Poster abstracts. (1st September 2013)

• Record Type: Journal Article
• Authors: Wecht, Jill M.; Ivan, Adrian M.; Radulovic, Miroslav; Yen, Christina; Pena, Stephanie; Bauman, William A.; Ivan, Adrian M.; Radulovic, Miroslav; Rosado-Rivera, Dwindally; Yen, Christina; Bauman, William A.; Wecht, Jill M.; Flavin, Kara; Perkowski, Matthew; Poduri, Kanakadurga R.; Kirshblum, Steven; Sanford, Timothy; Walker, Heather; Guihan, Marylou; Hayman, Amanda V.; Murphy, Deirdre; Rogers, Thea; Parachuri, Rama; Acho, Tamara; Young, Mala; Alfonso, Lourdes; Li, Carol; Yang, Sarah; Trbovich, Michelle; Chirumamilla, Sankar R.; Muniswamy, Vinod; Bernert, Silke; Salles, Sara S.; Galea, Marinella; Ferguson, Marcia; Acevedo-Hernandez, Ali; Delille, Carmel; Rivas, Carmen; Deitrick, George; Galea, Marinella; Kish, Laurie; Ferguson, Marcia; Mixon, Cheryl; Jones, April; Jones, Sabrina; Kelty, Lawrence; Kwok, Sze Wing Madeline; McLaughlin, Edward; Schilero, Gregory; Radulovic, Miroslav; Wecht, Jill; LaFountaine, Michael; Cirnigliaro, Christopher; Yen, Christina; Kirshblum, Steven; Bauman, William; Radulovic, Miroslav; Schilero, Gregory J.; Yen, Christina; Wecht, Jill M.; Jecmenica, Mladen; Ivan, Adrian; Bauman, William A.; Korsten, Mark A.; Yen, Christina; Radulovic, Miroslav; LaFountaine, Michael; Cirnigliaro, Christopher; Wecht, Jill; Kirshblum, Steven; Bauman, William; Schilero, Gregory; Fineberg, Drew B.; Korsten, Mark A.; Asselin, Pierre K.; Bauman, William A.; Harel, Noam Y.; Spungen, Ann M.; Brose, Steven W.; Bourbeau, Dennis J.; Gustafson, Kenneth J.; Armstrong, Kelly; Beck, Lisa; Pena, Stephanie; Ivan, Adrian; Radulovic, Miroslav; Yen, Christina; Bauman, William A.; Wecht, Jill M.; Wecht, Jill M.; Ivan, Adrian; Radulovic, Miroslav; Yen, Christina; Pena, Stephanie; Bauman, William A.; Hess, Marika; Foo, Dominic; Jayawardena, Vidya; Su, Peter; Asselin, Pierre; Fineberg, Drew; Harel, Noam Y.; Agranova-Breyter, Irina; Kornfeld, Stephen D.; Spungen, Ann M.; Xu, Jiashu; Bardakcioglu, Ovunc; Johnson, Frank E.; Skelton, Felicia; Hoffman, Jeanne; Reyes, Maria Regina; Burns, Stephen; Huang, Vincent; Johnson-Kunjukutty, Swapna R.; Li, Gang; Makeyev, Yan; Galea, Marinella; Kowalski, Krzysztof E.; Hromyak, Dana R.; Geertman, Robert T.; DiMarco, Anthony F.; Lin, Vernon; Patel, Deepak G.; Zhang, Xiaoming; Selvarajah, Shalini; Hammond, Edward R.; Haider, Adil H.; Schneider, Eric B.; Forrest, Gail F.; Lorenz, Douglas J.; Hutchinson, Karen; VanHiel, Leslie; Michele Basso, D.; Sisto, Sue Ann; Harkema, Susan; Noriega-Cruz, Elizabeth; Williams, Jason P.; Mendelson, Samantha; Frontera, Rebecca A.; Wilson, Catherine S.; Ames, Herb; Mignogna, Joseph; Midei, Aimee; Powers, Catherine; Andrews, Shiquina; Anderson, Tom; Holmes, Sally Ann; Ames, Herb; Mignogna, Joseph; Midei, Aimee; Powers, Catherine; Andrews, Shiquina; Anderson, Tom; Holmes, Sally Ann; Ames, Herb; Mignogna, Joseph; Midei, Aimee; Powers, Catherine; Andrews, Shiquina; Anderson, Tom; Holmes, Sally Ann; Fraser, Marsha Amoy; Lind, Jason D.; ARNP, Gail Powell-Cope, PhD,; Gavin-Dreschnack, Deborah; Klaas, Sara J.; Kelly, Erin; Vogel, Lawrence C.; Flanagan, Ann; Vogel, Lawrence C.; Kelly, Erin H.; Monden, Kimberley R.; Warren, Ann Marie; Catalano, Denise; Strozewski, Richard; Kelly, Erin H.; Flanagan, Ann; Vogel, Lawrence C.; Gontkovsky,, Samuel T.; Bombardier, Charles H.; January, Alicia; Zebracki, Kathy; Chlan, Kathleen M.; Vogel, Lawrence C.; Parmar, Raj; McKenzie, Nicole; LeBlond, Daniel; Ho, Chester; Liu, Nan; Fougere, Renee; Zhou, Mouwang; Krassioukov, Andrei V.; Fraser, Marsha Amoy; Lind, Jason D.; Powell-Cope, Gail; Gavin-Dreschnack, Deborah; Quinones, Evelyn C.; Jimenez, Zulma; Lind, Jason D.; Fraser, Marsha Amoy; Powell-Cope, Gail; Gavin-Dreschnack, Deborah; Lewis, Marissa Jones; Simmons, Erin; Rizzo, Kristine F.; Guilkey, Karen; Sayenko, Dimitry G.; Williams, Steve; Atkinson, Kimberly; Ardolino, Elizabeth; Behrman, Andrea L.; Harkema, Susan J.; Oakley, Amanda; Warwick, Lisa; Becker, Daniel; Rotondo, Kimberly; Greenemeier, Sarah; Martin, Rebecca; Sadowsky, Cristina; Morgan, Marie Vazquez; Tinsley, Suzanne; Ferguson, Shannon; Backus, Deborah; Riley, Casey; McClure, Isa A.; McCarthy, Sean K.; Frisina, Pasquale; Kirshblum, Steven C.; Gill, Megan; Kaufman, Kenton; Beck, Lisa; Reeves, Ronald; Mittelbrun, Ionica; Kimbrell, Megan; Switzer, Ernest; Franckowiak, Teresa; Rovito, Deborah; Sikka, Seema; Dixon, Thomas; Cavadini, Natalie; Wojciehowksi, Sandra; Brooks, Monifa; Forrest, Gail F.; Kirshblum, Steven; Taylor, Sally; Natale, Audrey; Jaramillo, J.; Johanson, M. E.; Dairaghi, C.; Murray, W.; Hentz, V.; Hong, Minna; Earhart, Gammon M.; Jenny Kiratli, B.; Young, Christa; Charlifue, Susan; Berman, Joseph E.; Monroy, Edwin P.; Benes, Paula; Eells, Janis T.; Handrakis, John P.; Liu, Shou-an; Rosado-Rivera, Dwindally; Krajewski, Megan; Sarker, Md. Samiul J.; Swonger, Kirsten; Bauman, William A.; DeMark, Lou;
• Is Part Of: Journal of spinal cord medicine. Volume 36:Number 5(2013:Sep.)
• Page Start: 524
• Page End: 567
• Publication Date: 2013-09-01
• Subjects: Spinal cord -- Wounds and injuries -- Periodicals; Spinal cord -- Diseases -- Periodicals; 616.8305
• DOI: 10.1179/1079026813Z.000000000207
• Languages: English
• ISSNs: 1079-0268

