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Blood flow response in individuals with incomplete spinal cord injuries
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OLIVE JL; MCCULLY K; DUDLEY GA
SPINAL CORD , 2002, vol. 40, n° 12, p. 639-645 Doc n°: 107477 Localisation : Centre de Réadaptation de Lay St Christophe , en ligne Descripteurs : AE21 - ORIGINE TRAUMATIQUE Url : http://www.nature.com/sc/archive/index.html Cross sectional comparison, control group. Objective: To determine if incomplete spinal cord injured patients (SCI) have an abnormal blood flow response to cuff ischemia compared to able-bodied individuals (AB). Setting: Academic institution. Methods: Blood flow in five chronic incomplete SCI patients (C4-C5) and 17 able bodied individuals was measured in the common femoral artery using quantitative Doppler ultrasound (GE LogiQ 400CL) at rest and after distal thigh cuff occlusion of 2, 4 and 10 min to investigate whether blood flow or vascular control were different in SCI's and AB. Results: Blood flow and the diameter of the common femoral artery at rest were similar in incomplete SCI and AB. Peak flow after 10 min of cuff ischemia (the highest found) was also comparable between incomplete SCI and AB. The half-time for recovery of blood flow to baseline after 2, 4 or 10 min of ischemia was 50% longer for incomplete SCI compared to the AB (P=0.023). In addition, peak blood flow after 2 and 4 min of ischemia relative to the maximum, 10 min value (2/10 and 4/10 ratios) was lower in incomplete SCI compared to AB (0.65+/-0.06 vs 0.76+/-0.15, P=0.029 and 0.75+/-0.10 vs 0.89+/-0.11, P=0.014, respectively). Conclusion: This study demonstrated that incomplete spinal cord injured patients have impaired vascular control seen as a slower return to resting flow after cuff ischemia and reduced sensitivity to ischemia relative to maximum flow. However, incomplete SCI patients did not demonstrate impaired flow capacity as seen in complete SCI patients suggesting that smaller cardiovascular abnormalities are seen with incomplete versus complete SCI injury. Impaired vascular control may serve to limit exercise capacity and may contribute to increased cardiovascular disease. Impaired circulation could contribute to impaired muscle function and poor cardiovascular health in incomplete SCI's, although these findings need to be replicated in a study with more subjects. Sponsorship: Paralyzed Vetrans Association and NIH grants HL65179 and HD33738. Langue : ANGLAIS Identifiant basis : 2003225558 |
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