DE Rossi Guilherme, Matos-Souza José R, Costa E Silva Anselmo D E A, Campos Luis F, Santos Luiz G, Azevedo Eliza R, Alonso Karina C, Paim Layde R, Schreiber Roberto, Gorla José I, Cliquet Alberto, Nadruz Wilson
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.
Med Sci Sports Exerc. 2014;46(5):887-92. doi: 10.1249/MSS.0000000000000187.
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.
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.
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).
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.
据报道，与健全人相比，脊髓损伤（SCI）患者存在左心室（LV）舒张功能受损的情况。本研究调查了规律体育活动对SCI患者心脏结构和功能的影响。
通过临床、实验室、血流动力学和超声心动图分析，对58名SCI男性（29名久坐不动者[SCI-S]和29名运动员[SCI-A]）以及29名健全男性进行横断面评估。所有纳入的受试者血压正常、无糖尿病、不吸烟且血脂正常，各研究组的年龄和体重指数相似。
与SCI-A和健全人相比，SCI-S的左心室结构和收缩参数相似，但E/Em比值更高（8.0±0.5），Em/Am比值更低（1.18±0.09）（SCI-A和健全人的E/Em比值分别为6.4±0.3和5.9±0.3；Em/Am比值分别为1.57±0.12和1.63±0.08；与SCI-S相比，所有P<0.05）。根据损伤水平对SCI个体进行分析发现，四肢瘫痪运动员与久坐不动的四肢瘫痪受试者相比，除了Em更高（10.9±0.6对8.6±0.7cm/s，P<0.05）和E/Em比值更低（6.3±0.4对8.8±0.8，P<0.05）外，其他特征相似；而截瘫运动员与久坐不动的截瘫个体相比，除了左心室舒张末期直径更大（49.4±1.4对45.0±1.0mm，P<0.05）、Em/Am比值更高（1.69±0.20对1.19±0.08，P<0.05）以及左心室相对壁厚更低（0.330±0.012对0.369±0.010，P<0.05）和心率更低（67.1±4.2对81.9±2.8次/分钟，P<0.05）外，其他特征相似。
规律体育活动与SCI患者左心室舒张功能改善相关，并且可能对四肢瘫痪和截瘫患者产生不同的心脏结构影响。
