PMID- 33192245
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231104
IS  - 1662-4548 (Print)
IS  - 1662-453X (Electronic)
IS  - 1662-453X (Linking)
VI  - 14
DP  - 2020
TI  - Beneficial Cardiac Structural and Functional Adaptations After Lumbosacral Spinal 
      Cord Epidural Stimulation and Task-Specific Interventions: A Pilot Study.
PG  - 554018
LID - 10.3389/fnins.2020.554018 [doi]
LID - 554018
AB  - Cardiac myocyte atrophy and the resulting decreases to the left ventricular mass 
      and dimensions are well documented in spinal cord injury. Therapeutic 
      interventions that increase preload can increase the chamber size and improve the 
      diastolic filling ratios; however, there are no data describing cardiac 
      adaptation to chronic afterload increases. Research from our center has 
      demonstrated that spinal cord epidural stimulation (scES) can normalize arterial 
      blood pressure, so we decided to investigate the effects of scES on cardiac 
      function using echocardiography. Four individuals with chronic, motor-complete 
      cervical spinal cord injury were implanted with a stimulator over the lumbosacral 
      enlargement. We assessed the cardiac structure and function at the following time 
      points: (a) prior to implantation; (b) after scES targeted to increase systolic 
      blood pressure; (c) after the addition of scES targeted to facilitate voluntary 
      (i.e., with intent) movement of the trunk and lower extremities; and (d) after 
      the addition of scES targeted to facilitate independent, overground standing. We 
      found significant improvements to the cardiac structure (left ventricular mass = 
      10 +/- 2 g, p < 0.001; internal dimension during diastole = 0.1 +/- 0.04 cm, p < 
      0.05; internal dimension during systole = 0.06 +/- 0.03 cm, p < 0.05; 
      interventricular septum dimension = 0.04 +/- 0.02 cm, p < 0.05), systolic function 
      (ejection fraction = 1 +/- 0.4%, p < 0.05; velocity time integral = 2 +/- 0.4 cm, p < 
      0.001; stroke volume = 4.4 +/- 1.5 ml, p < 0.01), and diastolic function (mitral 
      valve deceleration time = -32 +/- 11 ms, p < 0.05; mitral valve deceleration slope 
      = 50 +/- 25 cm s(-1), p < 0.05; isovolumic relaxation time = -6 +/- 1.9 ms, p < 0.05) 
      with each subsequent scES intervention. Despite the pilot nature of this study, 
      statistically significant improvements to the cardiac structure, systolic 
      function, and diastolic function demonstrate that scES combined with 
      task-specific interventions led to beneficial cardiac remodeling, which can 
      reverse atrophic changes that result from spinal cord injury. Long-term 
      improvements to cardiac function have implications for increased quality of life 
      and improved cardiovascular health in individuals with spinal cord injury, 
      decreasing the risk of cardiovascular morbidity and mortality.
CI  - Copyright (c) 2020 Legg Ditterline, Wade, Ugiliweneza, Singam, Harkema, Stoddard 
      and Hirsch.
FAU - Legg Ditterline, Bonnie E
AU  - Legg Ditterline BE
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, KY, United States.
AD  - Department of NeuroSurgery, University of Louisville, Louisville, KY, United 
      States.
FAU - Wade, Shelley
AU  - Wade S
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, KY, United States.
FAU - Ugiliweneza, Beatrice
AU  - Ugiliweneza B
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, KY, United States.
AD  - Department of NeuroSurgery, University of Louisville, Louisville, KY, United 
      States.
FAU - Singam, Narayana Sarma
AU  - Singam NS
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Louisville, Louisville, KY, United States.
FAU - Harkema, Susan J
AU  - Harkema SJ
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, KY, United States.
AD  - Department of NeuroSurgery, University of Louisville, Louisville, KY, United 
      States.
FAU - Stoddard, Marcus F
AU  - Stoddard MF
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Louisville, Louisville, KY, United States.
FAU - Hirsch, Glenn A
AU  - Hirsch GA
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Louisville, Louisville, KY, United States.
AD  - Division of Cardiology, Department of Medicine, National Jewish Health, Denver, 
      CO, United States.
LA  - eng
PT  - Journal Article
DEP - 20201022
PL  - Switzerland
TA  - Front Neurosci
JT  - Frontiers in neuroscience
JID - 101478481
PMC - PMC7643015
OTO - NOTNLM
OT  - cardiac structure and function
OT  - diastolic function
OT  - epidural stimulation
OT  - left ventricular structure
OT  - spinal cord injury
OT  - systolic function
EDAT- 2020/11/17 06:00
MHDA- 2020/11/17 06:01
PMCR- 2020/01/01
CRDT- 2020/11/16 08:43
PHST- 2020/04/20 00:00 [received]
PHST- 2020/09/15 00:00 [accepted]
PHST- 2020/11/16 08:43 [entrez]
PHST- 2020/11/17 06:00 [pubmed]
PHST- 2020/11/17 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fnins.2020.554018 [doi]
PST - epublish
SO  - Front Neurosci. 2020 Oct 22;14:554018. doi: 10.3389/fnins.2020.554018. 
      eCollection 2020.