Temporal Changes of Cardiac Structure, Function, and Mechanics During Sub-acute Cervical and Thoracolumbar Spinal Cord Injury in Humans: A Case-Series

Frontiers in Cardiovascular Medicine, 2022 · DOI: 10.3389/fcvm.2022.881741 · Published: June 15, 2022

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study investigates how the structure and function of the heart change in people with spinal cord injuries (SCI) during the first six months after the injury. It focuses on comparing individuals with cervical SCI (neck) to those with thoracolumbar SCI (upper and lower back). The study used echocardiography to assess the heart's structure, function, and mechanics at 3 and 6 months post-injury. The results showed that individuals with cervical SCI experienced a decline in cardiac function between the 3- and 6-month assessments, while those with thoracolumbar SCI did not. These findings suggest that the level of spinal cord injury can affect how the heart adapts in the early stages after injury. Early rehabilitation may be needed to minimize heart problems in people with cervical SCI.

Study Duration

6 months

Participants

10 male individuals with cervical (n = 5, c-SCI) or thoracolumbar (n = 5, tl-SCI) motor-complete SCI

Evidence Level

Case-Series

Key Findings

1
Individuals with cervical SCI showed significant reductions in cardiac function between 3 and 6 months post-injury, including decreases in end diastolic volume, stroke volume, myocardial contractile velocity, and peak diastolic longitudinal strain rate.
2
Ejection fraction was different between individuals with c-SCI and tl-SCI at both 3- and 6-month time points, though values were considered normal.
3
Individuals with thoracolumbar SCI did not exhibit significant changes in cardiac function between the 3- and 6-month assessments.

Research Summary

This study investigated the temporal changes in cardiac structure, function, and mechanics in individuals with cervical and thoracolumbar SCI during the sub-acute phase (within the first 6 months post-injury). The results demonstrated that individuals with cervical SCI experienced significant reductions in cardiac function from 3 to 6 months post-injury, whereas individuals with thoracolumbar SCI did not. These findings suggest the need for early rehabilitation strategies to minimize cardiac consequences in individuals with cervical SCI.

Practical Implications

Early Rehabilitation

Early rehabilitation interventions may be crucial for individuals with cervical SCI to mitigate the decline in cardiovascular function during the sub-acute period.

Targeted Therapies

Further research is needed to identify effective therapeutic strategies, including exercise modalities and pharmacological interventions, to improve or maintain cardiac health in individuals with cervical SCI.

Personalized Care

Healthcare providers should consider the neurological level of injury when developing care plans for individuals with SCI, as those with cervical injuries may require more intensive monitoring and intervention to address cardiac complications.

Study Limitations

1
The study was limited by a small sample size of 10 male participants.
2
Autonomic completeness of the injury was not measured, making it difficult to definitively attribute the findings to disrupted supraspinal cardiac control.
3
MH-LTPA variations also emphasize the potential limitations of using self-report questionnaires.

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