Pectoralis muscle area and mortality in smokers without airflow obstruction

IntroductionMuscle loss is an important extrapulmonary manifestation of COPD. Dual energy X-ray absorptiometry (DXA) is the method of choice for body composition measurement but is not widely used for muscle mass evaluation. The pectoralis muscle area (PMA) is quantifiable by CT and predicts cross-sectional COPD-related morbidity. There are no studies that compare PMA with DXA measures or that evaluate longitudinal relationships between PMA and lung disease progression.MethodsParticipants from our longitudinal tobacco-exposed cohort had baseline and 6-year chest CT (n=259) and DXA (n=164) data. Emphysema was quantified by CT density histogram parenchymal scoring using the 15th percentile technique. Fat-free mass index (FFMI) and appendicular skeletal mass index (ASMI) were calculated from DXA measurements. Linear regression model relationships were reported using standardised coefficient (β) with 95% CI.ResultsPMA was more strongly associated with DXA measures than with body mass index (BMI) in both cross-sectional (FFMI: β=0.76 (95% CI 0.65 to 0.86), p<0.001; ASMI: β=0.76 (95% CI 0.66 to 0.86), p<0.001; BMI: β=0.36 (95% CI 0.25 to 0.47), p<0.001) and longitudinal (ΔFFMI: β=0.43 (95% CI 0.28 to 0.57), p<0.001; ΔASMI: β=0.42 (95% CI 0.27 to 0.57), p<0.001; ΔBMI: β=0.34 (95% CI 0.22 to 0.46), p<0.001) models. Six-year change in PMA was associated with 6-year change in emphysema (β=0.39 (95% CI 0.23 to 0.56), p<0.001) but not with 6-year change in airflow obstruction.ConclusionsPMA is an accessible measure of muscle mass and may serve as a useful clinical surrogate for assessing skeletal muscle loss in smokers. Decreased PMA correlated with emphysema progression but not lung function decline, suggesting a difference in the pathophysiology driving emphysema, airflow obstruction and comorbidity risk.

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Pectoralis muscle area and its association with indices of disease severity in interstitial lung disease

Respiratory Medicine ◽

10.1016/j.rmed.2021.106539 ◽

2021 ◽

pp. 106539

Author(s):

Yannick Molgat-Seon ◽

Sabina A. Guler ◽

Carli M. Peters ◽

Dragoş M. Vasilescu ◽

Joseph H. Puyat ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Disease Severity ◽

Pectoralis Muscle ◽

Muscle Area

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Quantitative Pectoralis Muscle Area is Associated with the Development of Lung Cancer in a Large Lung Cancer Screening Cohort

Lung ◽

10.1007/s00408-020-00388-5 ◽

2020 ◽

Vol 198 (5) ◽

pp. 847-853

Author(s):

Lee Gazourian ◽

Chantal S. Durgana ◽

Devon Huntley ◽

Giulia S. Rizzo ◽

William B. Thedinger ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Pectoralis Muscle ◽

Muscle Area

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Pectoralis muscle area is associated with bone mineral density and lung function in lung transplant candidates

Osteoporosis International ◽

10.1007/s00198-020-05373-5 ◽

2020 ◽

Vol 31 (7) ◽

pp. 1361-1367

Author(s):

A. D. Parulekar ◽

T. Wang ◽

G. W. Li ◽

V. Hoang ◽

C. C. Kao

Keyword(s):

Bone Mineral Density ◽

Lung Function ◽

Bone Mineral ◽

Lung Transplant ◽

Pectoralis Muscle ◽

Mineral Density ◽

Muscle Area ◽

Transplant Candidates

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Chest CT measures of pectoralis muscle area predicts mortality in smokers

10.1183/13993003.congress-2015.pa620 ◽

2015 ◽

Author(s):

Alejandro Diaz ◽

Rola Harmouche ◽

James Ross ◽

Raul San Jose Estepar ◽

Gregory Kinney ◽

...

Keyword(s):

Chest Ct ◽

Pectoralis Muscle ◽

Muscle Area

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Association of pectoralis muscle area and survival outcomes after chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24094 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24094-e24094

Author(s):

Christina Gu ◽

Jason Wiederin ◽

Patricia Jewett ◽

Anne Hudson Blaes

Keyword(s):

