Reductions in Cardiac Structure and Function 24 Months After Spinal Cord Injury: A Cross-Sectional Study

Arch Phys Med Rehabil, 2021 · DOI: 10.1016/j.apmr.2021.01.070 · Published: August 1, 2021

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study looks at how the heart changes in people with spinal cord injuries (SCI) during the first two years after their injury. It checks heart size and how well the heart pumps blood. The study found that as time passes after a spinal cord injury, the heart tends to get smaller and pump less effectively. This happens regardless of where the injury is on the spine. These heart changes might be linked to the higher risk of heart problems seen in people with SCI, suggesting early interventions like exercise could be important.

Study Duration

24 Months

Participants

Twenty-nine (4F) volunteers 3 to 24 months post spinal cord injury

Evidence Level

Cross-sectional study

Key Findings

1
Time since injury was strongly associated with reductions in left ventricular end-diastolic volume, end-systolic volume, and mass.
2
Reduced stroke volume and cardiac output were observed, paralleling the structural changes in the heart.
3
The reductions in left ventricular structure and systolic function were not differentially affected by neurological or sensory levels of injury.

Research Summary

This cross-sectional study examined cardiac structure and function in individuals within the first 24 months after SCI and found that increased time since injury relates to a smaller cardiac structure. There were significant associations between increased time since injury and reduced systolic function, including reduced stroke volume and cardiac output. Neither neurological nor sensory level of spinal injury had an effect on these time-related declines.

Practical Implications

Early Intervention

Implementing training programs within the first 24 months following injury may be needed to attenuate or reverse cardiac mal-adaptations.

Clinical Monitoring

Clinicians should consider implementing interventions to prevent cardiac atrophy and the associated loss of systolic function within months of spinal cord injury.

Future Research

Longitudinal assessment of cardiac structure and function following SCI is needed to clarify the temporal relationship between SCI and adverse cardiac remodeling.

Study Limitations

1
Heart size and function were unknown prior to the date of injury.
2
The conclusions are based on a cross-sectional comparison of individuals 3 to 24 months post-injury, therefore predictions beyond this period should be made with caution.
3
Echocardiographs and blood pressure measures were taken up to 14 days apart.

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