Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects

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

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85 Scopus citations

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kessler, K. M., Pina, I., Green, B., Burnett, B., Laighold, M., Bilsker, M., Palomo, A. R., & 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