Abstract
Objective
To determine the alterations in cardiac structure and function that occur in the months
after spinal cord injury (SCI).
Study Design
Cross-sectional
Setting
Rehabilitation Hospital
Participants
Volunteers (N=29; 4 women, 25 men) between 3 and 24 months after SCI.
Main Outcome Measures
Transthoracic echocardiography was performed on each volunteer. The relationships
between time since injury and neurologic and sensory levels of injury to cardiac structure
and function were assessed via multiple linear regression.
Results
Time since injury was most strongly associated with reductions in left ventricular
end diastolic volume (r2=0.156; P=.034), end systolic volume (r2=0.141; P=.045), and mass (r2=0.138; P=.047). These structural changes were paralleled by reduced stroke volume (r2=0.143; P=.043) and cardiac output (r2=0.317; P=<.001). The reductions in left ventricular structure and systolic function were not
differentially affected by neurologic or sensory levels of injury (P=.084-.921).
Conclusions
These results suggest progressive reductions in left ventricular structure and systolic
function between 3 and 24 months after SCI that occur independent of neurologic and
sensory levels of injury.
Keywords
List of abbreviations:
2D (2-dimensional), LV (left ventricle), LVEDV (volume of the left ventricle during diastole), LVESV (volume of the left ventricle during systole), LVM (LV mass), SCI (spinal cord injury)To read this article in full you will need to make a payment
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References
- Cardiac consequences of spinal cord injury: systematic review and meta-analysis.Heart. 2019; 105: 217-225
- The effect of FES-rowing training on cardiac structure and function: pilot studies in people with spinal cord injury.Spinal Cord. 2016; 54: 822-829
- Resting cardiopulmonary function in paralympic athletes with cervical spinal cord injury.Med Sci Sports Exerc. 2012; 44: 323-329
- Structural and functional left ventricular impairment in subjects with chronic spinal cord injury and no overt cardiovascular disease.J Spinal Cord Med. 2014; 37: 85-92
- Preserved cardiac function after chronic spinal cord injury.Arch Phys Med Rehabil. 2006; 87: 1195-1200
- Altered left ventricular diastolic function in subjects with spinal cord injury.Spinal Cord. 2011; 49: 65-69
- Absence of training-specific cardiac adaptation in paraplegic athletes.Med Sci Sports Exerc. 2002; 34: 1699-1704
- Passive hind-limb cycling improves cardiac function and reduces cardiovascular disease risk in experimental spinal cord injury.J Physiol. 2014; 592: 1771-1783
- Genomic responses in mouse models poorly mimic human inflammatory diseases.Proc Natl Acad Sci U S A. 2013; 110: 3507-3512
- Animal models in spinal cord injury: a review.Rev Neurosci. 2008; 19: 47-60
- Autonomic function following cervical spinal cord injury.Respir Physiol Neurobiol. 2009; 169: 157-164
- A prospective study on physical activity levels after spinal cord injury during inpatient rehabilitation and the year after discharge.Arch Phys Med Rehabil. 2008; 89: 2094-2101
- Cardiovagal baroreflex gain relates to sensory loss after spinal cord injury.FASEB J. 2019; 33: 495
- Cardiovascular function in individuals with incomplete spinal cord injury: a systematic review.Top Spinal Cord Inj Rehabil. 2013; 19: 267-278
- Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis.Spinal Cord. 2012; 50: 484-492
- Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography.J Am Soc Echocardiogr. 2019; 32: 1-64
- Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete’s heart.Heart. 2013; 99: 1727-1733
- Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging.Eur Heart J Cardiovasc Imaging. 2015; 16: 233-271
- Clinical calorimetry: tenth paper a formula to estimate the approximate surface area if height and weight be known.Arch Intern Med. 1916; XVII: 863-871
- Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study.Eur Heart J Cardiovasc Imaging. 2014; 15 (680-90)
- Cardiac atrophy after bed rest and spaceflight.J Appl Physiol. 2001; 91: 645-653
- Selection of endurance capabilities and the trade-off between pressure and volume in the evolution of the human heart.Proc Natl Acad Sci. 2019; 116: 19905-19910
- Left ventricular structure and function in elite swimmers and runners.Front Physiol. 2018; 9: 1-6
- Training-specific changes in cardiac structure and function: a prospective and longitudinal assessment of competitive athletes.J Appl Physiol. 2008; 104: 1121-1128
- Reversal of adaptive left ventricular atrophy following electrically-stimulated exercise training in human tetraplegics.Paraplegia. 1991; 29: 590-599
- Autonomic cardiovascular control and sports classification in Paralympic athletes with spinal cord injury.Disabil Rehabil. 2017; 39: 127-134
- Multi-domain assessment of autonomic function in spinal cord injury using a modified autonomic reflex screen.J Neurotrauma. 2017; 34: 2624-2633
Article info
Publication history
Published online: February 05, 2021
Footnotes
Supported by NIH R01 HL117037 and NIDILRR–Spinal Cord Injury Model Systems Program 90S15021-01-00.
Clinical Trial Identifier: NCT02139436.
Disclosures: none.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine
