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Life (Basel, Switzerland) May 2024Muscle mass depletion is associated with unfavorable outcomes in many diseases. However, its relationship with cardiac arrest outcomes has not been explored. This...
Muscle mass depletion is associated with unfavorable outcomes in many diseases. However, its relationship with cardiac arrest outcomes has not been explored. This retrospective single-center study determined the relationship between muscle mass depletion and the neurological outcomes of patients with out-of-hospital cardiac arrest (OHCA) by measuring muscle mass at various locations. Adult patients with OHCA, who were treated with target temperature management, and who underwent abdominal or chest computed tomography (CT) within 3 months of the cardiac arrest were included. Skeletal muscle index (SMI) was measured at the third lumbar vertebra (L3) level, psoas muscle, fourth thoracic vertebra (T4) level, and pectoralis muscle. The Youden index was used to determine a low SMI based on sex-specific cutoff values. The outcome variables were "good neurological outcome" and "survival" at hospital discharge. Multivariable analyses revealed that patients with low T4 SMI level were significantly associated with good neurological outcomes at hospital discharge (odds ratio = 0.26, 95% confidence interval: 0.07-0.88, = 0.036). However, no significant differences were observed between good neurological outcomes and low SMI at the L3 level and psoas and pectoralis muscles; SMIs were not associated with survival at hospital discharge. T4 level SMI depletion was inversely associated with good neurological outcomes in patients with OHCA. Thoracic muscle depletion may be crucial for predicting the neurological outcomes in patients with OHCA and further investigation in larger prospective study is warranted.
PubMed: 38929664
DOI: 10.3390/life14060680 -
Animal Nutrition (Zhongguo Xu Mu Shou... Jun 2024Fat content is an important trait in pig production. Adipose tissue and muscle are important sites for fat deposition and affect production efficiency and quality. To...
Fat content is an important trait in pig production. Adipose tissue and muscle are important sites for fat deposition and affect production efficiency and quality. To regulate the fat content in these tissues, we need to understand the mechanisms behind fat deposition. Laiwu pigs, a Chinese indigenous breed, have significantly higher fat content in both adipose tissue and muscle than commercial breeds such as Duroc. In this study, we analyzed the transcriptomes in adipose tissue and muscle of 21-d-old Laiwu and Duroc piglets. Results showed that there were 828 and 671 differentially expressed genes (DEG) in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT), respectively. Functional enrichment analysis showed that these DEG were enriched in metabolic pathways, especially carbohydrate and lipid metabolism. Additionally, in the longissimus muscle (LM) and psoas muscle (PM), 312 and 335 DEG were identified, demonstrating enrichment in the cell cycle and metabolic pathways. The protein-protein interaction (PPI) networks of these DEG were analyzed and potential hub genes were identified, such as and in adipose tissues and and in muscles. Meanwhile, results showed that there were common DEG between adipose tissue and muscle, such as , , and . These findings showed that there are significant differences in the transcriptomes of the adipose tissue and muscle between Laiwu and Duroc piglets ( < 0.05), especially in metabolic patterns. This insight serves to advance our comprehensive understanding of metabolic regulation in these tissues and provide targets for fat content regulation.
PubMed: 38766520
DOI: 10.1016/j.aninu.2023.12.012 -
Journal of Endovascular Therapy : An... Dec 2023To report a case of a patient with May-Thurner syndrome who underwent endovenous stenting and was found to have pulsating arterial compression on the venous stent.
PURPOSE
To report a case of a patient with May-Thurner syndrome who underwent endovenous stenting and was found to have pulsating arterial compression on the venous stent.
REPORT
A 74-year-old man presented with 18 months of progressive right thigh and calf edema. After an extensive work-up, the patient underwent a venogram with intravascular ultrasound (IVUS), revealing compression of the right iliac vein by the external iliac artery and psoas muscle. Following stent deployment, fluoroscopy revealed extrinsic compression by an artery, but IVUS confirmed sufficient stent expansion. On follow-up, there was a significant resolution of right limb edema, and adjacent arterial pulsation/compression was deemed non-significant.
