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This case-control study aims to investigate left ventricular remodeling in individuals with chronic spinal cord injury or disease (SCI/D) (≥10 years) and autonomic dysreflexia (AD) who have no prior cardiovascular history. The primary objective is to compare cardiac changes between 24 individuals with high-level SCI/D (above Th6) who have AD and 24 individuals with low-level SCI/D (below Th10) who do not have AD. A secondary objective examines how factors such as age, sex, injury duration, and physical activity are associated with cardiac remodeling.
All 48 participants will undergo cardiac MRI as well as blood measurement of B-type natriuretic peptid to assess cardiac morphology and function. The findings could shed light on a potentially underestimated cardiovascular risk factor in the SCI/D population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AD+ | Spinal Cord Injury, above Th6, AIS A or B, Autonomic Dysreflexia | ||
| AD- | Spinal Cord Injury, below Th10, AIS A or B, no Autonomic Dysreflexia |
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| Measure | Description | Time Frame |
|---|---|---|
| Left ventricular end-diastolic volume (ml) | Left ventricular end-diastolic volume assessed by cardiac MRI | baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Left ventricular mass (g) | Left ventricular mass assessed by cardiac MRI | baseline |
| Left ventricular end systolic volume (ml) | Left ventricular end systolic volume assessed by cardiac MRI |
| Measure | Description | Time Frame |
|---|---|---|
| biological sex | biological sex assigned at birth | at enrolment |
| age (years) | age | at enrolment |
Inclusion Criteria:
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Participants will be recruited from all patients with a chronic spinal cord injury arriving for a routine urology check-up at the Swiss Paraplegic Center in Nottwil, Switzerland
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jörg Krebs, PD Dr. med. vet. PhD | Contact | +41 41 939 5946 | joerg.krebs@paraplegie.ch | |
| Florian van Dellen, Dr. sc. | Contact | +41 41 939 6542 | florian.vandellen@paraplegie.ch |
| Name | Affiliation | Role |
|---|---|---|
| Jens Wöllner, Prof. Dr. med. | Swiss Paraplegic Centre | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Swiss Paraplegic Center | Nottwil | 6207 | Switzerland |
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| ID | Term |
|---|---|
| D020211 | Autonomic Dysreflexia |
| D013119 | Spinal Cord Injuries |
| D004194 | Disease |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
| D013118 | Spinal Cord Diseases |
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| baseline |
| Left ventricular ejection fraction (%) | Percentage of blood pumped out of the heart's left ventricle with each contraction assessed by cardiac MRI | baseline |
| B-type natriuretic peptide level (pg/ml) | B-type natriuretic peptide levels in blood serum | baseline |
| body height (cm) | body height | at enrolment |
| body mass (kg) | body mass | at enrolment |
| duration of spinal cord injury or disease (years) | time from occurrence of spinal cord injury or disease to study enrolment | at enrolment |
| level of physical activity | self-reported hours of physical activity per week used to stratify participants into three groups: 1) not performing regular physical activity 2) exercising one to three hours per week and 3) more than three hours per week | at enrolment |
| D002493 | Central Nervous System Diseases |
| D014947 | Wounds and Injuries |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |