Time-course of Cardiac Changes following Acute Spinal Cord Injury
1Balthazaar S, 2Currie K, 1Gavric M, 1Krassioukov A
1International Collaboration On Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 2Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
Objective: Spinal cord injury (SCI) results in unfavourable changes to the cardiovascular system and its regulation via the autonomic nervous system. Rodent investigations demonstrates the heart changes after SCI. Studies in humans with chronic SCI demonstrate different cardiac indices compared to able-bodied individuals, as well as between lesion levels (i.e., cervical vs. thoracic). The time-course of cardiac adaptations post-SCI in humans is presently unknown. Therefore, the goal of this study was to track the time-course of cardiac changes following acute SCI using a longitudinal study design with measurements at 3, 6 and 12-months post-SCI. Data collection is currently ongoing, therefore we present a preliminary comparison of cardiac indices at 3 and 6-months post-SCI in cervical and thoracic SCI groups.
Design/Methods: Eight subjects (AIS A and B, males and females, age 18-60) with cervical (n=4) and thoracic (n=4) SCI underwent echocardiography at 3 and 6 months post-acute traumatic SCI. Stroke volume and ejection fraction (i.e., systolic function) were calculated by using a one plane volumetric assessment by method of disks (4 chamber, apical view). Diastolic function was assessed using the ratio of early transmitral filling velocity (E) to the average of early septal and lateral myocardial annular velocities (E').
Results: Preliminary analysis revealed no difference in E/E' between lesion level groups at 3 (p=0.23) and 6-months post-SCI (p=0.19). Stroke volume was also similar between groups at each time point. Mean ejection fraction was similar at 3-months (61 +/- 6% vs. 57 +/- 2%, for cervical vs. thoracic at p=0.22), but lower in cervical SCI at 6-months (54 +/- 2% vs. 62 +/- 2%, for cervical vs. thoracic at p<0.01).
Conclusion: This study is the first to examine the cardiac indices during acute and subacute periods of SCI in humans. Our observations suggest diastolic function is similar between lesion level groups during this acute period. Conversely, the difference in ejection fraction at 6-months suggests this variable may have changed. Further insight into what variables change and their specific time-course of adaptation will be established upon study completion. The importance of these temporal changes could provide us insight on clinical management and prevention of cardiac function deterioration following SCI.
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