CONCLUSION
The choice of venous stents is essential to prevent collapse from extrinsic compression, such as that from an adjacent artery.
CLINICAL IMPACT
Carefully choosing venous stents is essential to ensure stent patency in the face of external compression.
PubMed: 38115161
DOI: 10.1177/15266028231219673 -
Circulation. Cardiovascular... Feb 2024Frailty associates with worse outcomes after transcatheter aortic valve replacement (TAVR). Sarcopenia underlies frailty, but the association between a comprehensive...
BACKGROUND
Frailty associates with worse outcomes after transcatheter aortic valve replacement (TAVR). Sarcopenia underlies frailty, but the association between a comprehensive assessment of sarcopenia-muscle mass, strength, and performance-and outcomes after TAVR has not been examined.
METHODS
From a multicenter prospective registry of patients with symptomatic severe aortic stenosis undergoing TAVR, 445 who had a preprocedure computed tomography and clinical assessment of frailty were included. Cross-sectional muscle (psoas and paraspinal) areas were measured on computed tomography and indexed to height. Gait speed and handgrip strength were obtained, and patients were dichotomized into fast versus slow; strong versus weak; and normal versus low muscle mass. As measures of body composition, cross-sectional fat (subcutaneous and visceral) was measured and indexed to height.
RESULTS
The frequency of patients who were slow, weak, and had low muscle mass was 56%, 59%, and 42%, respectively. Among the 3 components of sarcopenia, only slower gait speed (muscle performance) was independently associated with increased post-TAVR mortality (adjusted hazard ratio, 1.12 per 0.1 m/s decrease [95% CI, 1.04-1.21]; =0.004; adjusted hazard ratio, 1.38 per 1 SD decrease [95% CI, 1.11-1.72]; =0.004). Meeting multiple sarcopenia criteria was not associated with higher mortality risk than fewer. Lower indexed visceral fat area (adjusted hazard ratio, 1.48 per 1 SD decrease [95% CI, 1.15-1.89]; =0.002) was associated with mortality but indexed subcutaneous fat was not. Death occurred in 169 (38%) patients.
CONCLUSIONS
Among patients with symptomatic severe aortic stenosis and comprehensive sarcopenia and body composition phenotyping, gait speed was the only sarcopenia measure associated with post-TAVR mortality. Lower visceral fat was also associated with increased risk pointing to an obesity paradox also observed in other patient populations. These findings reinforce the clinical utility of gait speed as a measure of risk and a potential target for adjunctive interventions alongside TAVR to optimize clinical outcomes.
Topics: Humans; Transcatheter Aortic Valve Replacement; Sarcopenia; Frailty; Treatment Outcome; Hand Strength; Cross-Sectional Studies; Risk Assessment; Aortic Valve Stenosis; Body Composition; Aortic Valve; Risk Factors
PubMed: 38235547
DOI: 10.1161/CIRCINTERVENTIONS.123.013298 -
The American Journal of Emergency... Nov 2023As sepsis is a life-threatening disease, it is important to predict the prognosis in the early stages to establish treatment plans. This study aimed to investigate the...
AIM OF THE STUDY
As sepsis is a life-threatening disease, it is important to predict the prognosis in the early stages to establish treatment plans. This study aimed to investigate the association between sarcopenia, determined by the psoas muscle area, and the prognosis of sepsis due to acute cholecystitis.
METHODS
This retrospective single-center observational study included adult patients with sepsis due to acute cholecystitis who visited the emergency department between January 2016 and December 2021. The area of both sides of the psoas muscle at the L3 level was measured, and the psoas muscle index (PMI) corrected by the patient's height was calculated. Sarcopenia was determined based on PMI. The primary outcome was in-hospital mortality, and secondary outcomes were intensive care unit (ICU) admission, length of hospital stay (LOS), and 14-day mortality.
RESULTS
A total of 374 patients were included in this study. In this cohort, the lower quartile of PMI according to gender was set as the cut-off value to define sarcopenia. Sarcopenia was defined as PMI < 423 mm/m for males and < 269 mm/m for females. There were 94 patients in the sarcopenic group and 280 in the non-sarcopenic group. There was a significant association between sarcopenia and ICU admission (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.05-3.76), and there was also a significant association between sarcopenia and in-hospital mortality (OR, 6.40; 95%CI, 1.13-36.09). Additionally, the median LOS in the sarcopenic group (11.5 (Cruz-Jentoft et al., 2010; Kawaguchi et al., 2019; Kim et al., 2017; Ritz et al., 2021; Cox et al., 2021; Lee et al., 2018; Okada et al., 2021; Prashanthi et al., n.d.; Amini et al., 2015; Fearon et al., 2011) days) was significantly longer than the median (8 (Rosenberg, 1989, 1997; Cruz-Jentoft et al., 2010; Kawaguchi et al., 2019; Kim et al., 2017; Ritz et al., 2021) days) in the non-sarcopenic group.
CONCLUSIONS
In patients with sepsis due to acute cholecystitis, sarcopenia was significantly associated with ICU admission, LOS, and in-hospital mortality.
PubMed: 37619445
DOI: 10.1016/j.ajem.2023.08.014 -
The Surgeon : Journal of the Royal... Jun 2024To evaluate whether computed tomography (CT)-derived psoas major muscle measurements could predict preoperative cardiopulmonary exercise testing (CPET) performance and...
OBJECTIVES
To evaluate whether computed tomography (CT)-derived psoas major muscle measurements could predict preoperative cardiopulmonary exercise testing (CPET) performance and long-term mortality in patients undergoing major colorectal surgery and to compare predictive performance of psoas muscle measurements using 2D approach and 3D approach.
METHODS
A retrospective cohort study compliant with STROCSS standards was conducted. Consecutive patients undergoing major colorectal surgery between January 2011 and January 2017 following CPET as part of their preoperative assessment were included. Regression analyses were modelled to investigate association between the CT-derived psoas major muscle mass variables [total psoas muscle area (TPMA), total psoas muscle volume (TPMV) and psoas muscle index (PMI)] and CPET performance and mortality (1-year and 5-year). Discriminative performances of the variables were evaluated using Receiver Operating Characteristic (ROC) curve analysis.
RESULTS
A total of 457 eligible patients were included. The median TPMA and TPMV were 21 cm (IQR: 15-27) and 274 cm (IQR: 201-362), respectively. The median PMI measured via 2D and 3D approaches were 7 cm/m (IQR: 6-9) and 99 cm/m (IQR: 76-120), respectively. The risks of 1-year and 5-year mortality were 7.4% and 27.1%, respectively. Regression analyses showed TPMA, TPMV, and PMI can predict preoperative CPET performance and long-term mortality. However, ROC curve analyses showed no significant difference in predictive performance amongst TPMA, TPMV, and PMI.
CONCLUSION
Radiologically-measured psoas muscle mass variables may predict preoperative CPET performance and may be helpful with informing more objective selection of patients for preoperative CPET and prehabilitation.
Topics: Humans; Psoas Muscles; Male; Retrospective Studies; Female; Aged; Tomography, X-Ray Computed; Middle Aged; Exercise Test; Survival Rate
PubMed: 38653641
DOI: 10.1016/j.surge.2024.04.005 -
Scientific Reports Jun 2024The study of muscle mass as an imaging-derived phenotype (IDP) may yield new insights into determining the normal and pathologic variations in muscle mass in the...
The study of muscle mass as an imaging-derived phenotype (IDP) may yield new insights into determining the normal and pathologic variations in muscle mass in the population. This can be done by determining 3D abdominal muscle mass from 12 distinct abdominal muscle regions and groups using computed tomography (CT) in a racially diverse medical biobank. To develop a fully automatic technique for assessment of CT abdominal muscle IDPs and preliminarily determine abdominal muscle IDP variations with age and sex in a clinically and racially diverse medical biobank. This retrospective study was conducted using the Penn Medicine BioBank (PMBB), a research protocol that recruits adult participants during outpatient visits at hospitals in the Penn Medicine network. We developed a deep residual U-Net (ResUNet) to segment 12 abdominal muscle groups including the left and right psoas, quadratus lumborum, erector spinae, gluteus medius, rectus abdominis, and lateral abdominals. 110 CT studies were randomly selected for training, validation, and testing. 44 of the 110 CT studies were selected to enrich the dataset with representative cases of intra-abdominal and abdominal wall pathology. The studies were divided into non-overlapping training, validation and testing sets. Model performance was evaluated using the Sørensen-Dice coefficient. Volumes of individual muscle groups were plotted to distribution curves. To investigate associations between muscle IDPs, age, and sex, deep learning model segmentations were performed on a larger abdominal CT dataset from PMBB consisting of 295 studies. Multivariable models were used to determine relationships between muscle mass, age and sex. The model's performance (Dice scores) on the test data was the following: psoas: 0.85 ± 0.12, quadratus lumborum: 0.72 ± 0.14, erector spinae: 0.92 ± 0.07, gluteus medius: 0.90 ± 0.08, rectus abdominis: 0.85 ± 0.08, lateral abdominals: 0.85 ± 0.09. The average Dice score across all muscle groups was 0.86 ± 0.11. Average total muscle mass for females was 2041 ± 560.7 g with a high of 2256 ± 560.1 g (41-50 year old cohort) and a change of - 0.96 g/year, declining to an average mass of 1579 ± 408.8 g (81-100 year old cohort). Average total muscle mass for males was 3086 ± 769.1 g with a high of 3385 ± 819.3 g (51-60 year old cohort) and a change of - 1.73 g/year, declining to an average mass of 2629 ± 536.7 g (81-100 year old cohort). Quadratus lumborum was most highly correlated with age for both sexes (correlation coefficient of - 0.5). Gluteus medius mass in females was positively correlated with age with a coefficient of 0.22. These preliminary findings show that our CNN can automate detailed abdominal muscle volume measurement. Unlike prior efforts, this technique provides 3D muscle segmentations of individual muscles. This technique will dramatically impact sarcopenia diagnosis and research, elucidating its clinical and public health implications. Our results suggest a peak age range for muscle mass and an expected rate of decline, both of which vary between genders. Future goals are to investigate genetic variants for sarcopenia and malnutrition, while describing genotype-phenotype associations of muscle mass in healthy humans using imaging-derived phenotypes. It is feasible to obtain 3D abdominal muscle IDPs with high accuracy from patients in a medical biobank using fully automated machine learning methods. Abdominal muscle IDPs showed significant variations in lean mass by age and sex. In the future, this tool can be leveraged to perform a genome-wide association study across the medical biobank and determine genetic variants associated with early or accelerated muscle wasting.
Topics: Humans; Female; Male; Tomography, X-Ray Computed; Middle Aged; Adult; Phenotype; Retrospective Studies; Aged; Abdominal Muscles; Biological Specimen Banks; Age Factors; Sex Factors; Aged, 80 and over
PubMed: 38926479
DOI: 10.1038/s41598-024-64603-6 -
Journal of Nuclear Medicine : Official... Aug 2023In patients with prostate cancer scheduled for systemic treatment, being overweight is linked to prolonged overall survival (OS), whereas sarcopenia is associated with...
Elevated Body Mass Index Is Associated with Improved Overall Survival in Castration-Resistant Prostate Cancer Patients Undergoing Prostate-Specific Membrane Antigen-Directed Radioligand Therapy.
