College of Medicine, University of Saskatchewan Regina Campus, Regina, SK, Canada; Prairie Vascular Research Inc, Regina, SK, Canada.
College of Medicine, University of Saskatchewan Regina Campus, Regina, SK, Canada; Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
Auton Neurosci. 2024 Apr;252:103160. doi: 10.1016/j.autneu.2024.103160. Epub 2024 Feb 24.
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.
目前，在诊断和处理运动相关性脑震荡（SRC）方面仍然存在很多不确定性。神经生物学的恢复可能会超出 SRC 后的临床恢复，这凸显了需要客观的生理参数来指导诊断和管理。随着人们对心脏和大脑之间联系的认识不断加深，评估 SRC 后心血管功能的效用引起了关注。因此，本综述重点关注 SRC 背景下的心血管参数评估。尽管报告的结果存在冲突，但在急性 SRC 中已经显示出心率变异性、血压变异性和收缩（射血）时间降低，以及自发性压力感受反射敏感性和心房收缩幅度增加。我们提出，这些发现是由脑震荡引发的神经代谢级联反应引起的，代表了心肌钙处理、自主神经功能障碍以及试图在 SRC 后维持体内平衡的代偿性反应的改变。心血管系统的评估有可能有助于 SRC 的诊断和管理，有助于更全面和多模式的评估策略。
