Vriz Olga, Bertin Nicole, Ius Arianna, Bizzarini Emiliana, Bossone Eduardo, Antonini-Canterin Francesco
Department of Cardiology and Emergency, San Antonio Hospital, San Daniele Del Friuli, Udine, Italy.
Department of Rehabilitation Medicine, IMFR, Udine, Italy.
J Cardiovasc Echogr. 2017 Oct-Dec;27(4):132-140. doi: 10.4103/jcecho.jcecho_43_17.
The aim of this study was to compare arterial stiffness between people with paraplegia and able-bodied persons (ABPs) and to assess cardiovascular markers that may be predictive of the development of arterial hypertension in people with spinal cord injury (SCI).
This study was conducted at rehabilitation Hospital, Udine (Italy).
Fifty-seven patients with SCI were prospectively enrolled and compared with 88 healthy ABPs. All patients underwent comprehensive transthoracic echocardiography, and one-point left common carotid artery (CCA) color-Doppler study for arterial stiffness.
Patients with SCI had significantly lower body mass index (BMI) and diastolic blood pressure (BP) compared with ABPs, and significantly higher carotid stiffness values (and lower arterial compliance) ( < 0.05) after adjustment for age, sex, BMI, physical activity, and heart rate. The SCI patients had lower values of the right ventricular function parameters (tricuspid annular plane systolic excursion and right Sm; < 0.0001), increased wall thickness, and impaired diastolic function. At 7-year follow-up, 10.5% of SCI patients showed high BP; they were significantly heavier with a tendency toward increased abdominal obesity after adjustment for age and systolic BP. BMI was found to be an independent predictor of the development of hypertension.
Patients with posttraumatic chronic SCI and no overt cardiovascular disease exhibit higher CCA stiffness along with the left and right ventricular involvement, compared with ABPs. People with paraplegia who develop arterial hypertension show increased CCA stiffness mediated by obesity. Lifestyle modifications and weight control should be promoted in all patients with SCI, even at a very early stage.
本研究旨在比较截瘫患者与健全人之间的动脉僵硬度，并评估可能预测脊髓损伤（SCI）患者发生动脉高血压的心血管标志物。
本研究在意大利乌迪内康复医院进行。
前瞻性纳入57例SCI患者，并与88例健康健全人进行比较。所有患者均接受了全面的经胸超声心动图检查，以及单点左颈总动脉（CCA）彩色多普勒研究以评估动脉僵硬度。
与健全人相比，SCI患者的体重指数（BMI）和舒张压（BP）显著较低，在调整年龄、性别、BMI、体力活动和心率后，其颈动脉僵硬度值显著更高（动脉顺应性更低）（P<0.05）。SCI患者右心室功能参数（三尖瓣环平面收缩期位移和右心室Sm；P<0.0001）值较低，室壁厚度增加，舒张功能受损。在7年随访中，10.5%的SCI患者出现高血压；在调整年龄和收缩压后，他们明显更重，有腹部肥胖增加的趋势。发现BMI是高血压发生的独立预测因素。
与健全人相比，创伤后慢性SCI且无明显心血管疾病的患者表现出更高的CCA僵硬度以及左右心室受累。发生动脉高血压的截瘫患者表现出由肥胖介导的CCA僵硬度增加。即使在非常早期阶段，也应促进所有SCI患者进行生活方式改变和体重控制。
