title: Cardiac Structure and Function in Elite Para-cyclists with Spinal Cord Injury.
abstract: We sought to explore the association between the spinal cord injury (SCI) level on the cardiac structure and the function observed in elite para-cyclists.
  
  
  
  Cross-sectional echocardiographic data from 44 elite SCI hand cyclists (39.8 ± 9 yr, 68% male/32% female) stratified by the level of SCI (cervical, N = 9; T1-T5, N = 10; below T5, N = 25) and 19 non-SCI blind/visually impaired (BVI) tandem cyclists (32.4 ± 7 yr, 58% male/42% female) were analyzed before the initiation of international competition.
  
  
  
  Compared with non-SCI BVI cyclists, cervical SCI para-cyclists were observed with lower indexed left ventricular (LV) mass (99.6 ± 12 vs 125 ± 20 g·m, P = 0.01), posterior wall thickness (4.5 ± 0.3 vs 5.8 ± 0.7 mm·m, P < 0.001), interventricular septal wall thickness (4.8 ± 0.5 vs 5.7 ± 0.7 mm·m; P = 0.03), and left atrial volume (21 ± 3.5 vs 28 ± 7 mL·m; P = 0.02). In multivariable analyses, cervical SCI was independently associated with decreased LV wall thickness [interventricular septum (β = -0.67, P = 0.01), posterior wall (β = -0.98, P = 0.001)], decreased LV mass (β = -21, P < 0.001), and decreased left atrial volume index (β = -6.9, P = 0.001) compared with other levels of SCI and non-SCI BVI cyclists. There were no differences in ventricular function among any of the athlete groups.
  
  
  
  Compared with para-cyclists with lower levels of SCI, the athletes with cervical SCI demonstrate attenuated cardiac size and concentric LV hypertrophy.
authors.affiliation: 1Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA; 2University of South Carolina School of Medicine Greenville, Greenville, SC; 3Department of Medicine, Greenville Health System, Greenville, SC; and 4Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Kim
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Trilk
authors.forename: Ryan
authors.initials: R
authors.lastname: Smith
authors.forename: Irfan
authors.initials: I
authors.lastname: Asif
authors.forename: Paul Tim
authors.initials: PT
authors.lastname: Maddux
authors.forename: Yi-An
authors.initials: YA
authors.lastname: Ko
authors.forename: Michael S
authors.initials: MS
authors.lastname: Emery
mesh_terms: D000328:Adult; D056352:Athletes; D001642:Bicycling / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology* / Q000502:physiology; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D016276:Ventricular Function