Cardiovascular and metabolic morbidity following spinal cord injury

Peterson, Mark D.; Berri, Maryam; Lin, Paul S.; Kamdar, Neil; Rodriguez, Gianna M.; Mahmoudi, Elham; Tate, Denise G.

doi:10.1016/j.spinee.2021.05.014

Cited by 27 publications

(34 citation statements)

References 27 publications

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“…The activities of the heart and other internal organs are regulated by descending pathways of sympathetic neurons located in the mid-lateral column of the spinal cord from T1 to L2. Therefore, patients with high SCI have a higher incidence and adjusted hazard ratio of cardiometabolic morbidities ( 11 ). As the impaired the sympathetic nerve that innervates the heart and blood vessels, leading to the relative advantage of vagus nerve function, which revealed deficiency in control of the autonomic nervous system ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

et al. 2022

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Spontaneous spinal subdural hematoma (SSDH) is a rare and dangerous intraspinal hematoma that usually occurs in the thoracic vertebra. The influence of early cardiovascular changes secondary to spinal cord injury is an important emergent issue. Herein, we report a case of a middle-aged woman with clinical manifestations of back pain and motion and sensory disturbances below the level of spinal cord compression. During the disease course, she also developed changes indicative of myocardial injury, such as tachycardia, markedly increased concentrations of brain natriuretic peptide and cardiac troponin I, and a decreased left ventricular ejection fraction, which were consistent with the diagnosis of Takotsubo cardiomyopathy (TTC). After the administration of supportive therapies, the symptoms of myocardial injury rapidly resolved. With the absorption of SSDH, the symptoms and clinical signs were alleviated. We also reviewed the literature on cases of concomitant SSDH and TTC. This rare case broadens the symptom spectrum of SSDH and highlights the need for clinicians to be aware of concomitant SSDH and TTC. Initial conservative treatment is a viable option for SSDH with concomitant TTC. However, urgent surgery may be a better option if the SSDH progressively enlarges and causes spinal cord compression.

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Section: Discussionmentioning

confidence: 99%

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

et al. 2022

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“…It is therefore likely that FPG and HbA1C, if used diagnostically, are underestimating prediabetes and T2DM in persons with SCI. The health, function, and economic burden associated with poor screening methods is of significant concern given the already large proportion of persons with SCI living with metabolic comorbidities [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gater and colleagues [ 8 ] recently observed that 32% of 71 persons with chromic motor complete SCI had a fasting plasma glucose (FPG) above 100 mg/dL (denoting prediabetes) or were under treatment for T2DM. Additionally, Cragg et al [ 9 ] and Lai et al [ 10 ] reported greater odds and adjusted hazard ratios, respectively, in persons with SCI compared to nondisabled controls, and Peterson et al [ 11 ] recently calculated an incidence almost double that of persons without SCI. These data underscore that glucose dysregulation is a profound public health issue in the SCI population that warrants universal surveillance.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Various Indices in Identifying Insulin Resistance and Diabetes in Chronic Spinal Cord Injury

Farkas

Gordon

Trewick

et al. 2021

JCM

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The purpose of this screening and diagnostic study was to examine the accord among indices of glucose metabolism, including the Homeostatic Model Assessment for Insulin Resistance (HOMA), HOMA2, Matsuda Index, Quantitative Insulin-sensitivity Check Index (QUICKI), hemoglobin A1C (HbA1C), and fasting plasma glucose (FPG) against intravenous glucose tolerance test-measured insulin sensitivity (Si) in individuals with chronic motor complete SCI. Persons with chronic (≥12-months post-injury) SCI (n = 29; 79% men; age 42.2 ± 11.4; body mass index 28.6 ± 6.4 kg/m2; C4-T10) were included. Measures were compared using adjusted R2 from linear regression models with Akaike information criterion (AIC, a measure of error). QUICKI had the greatest agreement with Si (adjusted R2 = 0.463, AIC = 91.1, p = 0.0001), followed by HOMA (adjusted R2 = 0.378, AIC = 95.4, p = 0.0008), HOMA2 (adjusted R2 = 0.256, AIC = 99.7, p = 0.0030), and the Matsuda Index (adjusted R2 = 0.356, AIC = 95.5, p = 0.0004). FPG (adjusted R2 = 0.056, AIC = 107.5, p = 0.1799) and HbA1C (adjusted R2 = 0.1, AIC = 106.1, p = 0.0975) had poor agreement with Si. While HbA1C and FPG are commonly used for evaluating disorders of glucose metabolism, QUICKI demonstrates the best accord with Si compared to the other measures.

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“…Specifically, low HDL-C was also observed in 54.2% of participants with SCI compared to only 15.4% of the controls [ 84 ]. In one of the most extensive epidemiological studies on cardiometabolic morbidities after SCI, Peterson et al [ 12 ] compared 9081 adults with SCI to approximately 1.5 million adults without an SCI from longitudinal data in a nationwide insurance claims database from the US. The authors reported that people living with traumatic SCI, compared to controls, had a higher 5-year incidence (SCI: 25.5% vs. Controls: 16.9%, respectively) and 1.53 (53%) greater hazard for hypercholesterolemia [ 12 ].…”

Section: Dyslipidemia After Scimentioning

confidence: 99%

“…Increases in body fat, coupled with sedentary behavior/physical inactivity after SCI [ 8 , 9 ], predispose people with SCI to myriad health issues. Recent data provide evidence that cardiovascular disease has emerged as a leading cause of mortality in people with chronic SCI [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury

Farkas

Burton

McMillan

et al. 2022

JPM

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Individuals with spinal cord injuries (SCI) commonly present with component risk factors for cardiometabolic risk and combined risk factors for cardiometabolic syndrome (CMS). These primary risk factors include obesity, dyslipidemia, dysglycemia/insulin resistance, and hypertension. Commonly referred to as “silent killers”, cardiometabolic risk and CMS increase the threat of cardiovascular disease, a leading cause of death after SCI. This narrative review will examine current data and the etiopathogenesis of cardiometabolic risk, CMS, and cardiovascular disease associated with SCI, focusing on pivotal research on cardiometabolic sequelae from the last five years. The review will also provide current diagnosis and surveillance criteria for cardiometabolic disorders after SCI, a novel obesity classification system based on percent total body fat, and lifestyle management strategies to improve cardiometabolic health.

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Cardiovascular and metabolic morbidity following spinal cord injury

Cited by 27 publications

References 27 publications

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

Acute spontaneous spinal subdural hematoma presenting with Takotsubo cardiomyopathy: a rare case report and literature review

Comparison of Various Indices in Identifying Insulin Resistance and Diabetes in Chronic Spinal Cord Injury

The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury

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