title: Altered left ventricular diastolic function in subjects with spinal cord injury.
abstract: METHODS
  This is cross-sectional study.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  São 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Campinas, São Paulo, Brazil.
authors.forename: J R
authors.initials: JR
authors.lastname: Matos-Souza
authors.forename: K R
authors.initials: KR
authors.lastname: Pithon
authors.forename: R T D
authors.initials: RT
authors.lastname: Oliveira
authors.forename: F H
authors.initials: FH
authors.lastname: Téo
authors.forename: M H S L
authors.initials: MH
authors.lastname: Blotta
authors.forename: A
authors.initials: A
authors.lastname: Cliquet
authors.forename: W
authors.initials: W
authors.lastname: Nadruz
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity / Q000639:trends; D003430:Cross-Sectional Studies; D054144:Heart Failure, Diastolic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology; D006801:Humans; D008297:Male; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000503:physiopathology*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*