Increased pulse wave velocity (PWV), a marker of cardiovascular disease (CVD), has been reported in otherwise healthy individuals with spinal cord injury (SCI) compared to age-matched uninjured controls. Due to decentralized descending sympathetic vascular control, individuals with injuries above T6 are prone to orthostatic hypotension and, as a result, depend on the renin-angiotensin aldosterone system (RAAS) to maintain orthostatic blood pressure (BP). The purpose of this study was to determine resting PWV, a non-invasive surrogate of central arterial stiffness, in individuals with cervical (C4-T1; n=11) and thoracic (T6-T12; n=11) SCI, compared to age-matched controls (controls; n=11). Secondly, our aim was to describe group differences in BP, plasma norepinephrine (NE) and renin response to head-up tilt (HUT). Lastly, we sought to determine the relationship between PWV and the orthostatic change in BP, NE and the plasma renin during HUT among the groups. PWV was significantly increased in both cervical (8.81 ± 1.91 m/s) and thoracic (7.36 ± 1.58 m/s) SCI compared to the controls (5.53 ± 0.95 m/s; p<0.05). The change from supine to 60° HUT, in BP and NE were significantly reduced and change in plasma renin was significantly increased in the cervical group compared to the thoracic and control groups. Group affiliation and change in plasma renin were significant predictors of PWV (R² = 0.63, p = 0.001). These data suggest that dependency on the RAAS for orthostatic BP maintenance may be associated with increased PWV and risk of CVD in the SCI population.

中文翻译：

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脊髓损伤患者脉搏波速度增加：肾素-血管紧张素-醛固酮系统的影响

与年龄相匹配的未受伤对照组相比，在其他健康的脊髓损伤（SCI）个体中，脉搏波速度（PWV）升高是心血管疾病（CVD）的标志，已有报道。由于交感神经血管控制的分散降落，损伤高于T6的个体容易发生体位性低血压，结果，依赖肾素-血管紧张素醛固酮系统（RAAS）来维持体位性血压（BP）。这项研究的目的是确定与年龄相关的宫颈（C4-T1; n = 11）和胸（T6-T12; n = 11）SCI患者的静息PWV，这是一种非侵入性的中央动脉硬化替代物-匹配的控件（控件； n = 11）。其次，我们的目的是描述血压，血浆去甲肾上腺素（NE）和肾素对抬头倾斜（HUT）反应的组别差异。最后，我们试图确定各组之间PWV与HUT期间BP，NE和血浆肾素的体位性变化之间的关系。与对照组（5.53±0.95 m / s）相比，宫颈（8.81±1.91 m / s）和胸（7.36±1.58 m / s）SCI的PWV显着增加。与胸部和对照组相比，颈椎组的BP和NE从仰卧位到60°HUT的变化显着减少，血浆肾素的变化显着增加。组的隶属关系和血浆肾素的变化是PWV（R 与胸部和对照组相比，颈椎组中从仰卧位到60°HUT的变化在BP和NE中显着减少，血浆肾素的变化显着增加。组的隶属关系和血浆肾素的变化是PWV（R 与胸部和对照组相比，宫颈组从仰卧位到60°HUT的变化显着降低，而BP组和NE组血浆肾素的变化显着增加。组的隶属关系和血浆肾素的变化是PWV（R² = 0.63，p = 0.001）。这些数据表明，对于直立性BP维持依赖RAAS可能与SCI人群中PWV升高和CVD风险有关。