1. Cardiac consequences of spinal cord injury: systematic review and meta-analysis
- Author
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Alexandra M. Williams, Cameron Marshall Gee, Christopher Roy West, and Christine Voss
- Subjects
medicine.medical_specialty ,Traumatic spinal cord injury ,business.industry ,Heart Ventricles ,MEDLINE ,Stroke volume ,030204 cardiovascular system & hematology ,Random effects model ,medicine.disease ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Data extraction ,Echocardiography ,Internal medicine ,Meta-analysis ,medicine ,Cardiology ,Humans ,Cardiac structure ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Spinal cord injury ,Spinal Cord Injuries - Abstract
ObjectiveConduct a meta-analysis to determine the impact of traumatic spinal cord injury (SCI) on echocardiographic measurements of left ventricular (LV) structure and function.MethodsMEDLINE and Embase were used for primary searches of studies reporting LV echocardiographic data in individuals with SCI. Of 378 unique citations, 36 relevant full-text articles were retrieved, and data from 27 studies were extracted for meta-analyses. Literature searches, article screening and data extraction were completed by two independent reviewers and compared for agreement. Primary analyses compared echocardiographic indices between individuals with SCI and able-bodied individuals, using a random effects model.ResultsData are reported as pooled effect estimates (95% CI). Data from 22 articles (474 participants) were included in the primary meta-analysis. Compared with able-bodied individuals, individuals with SCI had reductions to LV stroke volume of 11.8 mL (95% CI −17.8 to −5.9, pindex of −7.7 g/m2 (95% CI −11.6 to −3.8, pConclusionsIndividuals with SCI have smaller LV volumes and mass, and altered systolic and diastolic function. While this meta-analysis demonstrates important alterations to echocardiographic measures of cardiac structure and function at rest, future work should consider the impacts of SCI on the heart’s capacity or ‘reserve’ to respond to physiological challenges.PROSPERO registration numberCRD42017072333.
- Published
- 2018
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