Abstract 5842: Altered Left Ventricular Diastolic Function in Spinal Cord Injury Subjects
Background: Individuals with spinal cord injury (SCI) are reported to have increased cardiovascular risk in comparison to able-bodied ones. This study evaluated the hypothesis that cardiac structure and function might be altered in SCI individuals.
Methods: Sixty-five nondiabetic, nonhypertensive, sedentary, nonsmoker men (34 with SCI and 31 healthy subjects) were evaluated by medical history, anthropometry, routine laboratory tests, analysis of hemodynamic and inflammatory parameters and echocardiographic examination.
Results: SCI (18 quadriplegic and 16 paraplegic) subjects had lower systolic blood pressure (p=0.009) and higher levels of C-reactive protein (p=0.001) and tumor necrosis factor receptors (p<0.05) than healthy ones. The SCI group presented similar left ventricular (LV) structural and systolic parameters, but lower Em (p<0.0001) and higher E/Em ratio (p=0.008), compared to the able-bodied group, even after adjustment for systolic blood pressure and C-reactive protein levels. Furthermore, injured subjects with E/Em>8 (n=13) had lower Sm (p<0.001), cardiac output (p=0.03) and higher relative wall thickness (p=0.005) than SCI individuals with E/Em<8 (n=24), but similar age, body mass index, blood pressure, injury level, metabolic parameters and inflammatory marker levels.
Conclusion: Taken together, data demonstrated that subjects with SCI presented impaired LV diastolic function in comparison to able-bodied ones and revealed that worse LV diastolic function was associated with a pattern of LV concentric remodeling and subclinical decreases in systolic function among injured subjects. These findings might contribute to explain the increased cardiovascular risk reported for SCI individuals.