Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects

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

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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
Pages (from-to)525-530
Number of pages6
JournalThe American journal of cardiology
Volume58
Issue number6
DOIs
StatePublished - Sep 1 1986

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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

Cardiovascular findings in quadriplegic and paraplegic patients and in normal subjects. / Kessler, Kenneth M.; Pina, Ileana; Green, Barth A; Burnett, Betsy; Laighold, Martin; Bilsker, Martin S; 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, Kenneth M. ; Pina, Ileana ; Green, Barth A ; Burnett, Betsy ; Laighold, Martin ; Bilsker, Martin S ; 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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