Article

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 +/-
0.4 cm s(-1); P<0.001) and cardiac output (4.2 +/- 0.2 vs 5.0 +/- 0.2 l 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.

Langue : ANGLAIS