Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects

Kenneth M. Kessler, Ileana L. Pina, Barth Green, Betsy Burnett, Martin Laighold, Martin Bilsker, Andres R. Palomo, Robert J. Myerburg

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)525-530
Number of pages6
JournalThe American Journal of Cardiology
Volume58
Issue number6
DOIs
StatePublished - Sep 1 1986
Externally publishedYes

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Blood Pressure
Cardiac Output
Vascular Resistance
Atrophy
Echocardiography
Healthy Volunteers
Heart Rate
Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kessler, K. M., Pina, I. L., Green, B., Burnett, B., Laighold, M., Bilsker, M., ... Myerburg, R. J. (1986). Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. The American Journal of Cardiology, 58(6), 525-530. https://doi.org/10.1016/0002-9149(86)90027-5

Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. / Kessler, Kenneth M.; Pina, Ileana L.; Green, Barth; Burnett, Betsy; Laighold, Martin; Bilsker, Martin; Palomo, Andres R.; Myerburg, Robert J.

In: The American Journal of Cardiology, Vol. 58, No. 6, 01.09.1986, p. 525-530.

Research output: Contribution to journalArticle

Kessler, KM, Pina, IL, Green, B, Burnett, B, Laighold, M, Bilsker, M, Palomo, AR & Myerburg, RJ 1986, 'Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects', The American Journal of Cardiology, vol. 58, no. 6, pp. 525-530. https://doi.org/10.1016/0002-9149(86)90027-5
Kessler, Kenneth M. ; Pina, Ileana L. ; Green, Barth ; Burnett, Betsy ; Laighold, Martin ; Bilsker, Martin ; Palomo, Andres R. ; Myerburg, Robert J. / Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. In: The American Journal of Cardiology. 1986 ; Vol. 58, No. 6. pp. 525-530.
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