PDF(Pubmed)
Abstract：
Individuals with cervical spinal cord injury (SCI) experience deleterious changes in cardiac structure and function. However, knowledge on when cardiac alterations occur and whether this is dependent upon neurological level of injury remains to be determined. Transthoracic echocardiography was used to assess left ventricular structure, function, and mechanics in 10 male individuals (median age 34 years, lower and upper quartiles 32-50) with cervical (n = 5, c-SCI) or thoracolumbar (n = 5, tl-SCI) motor-complete SCI at 3- and 6-months post-injury. Compared to the 3-month assessment, individuals with c-SCI displayed structural, functional, and mechanical changes during the 6-month assessment, including significant reductions in end diastolic volume [121 mL (104-139) vs. 101 mL (99-133), P = 0.043], stroke volume [75 mL (61-85) vs. 60 mL (58-80), P = 0.042], myocardial contractile velocity (S\') [0.11 m/s (0.10-0.13) vs. 0.09 m/s (0.08-0.10), P = 0.043], and peak diastolic longitudinal strain rate [1.29°/s (1.23-1.34) vs. 1.07°/s (0.95-1.15), P = 0.043], and increased early diastolic filling over early myocardial relaxation velocity (E/E\') ratio [5.64 (4.71-7.72) vs. 7.48 (6.42-8.42), P = 0.043]. These indices did not significantly change in individuals with tl-SCI between time points. Ejection fraction was different between individuals with c-SCI and tl-SCI at 3 [61% (57-63) vs. 54% (52-55), P < 0.01] and 6 months [58% (57-62) vs. 55% (52-56), P < 0.01], though values were considered normal. These results demonstrate that individuals with c-SCI exhibit significant reductions in cardiac function from 3 to 6 months post-injury, whereas individuals with tl-SCI do not, suggesting the need for early rehabilitation to minimize cardiac consequences in this specific population.
摘要：
患有颈脊髓损伤（SCI）的个体会经历心脏结构和功能的有害变化。然而,关于心脏改变何时发生以及这是否取决于神经损伤程度的知识仍有待确定。经胸超声心动图用于评估左心室结构，函数,和力学在10个男性个体中(中位年龄34岁，受伤后3个月和6个月时，下四分位数32-50）伴有宫颈（n=5，c-SCI）或胸腰椎（n=5，tl-SCI）运动完全SCI。与3个月的评估相比，具有c-SCI的个体显示出结构，功能，以及6个月评估期间的机械变化，包括舒张末期容积显著减少[121毫升（104-139）与101毫升（99-133），P=0.043],每搏量[75毫升(61-85)vs.60毫升（58-80），P=0.042],心肌收缩速度(S')[0.11m/s(0.10-0.13)vs.0.09m/s(0.08-0.10),P=0.043],和峰值舒张纵向应变率[1.29°/s(1.23-1.34)vs.1.07°/s(0.95-1.15),P=0.043],早期舒张充盈高于早期心肌舒张速度(E/E')比值[5.64(4.71-7.72)vs.7.48(6.42-8.42),P=0.043]。这些指数在时间点之间在具有tl-SCI的个体中没有显著变化。c-SCI和tl-SCI患者的射血分数在3[61%（57-63）与54%（52-55），P<0.01]和6个月[58％（57-62）vs.55％（52-56），P<0.01],虽然值被认为是正常的。这些结果表明，患有c-SCI的个体在损伤后3至6个月表现出心脏功能的显着降低。而患有tl-SCI的人没有，建议需要早期康复，以最大程度地减少该特定人群的心脏后果。
