The Initial Systolic Time Interval in patients with spinal cord injury measured with impedance cardiography

The Initial Systolic Time Interval (ISTI), obtained from the electrocardiogram and impedance cardiogram, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart. This time delay is influenced by the sympathetic nerve system. Therefore, an observational study was performed in a group of patients (SCI) with spinal cord injuries. The relationship between the ISTI and the total heart cycle (RR-interval) was established by varying the RR-interval using an exercise stimulus to increase the heart rate. The slope of this relationship was observed to be significantly higher in the SCI-group as compared with a control group, although there was no difference in ISTI in the range of common heart rates during the test between the groups. This slope and the ISTI was observed to be significantly different in an acute patient having a recent spinal cord injury at a high level. Because of the variety in injury levels and incompleteness of the injuries further, more specific research is necessary to draw decisive conclusions with respect to the contribution of autonomic nervous control on the ISTI in SCI, although the present observations are notable.