{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:22:22Z","timestamp":1791818542868,"version":"4.3.4"},"reference-count":138,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Neurol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Spinal cord injury (SCI) disrupts autonomic circuits and impairs synchronistic functioning of the autonomic nervous system, leading to inadequate cardiovascular regulation. Individuals with SCI, particularly at or above the sixth thoracic vertebral level (T6), often have impaired regulation of sympathetic vasoconstriction of the peripheral vasculature and the splanchnic circulation, and diminished control of heart rate and cardiac output. In addition, impaired descending sympathetic control results in changes in circulating levels of plasma catecholamines, which can have a profound effect on cardiovascular function. Although individuals with lesions below T6 often have normal resting blood pressures, there is evidence of increases in resting heart rate and inadequate cardiovascular response to autonomic provocations such as the head-up tilt and cold face tests. This manuscript reviews the prevalence of cardiovascular disorders given the level, duration and severity of SCI, the clinical presentation, diagnostic workup, short- and long-term consequences, and empirical evidence supporting management strategies to treat cardiovascular dysfunction following a SCI.<\/jats:p>","DOI":"10.1055\/s-0040-1713885","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T23:03:41Z","timestamp":1599692621000},"page":"550-559","source":"Crossref","is-referenced-by-count":56,"title":["Cardiovascular Autonomic Dysfunction in Spinal Cord Injury: Epidemiology, Diagnosis, and Management"],"prefix":"10.1055","volume":"40","author":[{"given":"Jill M.","family":"Wecht","sequence":"additional","affiliation":[{"name":"VA RR&D National Center for the Medical Consequences of SCI, James J. Peters VAMC, Bronx, New York"},{"name":"Department of Medicine, The Icahn School of Medicine, Mount Sinai, New York, New York"},{"name":"Rehabilitation and Human Performance, The Icahn School of Medicine, Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noam Y.","family":"Harel","sequence":"additional","affiliation":[{"name":"VA RR&D National Center for the Medical Consequences of SCI, James J. Peters VAMC, Bronx, New York"},{"name":"Rehabilitation and Human Performance, The Icahn School of Medicine, Mount Sinai, New York, New York"},{"name":"Department of Neurology, The Icahn School of Medicine, Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Guest","sequence":"additional","affiliation":[{"name":"The Miami Project to Cure Paralysis, Miami, Florida"},{"name":"The Miller School of Medicine, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Kirshblum","sequence":"additional","affiliation":[{"name":"Kessler Institute For Rehabilitation, West Orange, New Jersey"},{"name":"Kessler Foundation, West Orange, New Jersey"},{"name":"Department of Physical Medicine and Rehabilitation, Rutgers Medical School, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail F.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Kessler Institute For Rehabilitation, West Orange, New Jersey"},{"name":"Kessler Foundation, West Orange, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ona","family":"Bloom","sequence":"additional","affiliation":[{"name":"The Feinstein Institute for Medical Research, Manhasset, New York"},{"name":"Zucker School of Medicine at Hofstra Northwell, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V.","family":"Ovechkin","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, Louisville, Kentucky"},{"name":"The University of Louisville, Department of Neurosurgery, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Harkema","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, Louisville, Kentucky"},{"name":"The 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