Abstract

Abstract : Background We have demonstrated comparable increases in blood pressure (BP) after administration of midodrine and L-NAME during laboratory assessments in individuals with spinal cord injury (SCI). However, effects of these anti-hypotensive agents on 24-hour hemodynamics in those with SCI compared to intact able-bodied (AB) controls have not been reported. Objective To determine average (avg), minimum (min), and maximum (max) 24-hour systolic BP (SBP) diastolic BP (DBP) and heart rate (HR) responses in individuals with SCI and controls following administration of (1) midodrine hydrochloride (10 mg), (2) a nitric oxide synthase inhibitor (L-NAME (1.0 mg/kg)), and (3) no drug. Design Open-label randomized prospective trial. Participants/Methods These anti-hypotensive agents were administered in random order over three visits in 13 individuals with SCI (T: C3-T4) and six AB controls. Twenty-four-hour hemodynamic data were collected using a portable BP monitor that recorded BP and HR every 20 minutes during the daytime and every 30 minutes during the nighttime. Data were analyzed with a 3 (condition: no drug, midodrine, L-NAME) by 2 (group: SCI, AB) repeated measures analysis of variance. Results There were no significant main or interaction effects for 24-hour SBPavg, DBPavg, HRavg, SBPmin, DBPmin, or HRmin. However, in subjects with SCI, 24-hour SBPmax and DBPmax were significantly increased with midodrine (135 ± 17/90 ± 13) and L-NAME (128 ± 10/84 ± 8) compared to no drug (92 ± 8/53 ± 7; P < 0.0001). In addition, HRmax, was significantly increased after administration of midodrine (88 ± 13 bpm) and L-NAME (97 ± 20 bpm) compared to no drug (55 ± 7 bpm; P < 0.0001) in those with SCI. Three subjects with SCI had hypertensive responses (SBPmax ≥ 140 or DBPmax ≥ 90 mmHg) to both L-NAME and midodrine; an additional four subjects had hypertensive responses to midodrine only, and one subject had a DBPmax in the hypertensive range after L-NAME administration. Conclusion Although average 24-hour hemodynamics were not significantly changed after administration of these anti-hypotensive agents, maximum BP was increased. Qualitatively, there was an increased proportion of hypertensive responses after midodrine than after L-NAME administration. Before these anti-hypotensive medications can be considered safe for long-term use in the SCI population, these hemodynamic responses should be studied in greater detail for extended periods.