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Assessment of cardiovascular functioning following sport-related concussion: A physiological perspective
Autonomic Neuroscience ( IF 2.7 ) Pub Date : 2024-02-24 , DOI: 10.1016/j.autneu.2024.103160
Chase J. Ellingson , M. Abdullah Shafiq , Cody A. Ellingson , J. Patrick Neary , Payam Dehghani , Jyotpal Singh

There is still much uncertainty surrounding the approach to diagnosing and managing a sport-related concussion (SRC). Neurobiological recovery may extend beyond clinical recovery following SRC, highlighting the need for objective physiological parameters to guide diagnosis and management. With an increased understanding of the connection between the heart and the brain, the utility of assessing cardiovascular functioning following SRC has gained attention. As such, this review focuses on the assessment of cardiovascular parameters in the context of SRC. Although conflicting results have been reported, decreased heart rate variability, blood pressure variability, and systolic (ejection) time, in addition to increased spontaneous baroreflex sensitivity and magnitude of atrial contraction have been shown in acute SRC. We propose that these findings result from the neurometabolic cascade triggered by a concussion and represent alterations in myocardial calcium handling, autonomic dysfunction, and an exaggerated compensatory response that attempts to maintain homeostasis following a SRC. Assessment of the cardiovascular system has the potential to assist in diagnosing and managing SRC, contributing to a more comprehensive and multimodal assessment strategy.

中文翻译:

运动相关脑震荡后心血管功能的评估:生理学角度

运动相关脑震荡 (SRC) 的诊断和治疗方法仍然存在很多不确定性。神经生物学恢复可能超出 SRC 后的临床恢复范围,这突出表明需要客观的生理参数来指导诊断和管理。随着对心脏和大脑之间联系的了解不断加深,SRC 后评估心血管功能的实用性已引起人们的关注。因此,本综述重点关注 SRC 背景下心血管参数的评估。尽管报道的结果相互矛盾,但在急性 SRC 中,心率变异性、血压变异性和收缩(射血)时间降低,并且自发性压力反射敏感性和心房收缩幅度增加。我们认为这些发现是脑震荡引发的神经代谢级联反应的结果,代表了心肌钙处理的改变、自主神经功能障碍以及 SRC 后试图维持体内平衡的过度补偿反应。心血管系统评估有可能协助诊断和管理 SRC,有助于制定更全面、多模式的评估策略。
更新日期:2024-02-24
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