compared to low-moderate hypothermia.
  • In contrast, patients with preoperative malperfusion had a higher risk of developing paraplegia with high-moderate hypothermia, suggesting that low-moderate hypothermia may be safer for this subgroup.
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  • The study aimed to compare two approaches to treating low blood pressure in patients with spinal cord injuries: one based on a blood pressure threshold regardless of symptoms (TXT) and the other based on treating symptoms (usual care, UC).
  • A total of 66 participants were involved, with 32 providing data on how low blood pressure affected their therapy sessions; results showed that low BP concerns impacted therapy sessions similarly in both groups.
  • The findings suggest that treating asymptomatic hypotension and orthostatic hypotension does not significantly change the amount of therapy received compared to treating symptomatic hypotension in this patient population.
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Introduction: The intersection of ageing and spinal cord injury (SCI) is of global concern. Two scenarios have been described: 1) "SCI with ageing," an increase in the average age of SCI onset, and 2) "ageing with SCI," an increase in post-injury life expectancy. These scenarios entail complex health care and rehabilitation needs due to the accumulation of comorbidities, ageing-related and SCI-induced physiological changes, and post-SCI secondary health conditions.

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Article Synopsis
  • The study used a mixed-methods approach to investigate intra-operative spinal cord injury (ISCI), which lacks a uniform definition, leading to variable reports on its frequency and risk factors.
  • A comprehensive review of existing literature was conducted, resulting in a table that summarizes risk factors for ISCI based on systematic analysis and expert input from a Guidelines Development Group.
  • Key findings revealed that ISCI frequency can range from 0 to 61%, with older age and certain medical conditions increasing risk, while improved neurological status and intra-operative neuromonitoring decrease risk.*
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Cardiorespiratory Responses to Acute Intermittent Hypoxia in Humans With Chronic Spinal Cord Injury.

J Neurotrauma

September 2024

Breathing Research and Therapeutics Center and Department of Physical Therapy, University of Florida, Gainesville, Florida, USA.

Brief exposure to repeated episodes of low inspired oxygen, or acute intermittent hypoxia (AIH), is a promising therapeutic modality to improve motor function after chronic, incomplete spinal cord injury (SCI). Although therapeutic AIH is under extensive investigation in persons with SCI, limited data are available concerning cardiorespiratory responses during and after AIH exposure despite implications for AIH safety and tolerability. Thus, we recorded immediate (during treatment) and enduring (up to 30 min post-treatment) cardiorespiratory responses to AIH in 19 participants with chronic SCI (>1 year post-injury; injury levels C1 to T6; American Spinal Injury Association Impairment Scale A to D; mean age = 33.

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Increased Risk of Myocardial Infarction, Heart Failure, and Atrial Fibrillation After Spinal Cord Injury.

J Am Coll Cardiol

February 2024

Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea. Electronic address:

Article Synopsis
  • - This study investigates the higher incidence of heart diseases, specifically myocardial infarction, heart failure, and atrial fibrillation, in spinal cord injury (SCI) survivors compared to a matched group of non-SCI individuals.
  • - Results indicate that SCI survivors face significantly increased risks for these heart conditions, especially among those with severe disabilities, with cervical and lumbar injuries showing the highest risks.
  • - The findings highlight the urgent need for healthcare providers to focus on heart health in SCI patients, as they are at a notably greater risk for these diseases than the general population.
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Background: Spinal cord injury (SCI) remains a significant health concern, with limited available treatment options. This condition poses significant medical, economic, and social challenges. SCI is typically categorized into primary and secondary injuries.

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Article Synopsis
  • A study surveyed 138 adults with spinal cord injury (SCI) to assess their knowledge and awareness of bone health, particularly bone mineral density (BMD).
  • Findings revealed that a significant number of participants (20%) had never heard of BMD, and around 70% felt they lacked sufficient knowledge on the subject, despite some having received information during rehabilitation.
  • Most participants expressed concern about low BMD risks and a strong desire for more education on prevention and treatment options, highlighting the importance of bone health education for this group.
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Spinal cord injuries at the cervical spine level represent the most consequential of the related injuries at all levels of the spine. They can trigger permanent unilateral or bilateral damage with conspicuous disability. Regarding unstable injuries, the gold standard approach is open reduction and osteosynthesis, which can select between anterior and posterior surgical access.

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Management of the left subclavian artery during aortic arch replacement using a frozen elephant trunk approach: a review.

Cardiovasc Diagn Ther

August 2023

Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.

The frozen elephant trunk (FET) technique for total aortic arch replacement extends repair into the proximal portion of the descending thoracic aorta. Several techniques and modifications of total arch replacement have been described in the literature, and many of these iterations are related to facilitating the distal anastomosis while preserving flow to the left subclavian artery (LSCA), as well as maintaining posterior circulation of the brain via the vertebral artery, by reducing the circulatory arrest time during reconstruction. Because of the LSCA's posterior and deep anatomic location in the chest, particularly in obese patients, this revascularization is often challenging; additional concerns regarding LSCA revascularization include patients with large aortic arch aneurysms, those with dissected or calcified arteries, and reoperation.

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Individuals with spinal cord injuries (SCI) report low physical activity participation levels. A lack of physical activity can lead to increased secondary health concerns, such as cardiovascular, psychological, genitourinary, and musculoskeletal complications. Adaptive sports, such as quad rugby, allow individuals with SCI to maintain appropriate physical activity levels.

