The Association Between Preoperative Pectoralis Muscle Quantity and Outcomes After Cardiac Transplantation.

Autor: DRIGGIN, ELISSA, CHUNG, ALICE, HARRIS, ERIN, BORDON, ABRAHAM, RAHMAN, SALWA, SAYER, GABRIEL, TAKEDA, KOJI, URIEL, NIR, MAURER, MATHEW S., LEB, JAY, CLERKIN, KEVIN
Zdroj: Journal of Cardiac Failure; Nov2024, Vol. 30 Issue 11, p1462-1468, 7p
Abstrakt: Sarcopenia is underappreciated in advanced heart failure and is not routinely assessed. In patients receiving a left ventricular assist device, preoperative sarcopenia, defined by using computed-tomography (CT)-derived pectoralis muscle-area index (muscle area indexed to body-surface area), is an independent predictor of postoperative mortality. The association between preoperative sarcopenia and outcomes after heart transplant (HT) is unknown. The primary aim of this study was to determine whether preoperative sarcopenia, diagnosed using the pectoralis muscle-area index, is an independent predictor of days alive and out of the hospital (DAOHs) post-transplant. Patients who underwent HT between January, 2018, and June, 2022, with available preoperative chest CT scans were included. Sarcopenia was diagnosed as pectoralis muscle-area index in the lowest sex-specific tertile. The primary endpoint was DAOHs at 1 year post-transplant. The study included 169 patients. Patients with sarcopenia (n = 55) had fewer DAOHs compared to those without sarcopenia, with a median difference of 17 days (320 vs 337 days; P = 0.004). Patients with sarcopenia had longer index hospitalizations and were also more likely to be discharged to a facility other than home. In a Poisson regression model, sarcopenia was a significant univariable and the strongest multivariable predictor of DAOHs at 1 year (parameter estimate = -0.17, 95% CI -0.19 to -14; P = < 0.0001). Preoperative sarcopenia, diagnosed using the pectoralis muscle-area index, is an independent predictor of poor outcomes after HT. This parameter is easily measurable from commonly obtained preoperative CT scans and may be considered in transplant evaluations. • Sarcopenia is underdiagnosed in patients with advanced heart failure who are eligible for cardiac transplantation and may impact post-transplant outcomes. • Patients with sarcopenia, defined by low pectoralis muscle-area index (muscle area indexed to body-surface area) using available preoperative CT scans, was independently associated with fewer days alive and out of the hospital compared to those without sarcopenia. • Pectoralis muscle-area index is easily measurable from routinely obtained preoperative CT scans and may aid in identifying sarcopenia during transplant evaluations. [ABSTRACT FROM AUTHOR]
Databáze: Supplemental Index
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