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脊髓损伤 24 个月后心脏结构和功能的变化:一项横断面研究。

Reductions in Cardiac Structure and Function 24 Months After Spinal Cord Injury: A Cross-Sectional Study.

机构信息

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, United States.

Cardiovascular Performance Program, Harvard Medical School, Cambridge, Massachusetts, United States.

出版信息

Arch Phys Med Rehabil. 2021 Aug;102(8):1490-1498. doi: 10.1016/j.apmr.2021.01.070. Epub 2021 Feb 5.

Abstract

OBJECTIVE

To determine the alterations in cardiac structure and function that occur in the months after spinal cord injury (SCI).

STUDY DESIGN

Cross-sectional SETTING: Rehabilitation Hospital PARTICIPANTS: Volunteers (N=29; 4 women, 25 men) between 3 and 24 months after SCI.

MAIN OUTCOME MEASURES

Transthoracic echocardiography was performed on each volunteer. The relationships between time since injury and neurologic and sensory levels of injury to cardiac structure and function were assessed via multiple linear regression.

RESULTS

Time since injury was most strongly associated with reductions in left ventricular end diastolic volume (r=0.156; P=.034), end systolic volume (r=0.141; P=.045), and mass (r=0.138; P=.047). These structural changes were paralleled by reduced stroke volume (r=0.143; P=.043) and cardiac output (r=0.317; P=<.001). The reductions in left ventricular structure and systolic function were not differentially affected by neurologic or sensory levels of injury (P=.084-.921).

CONCLUSIONS

These results suggest progressive reductions in left ventricular structure and systolic function between 3 and 24 months after SCI that occur independent of neurologic and sensory levels of injury.

摘要

目的

确定脊髓损伤(SCI)后数月中心脏结构和功能的变化。

研究设计

横断面研究

地点

康复医院

参与者

SCI 后 3 至 24 个月的志愿者(N=29;4 名女性,25 名男性)。

主要观察指标

对每位志愿者进行经胸超声心动图检查。通过多元线性回归评估损伤后时间与心脏结构和功能的神经和感觉损伤水平之间的关系。

结果

损伤后时间与左心室舒张末期容积(r=0.156;P=.034)、收缩末期容积(r=0.141;P=.045)和质量(r=0.138;P=.047)的降低呈最强相关。这些结构变化与每搏量(r=0.143;P=.043)和心输出量(r=0.317;P<.001)降低相平行。左心室结构和收缩功能的降低不受神经或感觉损伤水平的差异影响(P=.084-.921)。

结论

这些结果表明,SCI 后 3 至 24 个月期间,左心室结构和收缩功能呈进行性下降,与神经和感觉损伤水平无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b56/8339187/d2bac5ee997e/nihms-1673588-f0001.jpg

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