Purpose: We sought to explore the association between the spinal cord injury (SCI) level on the cardiac structure and the function observed in elite para-cyclists. Methods: Cross-sectional echocardiographic data from 44 elite SCI hand cyclists (39.8 ± 9 yr, 68% male/32% female) stratified by the level of SCI (cervical, N = 9; T1-T5, N = 10; below T5, N = 25) and 19 non-SCI blind/visually impaired (BVI) tandem cyclists (32.4 ± 7 yr, 58% male/42% female) were analyzed before the initiation of international competition. Results: Compared with non-SCI BVI cyclists, cervical SCI para-cyclists were observed with lower indexed left ventricular (LV) mass (99.6 ± 12 vs 125 ± 20 g·m-2, P = 0.01), posterior wall thickness (4.5 ± 0.3 vs 5.8 ± 0.7 mm·m-2, P < 0.001), interventricular septal wall thickness (4.8 ± 0.5 vs 5.7 ± 0.7 mm·m-2; P = 0.03), and left atrial volume (21 ± 3.5 vs 28 ± 7 mL·m-2; P = 0.02). In multivariable analyses, cervical SCI was independently associated with decreased LV wall thickness [interventricular septum (ß = -0.67, P = 0.01), posterior wall (ß = -0.98, P = 0.001)], decreased LV mass (ß = -21, P < 0.001), and decreased left atrial volume index (ß = -6.9, P = 0.001) compared with other levels of SCI and non-SCI BVI cyclists. There were no differences in ventricular function among any of the athlete groups. Conclusion: Compared with para-cyclists with lower levels of SCI, the athletes with cervical SCI demonstrate attenuated cardiac size and concentric LV hypertrophy.
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