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Cardiovascular control at rest and during exercise after Spinal Cord Injury: Implications for health

      Spinal cord injury (SCI) is associated with marked and rapid vascular adaptations that negatively impact upon activities of daily living, for example, orthostatic tolerance, heat stress and exercise performance, as well as cardiovascular health. Understanding the vascular adaptations after SCI will help to understand the underlying mechanisms for poor exercise tolerance and health in SCI. The onset of SCI is associated with rapid arterial remodeling in both large and smaller arteries. In conduit and resistance arteries, a rapid and strong inward remodeling is present, whilst results in impaired vascular function after SCI. Studies performed after exercise training in able-bodied individuals result in improved vascular function, largely through an increase in vasodilators. In contrast, SCI is not associated with favorable changes in vasodilators, but rather causes an increased role of vasoconstrictors in vascular function. Therefore, the effects of deconditioning, e.g., SCI, on the vasculature are not simply the opposite of those in response to exercise training. Moreover, exercise training in SCI is able to reverse functional and structural remodeling, which suggests that vascular adaptations in SCI are primarily caused by deconditioning.
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