Exploring the Correlation between Pulmonary Hypertension and Pectoralis Muscle Area and Density
-
Marzieh Mirtajaddini
,
Nasim Naderi
,
Somayeh Sadat Jalali
,
Alireza Hosseinpour
,
Hamidreza Pouraliakbar
,
Sepideh Taghavi
,
Razieh Omidvar
,
Hooman Bakhshandeh
,
Armin Attar
,
Tahereh Sadeghi
,
Fatemeh Ghorbani
Abstract
Background: Sarcopenia is a predictor of mortality in multiple conditions but the potential prognostic value of indices of sarcopenia in pulmonary hypertension (PH) is not clarified. The aim of this study was to determine if there is an association between CT scan-measured pectoralis muscle area (PMA) and density (PMD) and adverse clinical outcomes in patients with PH.
Methods: In a cross-sectional study, medical records of PH patients (clinical class I and IV) referred to Rajaie Cardiovascular Center from March 2016 to March 2021 were retrospectively screened. CT scan-measured PMA and PMD were compared between survivors and non-survivors in addition to blood biomarkers and right heart catheterization variables. A binary logistic regression analysis was performed to determine the potential predictors of mortality.
Results: A total of 45 patients with PH (34 patients in survivor and 11 in non-survivor group) were included for data analysis. PMA was not significantly different between the two groups (p=0.124) whereas difference of PMD measures was weakly significant between survivors and non survivors (survivor: 45 HU (25.8-51.3), non-survivors: 31 HU (23-36); p=0.062)). In logistic regression analysis, none of the sarcopenia indices could predict mortality (p>0.05), although phosphodiesterase-5 (PDE-5) inhibitors, right atrial pressure (RAP), and systemic arterial oxygen saturation could serve as potential predictors (p<0.05).
Conclusion: Although CT scan-measured area and density of pectoralis muscle showed a weak correlation with prognosis of PH, there is a possibility that these factors could serve as potential markers for mortality in patients with idiopathic and chronic thromboembolic PH. Further confirmation is required through future studies with larger sample sizes.
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19. Wang Y, Tan S, Yan Q, Gao Y. Sarcopenia and COVID-19 Outcomes. Clinical interventions in aging. 2023;18:359-73.
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21. Shu X, Lin T, Wang H, Zhao Y, Jiang T, Peng X, Yue J. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis. Journal of cachexia, sarcopenia and muscle. 2022;13(1):145-58.
22. McDonald ML, Diaz AA, Ross JC, San Jose Estepar R, Zhou L, Regan EA, Eckbo E, Muralidhar N, Come CE, Cho MH, Hersh CP, Lange C, Wouters E, Casaburi RH, Coxson HO, Macnee W, Rennard SI, Lomas DA, Agusti A, Celli BR, Black-Shinn JL, Kinney GL, Lutz SM, Hokanson JE, Silverman EK, Washko GR. Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease. A cross-sectional study. Annals of the American Thoracic Society. 2014;11(3):326-34.
23. Riou M, Pizzimenti M, Enache I, Charloux A, Canuet M, Andres E, Talha S, Meyer A, Geny B. Skeletal and respiratory muscle dysfunctions in pulmonary arterial hypertension. Journal of clinical medicine. 2020;9(2):410.
24. Breda AP, Pereira de Albuquerque AL, Jardim C, Morinaga LK, Suesada MM, Fernandes CJC, Dias B, Lourenço RB, Salge JM, Souza R. Skeletal muscle abnormalities in pulmonary arterial hypertension. PLoS One. 2014;9(12):e114101.
2. Poch D, Mandel J. Pulmonary Hypertension. Annals of internal medicine. 2021;174(4):Itc49-itc64.
3. Farber HW, Miller DP, McGoon MD, Frost AE, Benton WW, Benza RL. Predicting outcomes in pulmonary arterial hypertension based on the 6-minute walk distance. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2015;34(3):362-8.
4. Benza RL, Miller DP, Gomberg-Maitland M, Frantz RP, Foreman AJ, Coffey CS, Frost A, Barst RJ, Badesch DB, Elliott CG, Liou TG, McGoon MD. Predicting survival in pulmonary arterial hypertension: insights from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL). Circulation. 2010;122(2):164-72.
5. Stępnowska E, Lewicka E, Dąbrowska-Kugacka A, Miękus P, Raczak G. Prognostic factors in pulmonary arterial hypertension: Literature review. Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2017;26(3):549-53.
6. Bustamante-Labarta M, Perrone S, De La Fuente RL, Stutzbach P, De La Hoz RP, Torino A, Favaloro R. Right atrial size and tricuspid regurgitation severity predict mortality or transplantation in primary pulmonary hypertension. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 2002;15(10 Pt 2):1160-4.