In patients with prostate cancer scheduled for systemic treatment, being overweight is linked to prolonged overall survival (OS), whereas sarcopenia is associated with shorter OS. We investigated fat-related and body composition parameters in patients undergoing prostate-specific membrane antigen (PSMA)-directed radioligand therapy (RLT) to assess their predictive value for OS. Body mass index (BMI, in kg/m) and CT-derived body composition parameters (total, subcutaneous, visceral fat area, and psoas muscle area at the L3-L4 level) were determined for 171 patients scheduled for PSMA-directed RLT. After normalization for stature, the psoas muscle index was used to define sarcopenia. Outcome analysis was performed using Kaplan-Meier curves and Cox regression including fat-related and other clinical parameters (Gleason score, C-reactive protein [CRP], lactate dehydrogenase [LDH], hemoglobin, and prostate-specific antigen levels). The Harrell C-index was used for goodness-of-fit analysis. Sixty-five patients (38%) had sarcopenia, and 98 patients (57.3%) had increased BMI. Relative to the 8-mo OS in normal-weight men (BMI < 25), overweight men (25 ≥ BMI > 30) and obese men (BMI ≥ 30) achieved a longer OS of 14 mo (hazard ratio [HR], 0.63; 95% CI, 0.40-0.99; = 0.03) and 13 mo (HR, 0.47; 95% CI, 0.29-0.77; = 0.004), respectively. Sarcopenia showed no impact on OS (11 vs. 12 mo; HR, 1.4; 95% CI, 0.91-2.1; = 0.09). Most of the body composition parameters were tightly linked to OS on univariable analyses, with the highest C-index for BMI. In multivariable analysis, a higher BMI (HR, 0.91; 95% CI, 0.86-0.97; = 0.006), lower CRP (HR, 1.09; 95% CI, 1.03-1.14; < 0.001), lower LDH (HR, 1.08; 95% CI, 1.03-1.14; < 0.001), and longer interval between initial diagnosis and RLT (HR, 0.95; 95% CI, 0.91-0.99; = 0.02) were significant predictors of OS. Increased fat reserves assessed by BMI, CRP, LDH, and interval between initial diagnosis and RLT, but not CT-derived body composition parameters, were relevant predictors for OS. As BMI can be altered, future research should investigate whether a high-calorie diet before or during PSMA RLT may improve OS.
Topics: Male; Humans; Body Mass Index; Prostatic Neoplasms, Castration-Resistant; Sarcopenia; Prostate-Specific Antigen; Overweight; Prostate; Treatment Outcome; Lutetium; Retrospective Studies; Heterocyclic Compounds, 1-Ring; Dipeptides
PubMed: 37290794
DOI: 10.2967/jnumed.122.265379 -
Anticancer Research Sep 2023Sarcopenia is a progressive and generalized muscle disorder correlated with an increased risk of adverse outcomes, including falls, fractures, physical disability and...
BACKGROUND/AIM
Sarcopenia is a progressive and generalized muscle disorder correlated with an increased risk of adverse outcomes, including falls, fractures, physical disability and mortality. Moreover, sarcopenia is associated with short- and long-term outcomes after surgery in patients with gastrointestinal malignancies. Additionally, severe skeletal muscle loss after surgery reduces quality of life. In this study, we analyzed the perioperative risk factors for skeletal muscle loss after gastrectomy in elderly patients undergoing radical gastrectomy for gastric cancer.
PATIENTS AND METHODS
In this case-control study, we enrolled patients aged ≥75 years who underwent radical gastrectomy for gastric cancer between January 2014 and December 2020 at our Institution. The psoas muscle index was used to assess skeletal muscle mass. They were divided into two groups-muscle depletion (D group) and no depletion (ND group)-depending on the ratio of skeletal muscle loss before and after gastrectomy.
RESULTS
The D and ND groups comprised 34 and 41 patients, respectively. Univariate analysis showed that open gastrectomy was a potential risk factor for postoperative skeletal muscle loss in elderly gastric cancer patients (p=0.017). In multiple logistic regression analysis using the following variables: sex, operation and approach, the D group had a significantly higher proportion of patients who underwent open surgery than the ND group (p=0.032).
CONCLUSION
Open gastrectomy is an independent risk factor for the progression of sarcopenia after gastrectomy in elderly patients with gastric cancer. Laparoscopic surgery is an eligible method for preserving skeletal muscle mass in elderly patients with gastric cancer.
Topics: Aged; Humans; Stomach Neoplasms; Sarcopenia; Case-Control Studies; Quality of Life; Gastrectomy; Psoas Muscles
PubMed: 37648324
DOI: 10.21873/anticanres.16612