Mechanisms related to increased cardiovascular risk in spinal cord injury subjects

Abstract

Clinical and epidemiological data have demonstrated that spinal cord injury (SCI) subjects exhibit higher prevalence of cardiovascular diseases in comparison with the general population. Likewise, our group recently showed that subjects with chronic SCI presented higher carotid intima-media thickness (IMT) and worse left ventricular diastolic function than able-bodied ones. These findings were independent of traditional risk factors, such as age, hypertension, body mass index, metabolic alterations, smoking and plasmatic levels of inflammatory markers. Conversely, new data from our institution demonstrate that carotid IMT from normotensive SCI individuals exhibits a strong correlation with diastolic blood pressure measured on Ambulatory Blood Pressure Monitoring, suggesting that cells from such subjects are more sensitive to hemodynamic/mechanical stimuli, even within normal blood pressure ranges. This body of evidence indicates that the study of human SCI might expand the comprehension of atherosclerosis and left ventricular diastolic dysfunction physiopathology. The aim of this study is to investigate potential mechanisms underlying the higher cardiovascular risk detected in SCI subjects. In this regard, we will evaluate the role of renin-angiotensin-aldosterone axis, sympathetic system, metalloproteinases and hemodynamic/mechanical stimuli in the development of SCI-related atherosclerosis and left ventricular diastolic dysfunction. (AU)