TY - JOUR
T1 - Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects
AU - Kessler, Kenneth M.
AU - Pina, Ileana
AU - Green, Barth
AU - Burnett, Betsy
AU - Laighold, Martin
AU - Bilsker, Martin
AU - Palomo, Andres R.
AU - Myerburg, Robert J.
N1 - Funding Information:
From the Division of Cardiology, Department of Medicine, and the Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida. Dr. Bilsker is supported in part by an Investigator Grant from the American Heart Association, Broward County Chapter, Florida. Manuscript received December 23, 1985; revised manuscript received March 14, 1986, accepted March 17,1986.
PY - 1986/9/1
Y1 - 1986/9/1
N2 - Seven normal, 7 paraplegic and 7 quadriplegic patients underwent cross-sectional cardiovascular evaluation, including recording of sitting heart rate, blood pressure and echocardiography. Quadriplegic patients had a 26% lower left ventricular (LV) mass index (75 ± 13 g/m2, p < 0.01) compared with normal volunteers (102 ± 16 g/m2) or paraplegic patients (110 ± 26 g/m2). Six quadriplegic patients and 3 paraplegic patients had an unusual pattern of LV posterior wall asynergy, which was associated with a significant rightward shift of the frontal-plane QRS axis (92 ± 22 ° vs 42 ± 41 °, p < 0.005) and smaller left atrial dimensions (2.4 ± 0.4 vs 3.0 ± 0.3 cm, p < 0.005). The quadriplegic group was characterized by a significantly reduced mean blood pressure (67 ± 7 vs 88 ± 8 mm Hg in normal subjects, p < 0.002), high normal peripheral resistances (22 ± 5 vs 17 ± 5 units in normal subjects, difference not significant) and a markedly reduced calculated cardiac output (3.2 ± 0.6 vs 5.4 ± 1.4 liters/min in normal subjects, p < 0.01). Hemodynamic data for the paraplegic patients were similar to those in the normal group. A decrease in LV wall stress, mediated primarily by a decrease in venous return, appeared to result in the "adaptive" cardiac atrophy seen in these quadriplegic patients. LV asynergy was common and also may be related to a decrease in cardiac filling.
AB - Seven normal, 7 paraplegic and 7 quadriplegic patients underwent cross-sectional cardiovascular evaluation, including recording of sitting heart rate, blood pressure and echocardiography. Quadriplegic patients had a 26% lower left ventricular (LV) mass index (75 ± 13 g/m2, p < 0.01) compared with normal volunteers (102 ± 16 g/m2) or paraplegic patients (110 ± 26 g/m2). Six quadriplegic patients and 3 paraplegic patients had an unusual pattern of LV posterior wall asynergy, which was associated with a significant rightward shift of the frontal-plane QRS axis (92 ± 22 ° vs 42 ± 41 °, p < 0.005) and smaller left atrial dimensions (2.4 ± 0.4 vs 3.0 ± 0.3 cm, p < 0.005). The quadriplegic group was characterized by a significantly reduced mean blood pressure (67 ± 7 vs 88 ± 8 mm Hg in normal subjects, p < 0.002), high normal peripheral resistances (22 ± 5 vs 17 ± 5 units in normal subjects, difference not significant) and a markedly reduced calculated cardiac output (3.2 ± 0.6 vs 5.4 ± 1.4 liters/min in normal subjects, p < 0.01). Hemodynamic data for the paraplegic patients were similar to those in the normal group. A decrease in LV wall stress, mediated primarily by a decrease in venous return, appeared to result in the "adaptive" cardiac atrophy seen in these quadriplegic patients. LV asynergy was common and also may be related to a decrease in cardiac filling.
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U2 - 10.1016/0002-9149(86)90027-5
DO - 10.1016/0002-9149(86)90027-5
M3 - Article
C2 - 3751915
AN - SCOPUS:0022469035
SN - 0002-9149
VL - 58
SP - 525
EP - 530
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
IS - 6
ER -