Altered left ventricular diastolic function in subjects with spinal cord injury

Author(s)

Matos-Souza, J. R. ^[1] ; Pithon, K. R. ^[2] ; Oliveira, R. T. D. ^[3] ; Teo, F. H. ^[3] ; Blotta, M. H. S. L. ^[3] ; Cliquet, Jr., A. ^{[4, 2]} ; Nadruz, Jr., W. ^[1]

Affiliation

^[1] Univ Estadual Campinas, Sch Med, Dept Internal Med, Sao Paulo - Brazil

^[2] Univ Estadual Campinas, Sch Med, Dept Orthopaed, Sao Paulo - Brazil

^[3] Univ Estadual Campinas, Sch Med, Dept Clin Pathol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Dept Elect Engn, Sao Paulo - Brazil

• Document type: Journal article
• Source: SPINAL CORD; v. 49, n. 1, p. 65-69, JAN 2011.
• Web of Science Citations: 18

Abstract

Study design: This is cross-sectional study. Objectives: The aim of this study is to investigate the cardiac structure and function of subjects with spinal cord injury (SCI) and the impact of metabolic, hemodynamic and inflammatory factors on these parameters. Setting: Sao Paulo, Brazil. Methods: Sixty-five nondiabetic, nonhypertensive, sedentary, nonsmoker men (34 with SCI and 31 healthy subjects) were evaluated by medical history, anthropometry, laboratory tests, analysis of hemodynamic and inflammatory parameters and echocardiography. Results: Subjects with SCI had lower systolic blood pressure and higher levels of C-reactive protein and tumor necrosis factor receptors than the healthy ones. Echocardiography data showed that the SCI group presented similar left ventricular (LV) structural and systolic parameters, but lower initial diastolic velocity (Em) (9.2 +/- 0.5 vs 12.3 +/- 0.5 cm s(-1); P<0.001) and higher peak early inflow velocity (E)/Em ratio (7.7 +/- 0.5 vs 6.1 +/- 0.3; P = 0.009) compared with the able-bodied group, even after adjustment for systolic blood pressure and C-reactive protein levels. Furthermore, injured subjects with E/Em >8 had lower peak spectral longitudinal contraction (Sm) (9.0 +/- 0.7 vs 11.6 +/- 0.4cm s(-1); P<0.001) and cardiac output (4.2 +/- 0.2 vs 5.0 +/- 0.21 min(-1); P = 0.029), as well as higher relative wall thickness (0.38 +/- 0.01 vs 0.35 +/- 0.01; P = 0.005), than individuals with SCI with E/Em<8, but similar age, body mass index, blood pressure, injury level, metabolic parameters and inflammatory marker levels. Conclusion: Subjects with SCI presented impaired LV diastolic function in comparison with able-bodied ones. Moreover, worse LV diastolic function was associated with a pattern of LV concentric remodeling and subclinical decreases in systolic function among injured subjects. Overall, these findings might contribute to explain the increased cardiovascular risk reported for individuals with SCI. Spinal Cord (2011) 49, 65-69; doi: 10.1038/sc.2010.88; published online 27 July 2010 (AU)