7. Zhong XJ, Jiang R, Yang L, Yuan P, Gong SG, Zhao QH, Luo CJ, Qiu HL, Li HT, Zhang R, He J, Wang L, Tang J, Liu JM. Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease. BMC cardiovascular disorders. 2022;22(1):137.
8. Mirtajaddini M, Naderi N, Chenaghlou M, Taghavi S, Amin A. The prediction of right atrial pressure using electrocardiogram: a novel approach. ESC heart failure. 2021;8(6):5040-4.
9. Mirtajaddini M, Naderi N, Mohammadi K, Taghavi S, Maharloo M, Mazloomzadeh S, Amin A. Predicting cardiac index using the electrocardiogram in pulmonary hypertension patients. Research in Cardiovascular Medicine. 2022;11(3):76-80.
10. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
11. Bak SH, Kwon SO, Han S-S, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respiratory Research. 2019;20(1):1-12.
12. Hocaoglu E, Ors S, Yildiz O, Inci E. Correlation of pectoralis muscle volume and density with severity of COVID-19 pneumonia in adults. Academic radiology. 2021;28(2):166-72.
13. Sjøblom B, Grønberg BH, Wentzel-Larsen T, Baracos VE, Hjermstad MJ, Aass N, Bremnes RM, Fløtten Ø, Bye A, Jordhøy M. Skeletal muscle radiodensity is prognostic for survival in patients with advanced non-small cell lung cancer. Clinical Nutrition. 2016;35(6):1386-93.
14. Hayashi N, Ando Y, Gyawali B, Shimokata T, Maeda O, Fukaya M, Goto H, Nagino M, Kodera Y. Low skeletal muscle density is associated with poor survival in patients who receive chemotherapy for metastatic gastric cancer. Oncology reports. 2016;35(3):1727-31.
15. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). European heart journal. 2016;37(1):67-119.
16. Xu J, Wan CS, Ktoris K, Reijnierse EM, Maier AB. Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis. Gerontology. 2022;68(4):361-76.
17. Zhang Y, Zhang J, Ni W, Yuan X, Zhang H, Li P, Xu J, Zhao Z. Sarcopenia in heart failure: a systematic review and meta-analysis. ESC heart failure. 2021;8(2):1007-17.
18. Sepúlveda-Loyola W, Osadnik C, Phu S, Morita AA, Duque G, Probst VS. Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis. Journal of cachexia, sarcopenia and muscle. 2020;11(5):1164-76.
19. Wang Y, Tan S, Yan Q, Gao Y. Sarcopenia and COVID-19 Outcomes. Clinical interventions in aging. 2023;18:359-73.
20. Ubachs J, Ziemons J, Minis-Rutten IJG, Kruitwagen R, Kleijnen J, Lambrechts S, Olde Damink SWM, Rensen SS, Van Gorp T. Sarcopenia and ovarian cancer survival: a systematic review and meta-analysis. Journal of cachexia, sarcopenia and muscle. 2019;10(6):1165-74.
21. Shu X, Lin T, Wang H, Zhao Y, Jiang T, Peng X, Yue J. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis. Journal of cachexia, sarcopenia and muscle. 2022;13(1):145-58.
22. McDonald ML, Diaz AA, Ross JC, San Jose Estepar R, Zhou L, Regan EA, Eckbo E, Muralidhar N, Come CE, Cho MH, Hersh CP, Lange C, Wouters E, Casaburi RH, Coxson HO, Macnee W, Rennard SI, Lomas DA, Agusti A, Celli BR, Black-Shinn JL, Kinney GL, Lutz SM, Hokanson JE, Silverman EK, Washko GR. Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease. A cross-sectional study. Annals of the American Thoracic Society. 2014;11(3):326-34.
23. Riou M, Pizzimenti M, Enache I, Charloux A, Canuet M, Andres E, Talha S, Meyer A, Geny B. Skeletal and respiratory muscle dysfunctions in pulmonary arterial hypertension. Journal of clinical medicine. 2020;9(2):410.
24. Breda AP, Pereira de Albuquerque AL, Jardim C, Morinaga LK, Suesada MM, Fernandes CJC, Dias B, Lourenço RB, Salge JM, Souza R. Skeletal muscle abnormalities in pulmonary arterial hypertension. PLoS One. 2014;9(12):e114101.
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| pectoralis muscle area pectoralis muscle density Sarcopenia Pulmonary hypertension Right heart catheterization | ||
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How to Cite
1.
Mirtajaddini M, Naderi N, Jalali SS, Hosseinpour A, Pouraliakbar H, Taghavi S, Omidvar R, Bakhshandeh H, Attar A, Sadeghi T, Ghorbani F. Exploring the Correlation between Pulmonary Hypertension and Pectoralis Muscle Area and Density. J Tehran Heart Cent. 2024;.
