Differences in Left Ventricular Global Function and Mechanics in Paralympic Athletes with Cervical and Thoracic Spinal Cord Injuries

Frontiers in Physiology, 2016 · DOI: 10.3389/fphys.2016.00110 · Published: March 29, 2016

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study investigates the heart function of Paralympic athletes with spinal cord injuries. It compares athletes with cervical injuries (TETRA) to those with thoracic injuries (PARA) to see if differences in their stroke volume (the amount of blood pumped by the heart with each beat) can be linked to the heart's ability to function correctly. The study found that while both groups had similar heart structure and diastolic function (the heart's ability to relax and fill with blood), the TETRA group had lower stroke volume and cardiac output (the total amount of blood pumped per minute). However, surprisingly, the TETRA group showed better heart muscle mechanics than the PARA group. The researchers suggest that the lower stroke volume in the TETRA group is likely due to problems with blood returning to the heart, rather than a problem with the heart muscle itself. The PARA group's lower heart muscle mechanics might be a result of their training, allowing for a greater range of cardiovascular adjustments during exercise.

Study Duration

Not specified

Participants

16 male Paralympic athletes (8 TETRA, 8 PARA)

Evidence Level

Level 3: Retrospective Comparative Study

Key Findings

1
There was no difference in left ventricular dimensions between TETRA and PARA groups.
2
Indices of global diastolic function were similar between groups.
3
Global systolic function was reduced in TETRA compared to PARA, including lower SV and cardiac output.

Research Summary

This study examined the influence of spinal cord lesion level on resting left ventricular (LV) structure, function, and mechanics in Paralympic athletes. The primary aim was to determine if alterations in stroke volume (SV) following SCI are attributable to inherent LV dysfunction. The study revealed that while there were no differences in LV dimensions or global diastolic function, global systolic function was reduced in TETRA (cervical SCI) compared to PARA (thoracic SCI). This was evident in lower SV and cardiac output (Q). Despite the reduced systolic function in TETRA, there were no indicators of LV mechanical dysfunction in this group. PARA athletes, conversely, presented with attenuated systolic and diastolic mechanics. The study concludes that reduced SV is likely due to impaired venous return rather than inherent LV dysfunction.

Practical Implications

Training Strategies

Training programs for athletes with tetraplegia should focus on improving venous return to enhance stroke volume and cardiac output.

Performance Optimization

Understanding the differences in cardiovascular adaptations between cervical and thoracic SCI can help tailor training regimens to optimize athletic performance.

Clinical Relevance

The study highlights the importance of considering lesion level when assessing cardiovascular function in individuals with SCI, which may inform clinical management strategies.

Study Limitations

1
The absence of an able-bodied control group makes it difficult to draw conclusions regarding the direction of the LV mechanics.
2
The study acknowledges the potential influence of training modality on the observed differences.
3
Future research should evaluate athletes in similar sporting events to control for sport-specific adaptations.

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