Overall Survival ◽

Body Surface ◽

Cox Regression ◽

Nonlinear Effects ◽

Pectoral Muscle ◽

Cancer Type ◽

Pectoralis Muscle ◽

Muscle Area ◽

Hazard Ratios ◽

Overall Mortality

e24094 Background: Chemotherapy use may be associated with muscle wasting, a marker of frailty that can predispose individuals to poor outcomes. We assessed the association between pre-treatment pectoralis muscle area and overall mortality following chemotherapy. Methods: We identified individuals diagnosed with breast cancer (N=221), lymphoma (N=216), or sarcoma (N=115) who received chemotherapy at the University of Minnesota Masonic Cancer Clinic and had CT scans prior to chemotherapy 2009-2014. Using CoreSlicer, right pectoral muscle area was measured at baseline and indexed to body surface (right pectoralis muscle area [cm2] / body surface [m2]) and divided into quartiles. Restricting to individuals who started chemotherapy within 6 months after their CT, we used cox regression (adjusted for age, sex, cancer type, stage, ever-smoking, BMI, and chemotherapy type) to assess associations between baseline muscle area and overall survival, testing for nonlinear effects using cubic splines. Results: 536 individuals (66% female) were identified who were treated with anthracyclines based chemotherapy (N=408), Trastuzumab (N=64), or both (N=64). Mean baseline muscle area was 14.9 (4.6) cm2 in females and 26.3 (9.3) cm2 in males. Median follow-up was 4.6 years. Larger baseline pectoralis muscle area (per m2 body surface) was associated with improved survival (adjusted model, overall effect, P=0.01), with some nonlinear effects (P=0.05). With muscle area (per m2 body surface) categorized as quartiles, individuals in the 3rd and 4th quartiles were at lower risk of dying (compared with people in the 1st quartile, hazard ratios 0.59 and 0.55 respectively, 95% CI range 0.35-0.90, P=0.01). There were no differences comparing the 4th vs the 3rd quartile (P=0.79), or the 2nd vs the 1st quartile (P=0.5). Conclusions: We found a protective association between larger right pectoral muscle size (relative to body surface) and overall survival after chemotherapy. There may be ceiling and threshold effects given evidence for nonlinear effects, since neither the 2nd vs. 1st quartile, nor the 4th vs. 3rd quartile comparisons in the categorical model were significant. Hazard ratios and confidence intervals of overall mortality by pectoral muscle area at baseline indexed to body surface, N=536, 2009-14. [Table: see text]

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Pectoralis muscle wasting during chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24069 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24069-e24069

Author(s):

Jason Wiederin ◽

Christina Gu ◽

Patricia Jewett ◽

Anne Hudson Blaes

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Muscle Mass ◽

Body Surface ◽

Cox Regression ◽

Nonlinear Effects ◽

Pectoralis Muscle ◽

Muscle Loss ◽

Muscle Area

e24069 Background: Chemotherapy is often followed by muscle mass loss which has been associated with frailty. We explored factors associated with change in pectoralis muscle mass after chemotherapy. We hypothesized greater muscle loss with time would be associated with poorer overall survival. Methods: We identified individuals with breast cancer (N = 221), sarcoma (N = 115), and lymphoma (N = 216) who received chemotherapy at the University of Minnesota MHealth Fairview and had CT scans before and after chemotherapy. Right pectoralis muscle area was measured using CORESLICER and indexed to body surface (right pectoralis muscle area [cm2] / body surface [m2]). We calculated quartiles of the indexed pectoralis measure. We restricted our analyses to participants who received a follow-up CT within two years after starting chemotherapy. In a multivariate linear regression, we explored associations of sex, age, BMI, ever-smoking, time since start of chemotherapy, indexed baseline muscle area, stage, type of diagnosis, and cumulative anthracycline dose with relative (%) change in muscle area. In a Cox regression we tested the association of relative muscle change with overall mortality. We used cubic splines to test for nonlinear effects. Results: Of 477 participants (66% female; mean age 61.3 (10.1) years), 366 received anthracyclines, 61 Trastuzumab, and 60 both. The average loss in right pectoral muscle area was -10% for women and -12% for men. We detected nonlinear effects of indexed baseline muscle area, P = 0.03. In a model using quartiles of indexed baseline muscle area, significant predictors of muscle loss included sex (women vs. men, -9.0%, 95% confidence interval (CI) -14.2- -3.7%, P = 0.0008), larger indexed baseline muscle area (quartiles 2, 3, 4 compared with quartile 1, change range -7 - -24%, 95% CI range, -2 - -30%, P-range < 0.0001 – 0.006), smoking (ever vs. never, -4.1%, 95% CI -7.6 - -0.7%, P = 0.02), and diagnosis (sarcoma vs breast cancer, -5.7%, 95% CI -11.1 - -0.3%, P = 0.04). There was no significant association between muscle change and overall survival (median follow-up time 4.1). Conclusions: Being female, larger baseline muscle mass (per m2 body surface), ever-smoking, and a sarcoma diagnosis were associated with greater relative muscle loss after chemotherapy. More data is needed to understand the course of sarcopenia in terms of recovery and survivorship. [Table: see text]

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