Masashi Yamashita1, Kentaro Kamiya2, Atsuhiko Matsunaga3, Tadashi Kitamura4, Nobuaki Hamazaki5, Ryota Matsuzawa6, Kohei Nozaki6, Shinya Tanaka7, Takeshi Nakamura7, Emi Maekawa8, Takashi Masuda9, Junya Ako8, Kagami Miyaji4. 1. Department of Rehabilitation Sciences, Kitasato University, Graduate School of Medical Sciences, Sagamihara, Japan. 2. Department of Rehabilitation Sciences, Kitasato University, Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp. 3. Department of Rehabilitation Sciences, Kitasato University, Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan. 4. Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan. 5. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan; Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan. 6. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. 7. Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan. 8. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 9. Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan; Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Abstract
BACKGROUND: Low skeletal muscle density, determined using computed tomography (CT), has yet to be examined in terms of muscle function and prognostic capability in patients who require open cardiovascular surgery. This study was performed to examine whether psoas muscle area and density, determined using CT, are associated with postoperative mortality in patients who undergo cardiovascular surgery. METHODS: We reviewed the findings in 773 consecutive patients who underwent preoperative CT imaging, including the level of the third lumbar vertebra for clinical purposes. We measured grip strength, gait speed, and 6-minute walking distance to assess muscle function before hospital discharge. Skeletal muscle area was calculated from psoas muscle cross-sectional area (in squared centimeters) on preoperative CT images at the level of the third lumbar vertebra divided by the square of the patient's height in metres to give the skeletal muscle index (SMI). Skeletal muscle density determined by muscle attenuation (MA) was calculated by measuring the average Hounsfield units of the psoas muscle cross-sectional area. RESULTS: The mean age of the study population was 65.0 ± 13.1 years, and 64.7% of the patients were male. Multivariate logistic regression analysis and multivariate Cox regression analysis showed that low MA, but not SMI, was significantly associated with muscle function, and all-cause mortality (P < 0.05). Kaplan-Meier analysis showed that low MA, but not low SMI, predicted mortality (P = 0.014). CONCLUSIONS: Low skeletal muscle density, but not skeletal muscle area, predicted poorer muscle function and mortality in patients who undergo cardiac surgery.
BACKGROUND: Low skeletal muscle density, determined using computed tomography (CT), has yet to be examined in terms of muscle function and prognostic capability in patients who require open cardiovascular surgery. This study was performed to examine whether psoas muscle area and density, determined using CT, are associated with postoperative mortality in patients who undergo cardiovascular surgery. METHODS: We reviewed the findings in 773 consecutive patients who underwent preoperative CT imaging, including the level of the third lumbar vertebra for clinical purposes. We measured grip strength, gait speed, and 6-minute walking distance to assess muscle function before hospital discharge. Skeletal muscle area was calculated from psoas muscle cross-sectional area (in squared centimeters) on preoperative CT images at the level of the third lumbar vertebra divided by the square of the patient's height in metres to give the skeletal muscle index (SMI). Skeletal muscle density determined by muscle attenuation (MA) was calculated by measuring the average Hounsfield units of the psoas muscle cross-sectional area. RESULTS: The mean age of the study population was 65.0 ± 13.1 years, and 64.7% of the patients were male. Multivariate logistic regression analysis and multivariate Cox regression analysis showed that low MA, but not SMI, was significantly associated with muscle function, and all-cause mortality (P < 0.05). Kaplan-Meier analysis showed that low MA, but not low SMI, predicted mortality (P = 0.014). CONCLUSIONS: Low skeletal muscle density, but not skeletal muscle area, predicted poorer muscle function and mortality in patients who undergo cardiac surgery.
Authors: Britta Larsen; John Bellettiere; Matthew Allison; Robyn L McClelland; Iva Miljkovic; Chantal A Vella; Pamela Ouyang; Kimberly R De-Guzman; Michael Criqui; Jonathan Unkart Journal: Metabolism Date: 2020-07-23 Impact factor: 8.694
Authors: Ainsley C J Smith; Justin J Tse; Tadiwa H Waungana; Kirsten N Bott; Michael T Kuczynski; Andrew S Michalski; Steven K Boyd; Sarah L Manske Journal: PLoS One Date: 2022-10-17 Impact factor: 3.752
Authors: Min Suk Chae; Jong-Woan Kim; Joon-Yong Jung; Ho Joong Choi; Hyun Sik Chung; Chul Soo Park; Jong Ho Choi; Sang Hyun Hong Journal: BMC Anesthesiol Date: 2019-06-28 Impact factor: 2.217
Authors: Katerina Deike-Hofmann; Lukas Gutzweiler; Julia Reuter; Daniel Paech; Jessica C Hassel; Oliver Sedlaczek; Alexander Radbruch; Heinz-Peter Schlemmer; Philipp Bäumer Journal: Sci Rep Date: 2019-07-05 Impact factor: 4.379