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Background And Aims: Major complications of central neuraxial block (CNB) are rare and their incidence in India is not known. This information is essential for explaining risk and medico-legal concerns. The present multi-centre study in Maharashtra was conducted to provide insight into the characteristics of rare complications following this popular anaesthetic technique.

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Blunt aortic injury is a serious condition with a high mortality rate. Although rare, blunt aortic injury associated with spinal fracture has also been reported, and appropriate management of aortic disease is key to a good outcome. This report is a case of a 78-year-old man who was found to have a transverse fracture (Chance fracture) in the ninth thoracic vertebra, with a sharp bone fragment compressing the thoracic aorta.

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Outcomes following thoracic endovascular aortic repair for blunt thoracic aortic injury stratified by Society for Vascular Surgery grade.

J Vasc Surg

July 2023

Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Objectives: Although the Society for Vascular Surgery (SVS) aortic injury grading system is used to depict the severity of injury in patients with blunt thoracic aortic injury, prior literature on its association with outcomes after thoracic endovascular aortic repair (TEVAR) is limited.

Methods: We identified patients undergoing TEVAR for BTAI within the VQI between 2013 and 2022. We stratified patients based on their SVS aortic injury grade (grade 1, intimal tear; grade 2, intramural hematoma; grade 3, pseudoaneurysm; and grade 4, transection or extravasation).

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Article Synopsis
  • Low patency rates in separate tube grafts for intercostal artery reconstruction prompted a study to determine the optimal size and length of grafts, analyzing their effectiveness using computational fluid dynamics (CFD).
  • The study involved 41 patients and found that grafts longer than 25 mm tended to occlude, with a patency rate of 63% overall, which varied between different types of aortic replacements.
  • Results suggested that 8-mm and 10-mm grafts provided better patency compared to 12-mm grafts, and shorter grafts (less than 25 mm) showed improved outcomes, highlighting the potential of CFD in optimizing graft configurations.
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Autonomic dysfunction is a prominent concern following spinal cord injury (SCI). In particular, autonomic dysreflexia (AD; paroxysmal hypertension and concurrent bradycardia in response to sensory stimuli below the level of injury) is common in autonomically-complete injuries at or above T6. AD is currently defined as a >20 mmHg increase in systolic arterial pressure (SAP) from baseline, without heart rate (HR) criteria.

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Study Design: Systematic review.

Objective: To evaluate the efficacy and safety of mirabegron in patients with neurogenic detrusor overactivity due to SCI or MS.

Methods: A comprehensive search of the Pubmed, Cochrane, Scopus, and Embase databases was performed.

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Background: Recent developments in wearable powered exoskeletons (WPE) allow gait training (GT) for patients after spinal cord injury (SCI). Two recent meta-analyses on GT using WPE showed promising results for paraplegic patients (PP). To this date, there is no review focusing on tetraplegic patients (TP).

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Non-Communicable Neurological Disorders and Neuroinflammation.

Front Immunol

July 2022

Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Traumatic brain injury, stroke, and neurodegenerative diseases represent a major cause of morbidity and mortality in Africa, as in the rest of the world. Traumatic brain and spinal cord injuries specifically represent a leading cause of disability in the younger population. Stroke and neurodegenerative disorders predominantly target the elderly and are a major concern in Africa, since their rate of increase among the ageing is the fastest in the world.

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Thoracic endovascular repair of chronic type B aortic dissection: a systematic review.

Ann Cardiothorac Surg

January 2022

Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.

Background: At present, the optimal management strategy for chronic type B aortic dissection (CTBAD) remains unknown, as equipoise remains regarding medical management versus endovascular treatment versus open surgery. However, the results over recent years of thoracic endovascular aortic repair (TEVAR) in CTBAD appear promising. The aim of this systematic review was to provide a comprehensive analysis of the available data reporting outcomes and survival rates for TEVAR in CTBAD.

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Perioperative management of patients undergoing thoracic endovascular repair.

Ann Cardiothorac Surg

November 2021

Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.

Thoracic endovascular aortic repair (TEVAR) is a less invasive method for treating thoracic and some thoracoabdominal aortic aneurysms, dissections of the thoracic aorta and blunt traumatic aortic injury, compared with conventional open surgery. Maximizing the likelihood of a successful outcome requires diligent multidisciplinary (surgical, critical care, nursing, pharmacy, nutrition and physical therapy) perioperative care. In this article, we discuss fundamentals for managing patients after endovascular aortic aneurysm repair.

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Benefits and interval training in individuals with spinal cord injury: A thematic review.

J Spinal Cord Med

May 2022

Spinal Cord Injury & Disorders Center, Hunter Holmes McGuire VAMC and Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, USA.

Background: Arm crank ergometry (ACE), functional electrical stimulation leg cycling exercise (FES-LCE), and the combination of the two (FES hybrid exercise) have all been used as activities to help improve the fitness-related health of individuals with spinal cord injury (SCI). More recently, high-intensity interval training (HIIT) has become popular in the non-disabled community due to its ability to produce greater aerobic fitness benefits or equivalent benefits with reduced time commitment.

Objective: This thematic review of the literature sought to determine the potential benefits and practicality of using ACE, FES-LCE, and FES hybrid exercise in an interval training format for individuals with SCI.

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The present study was designed to compare the body composition and indicators of chronic inflammatory grade, such as leptin, adiponectin, and resistin concentrations in irregularly active and active SCI subjects. Thirty-two male subjects participated in this study. They were divided into three groups: able-bodied control irregularly active (control, = 11), irregularly active with SCI (SCI-IA, = 8), and physically active with SCI (SCI-PA, = 13).

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