title: Physical activity and improved diastolic function in spinal cord-injured subjects.
abstract: OBJECTIVE
  Subjects with spinal cord injury (SCI) have been reported to present impaired left ventricular (LV) diastolic function in comparison with able-bodied (AB) ones. The present study investigated the effect of regular physical activity on the cardiac structure and function of SCI subjects.
  
  
  METHODS
  Fifty-eight SCI men (29 sedentary [SCI-S] and 29 athletes [SCI-A]) and 29 AB men were cross-sectionally evaluated by clinical, laboratory, hemodynamic, and echocardiographic analysis. All enrolled subjects were normotensive, nondiabetic, nonsmoker, and normolipemic, and the studied groups presented similar age and body mass index.
  
  
  RESULTS
  SCI-S presented similar LV structural and systolic parameters but higher E/Em (8.0 ± 0.5) and lower Em/Am (1.18 ± 0.09) ratios than SCI-A and AB (E/Em = 6.4 ± 0.3 and 5.9 ± 0.3, respectively; Em/Am = 1.57 ± 0.12 and 1.63 ± 0.08, respectively; all P < 0.05 compared with SCI-S). Analysis of SCI individuals according to injury level revealed that tetraplegic athletes had similar features compared with sedentary tetraplegic subjects, except for higher Em (10.9 ± 0.6 vs 8.6 ± 0.7 cm s, P < 0.05) and lower E/Em ratio (6.3 ± 0.4 vs 8.8 ± 0.8, P < 0.05), whereas paraplegic athletes had similar features compared with sedentary paraplegic individuals, except for higher LV end-diastolic diameter (49.4 ± 1.4 vs 45.0 ± 1.0 mm, P < 0.05) and Em/Am ratio (1.69 ± 0.20 vs 1.19 ± 0.08, P < 0.05) and lower LV relative wall thickness (0.330 ± 0.012 vs 0.369 ± 0.010, P < 0.05) and heart rate (67.1 ± 4.2 vs 81.9 ± 2.8 bpm, P < 0.05).
  
  
  CONCLUSIONS
  Regular physical activity is associated with improved LV diastolic function in SCI subjects and might exert distinct cardiac structural effects in tetraplegic and paraplegic subjects.
authors.affiliation: 1Department of Internal Medicine, University of Campinas, Campinas, BRAZIL; 2School of Physical Education, University of Campinas, Campinas, SP, BRAZIL; 3Department of Orthopaedics, School of Medical Sciences, University of Campinas, Campinas, SP, BRAZIL; and 4Department of Electrical Engineering, University of São Paulo, São Carlos, SP, BRAZIL.
authors.forename: Guilherme
authors.initials: G
authors.lastname: DE Rossi
authors.forename: José R
authors.initials: JR
authors.lastname: Matos-Souza
authors.forename: Anselmo D E A
authors.initials: AD
authors.lastname: Costa E Silva
authors.forename: Luis F
authors.initials: LF
authors.lastname: Campos
authors.forename: Luiz G
authors.initials: LG
authors.lastname: Santos
authors.forename: Eliza R
authors.initials: ER
authors.lastname: Azevedo
authors.forename: Karina C
authors.initials: KC
authors.lastname: Alonso
authors.forename: Layde R
authors.initials: LR
authors.lastname: Paim
authors.forename: Roberto
authors.initials: R
authors.lastname: Schreiber
authors.forename: José I
authors.initials: JI
authors.lastname: Gorla
authors.forename: Alberto
authors.initials: A
authors.lastname: Cliquet
authors.forename: Wilson
authors.initials: W
authors.lastname: Nadruz
mesh_terms: D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000503:physiopathology; D011782:Quadriplegia / Q000503:physiopathology; D057185:Sedentary Behavior; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*