Associations between left ventricular structure and function with cardiorespiratory ﬁtness and body composition in individuals with cervical and upper thoracic spinal cord injury

Spinal Cord, 2021 · DOI: https://doi.org/10.1038/s41393-020-00591-4 · Published: December 7, 2020

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study investigates the relationship between heart structure and function, cardiorespiratory fitness, and body composition in people with spinal cord injuries. The study found that resting heart measurements were not related to cardiorespiratory fitness but were linked to fat-free mass. These findings suggest that fat-free mass may be an important factor to consider when assessing heart health in individuals with spinal cord injuries.

Study Duration

April 2013 and August 2017

Participants

32 individuals with chronic, motor-complete SCI between the fourth cervical and sixth thoracic levels

Evidence Level

Cross-sectional study

Key Findings

1
Resting left ventricular parameters are not associated with peak oxygen consumption (V̇O2peak) in individuals with cervical and upper-thoracic SCI.
2
There is a medium association between CRF test-obtained peak O2pulse, a surrogate of exercise SV, and resting echocardiographic-obtained SV.
3
Left ventricular mass (LVM) was positively associated with fat-free mass (FFM) in individuals with motor-complete SCI.

Research Summary

This study examined the associations between resting echocardiographic LV structure and function parameters and CRF, as well as exploring the associations between LVM and DXA-obtained body composition (i.e., FFM and FM) in individuals with cervical and upper-thoracic SCI. The results of this study show that none of the resting LV parameters (i.e., structure and function) are associated with V̇O2peak (relative to body mass or FFM). Our results show that LVM was positively associated with FFM in individuals with motor-complete (i.e., AIS A and B) and above mid-thoracic level (≥T6) SCI.

Practical Implications

Indexing Cardiovascular Measures

Future studies may consider utilizing FFM for indexing cardiovascular measures following SCI.

Exercise Training Responses

Assessing CRF is crucial to quantify the responses to exercise training, irrespective of LV parameters and likely provides an indication of peripheral adaptations and functional improvements.

LV Parameter Indexing

The nature of the associations between LVM and FFM needs further studies to investigate the possibility of using this measure to index LV parameters in the SCI population.

Study Limitations

1
Cross-sectional design limits the ability to determine longitudinal changes.
2
Relatively small sample size may impede the ability to detect large or significant associations.
3
Homogeneity and lower CRF levels of the included cohort (i.e., less variability) may impede our ability to detect large or significant associations

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