Impact of Muscle Mass as a Prognostic Factor for Failed Waiting Time Prior to Heart Transplantation

Objectives: Clinical deterioration during the waiting time impairs the prognosis of patients listed for heart transplantation. Reduced muscle mass increases the risk for mortality after cardiac surgery, but its impact on resilience against deterioration during the waiting time remains unclear.Methods: We retrospectively analyzed data from 93 patients without a VAD who were listed in Eurotransplant status “high urgent (HU)” for heart transplantation between January 2015 and October 2020. The axial muscle area of the erector spinae muscles at the level of thoracic vertebra 12 indexed to body surface area (TMESA/BSA) measured in the preoperative thoracic computed tomography scan was used to measure muscle mass.Results: Forty patients (43%) underwent emergency VAD implantation during the waiting time and four patients (4%) died during the waiting time. The risk of emergency VAD implantation/death during the waiting time decreased by 10% for every cm2/m2 increase in muscle area [OR 0.901 (95% CI: 0.808–0.996); p = 0.049]. After adjusting for gender [OR 0.318 (95% CI: 0.087–1.073); p = 0.072], mean pulmonary artery pressure [OR 1.061 (95% CI: 0.999–1.131); p = 0.060], C-reactive protein [OR 1.352 (95% CI: 0.986–2.027); p = 0.096], and hemoglobin [OR 0.862 (95% CI: 0.618–1.177); p = 0.360], TMESA/BSA [OR 0.815 (95% CI: 0.698–0.936); p = 0.006] remained an independent risk factor for emergency VAD implantation/death during the HU waiting time.Conclusion: Muscle area of the erector spinae muscle appears to be a potential, easily identifiable risk factor for emergency VAD implantation or death in patients on the HU waiting list for heart transplantation. Identifying patients at risk could help optimize the outcome and the timing of VAD support.

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Sarcopenia and myosteatosis at presentation adversely affect survival after esophagectomy for esophageal cancer

Radiology and Oncology ◽

10.2478/raon-2020-0016 ◽

2020 ◽

Vol 54 (2) ◽

pp. 237-246

Author(s):

Matevz Srpcic ◽

Taja Jordan ◽

Karteek Popuri ◽

Mihael Sok

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Muscle Mass ◽

Perioperative Complications ◽

Muscle Area ◽

Radical Esophagectomy ◽

Therapeutic Decisions ◽

Patients At Risk ◽

Skeletal Muscle Area ◽

The Impact

AbstractBackgroundEsophageal cancer remains a disease with poor survival and many complications. Measuring muscle mass and quality can identify patients with diminished muscle mass (sarcopenia) and muscle fat infiltration (myosteatosis). We studied the impact of sarcopenia and myosteatosis in resectable esophageal cancer on overall survival and complications.Patients and methods139 patients received a radical esophagectomy. Skeletal muscle area (SMA) and muscle attenuation (MA) in CT images at L3 level were recorded and groups with and without sarcopenia and myosteatosis were compared for overall survival (OS), perioperative mortality, conduit complications, pleuropulmonary complications, respiratory failure requiring mechanical ventilation and other significant complications.ResultsPrevalence of sarcopenia and myosteatosis at presentation was 16.5% and 51.8%, respectively. Both were associated with decreased OS. Median survival was 18.3 months (CI 5.4–31.1) vs 31.0 months (CI 7.4–54.6) for sarcopenia/no sarcopenia (log rank p = 0.042) and 19.0 months (CI 13.3–24.7) vs 57.1 months (CI 15.2–99.0) for myosteatosis (log rank p = 0.044), respectively. A relationship between sarcopenia and myosteatosis and other negative outcomes after esophagectomy could not be established.ConclusionsSarcopenia and myosteatosis before esophagectomy are associated with decreased overall survival but not with more frequent perioperative complications. Identification of patients at risk can guide therapeutic decisions and interventions aimed at replenishing muscle reserves.

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The BMI and skeletal muscle mass as a risk factor of carotid atherosclerosis in patients with type 2 diabetes

Endocrine Abstracts ◽

10.1530/endoabs.56.gp73 ◽

2018 ◽

Author(s):

Se-Hwa Kim ◽

Soo-Kyung Kim ◽

Young-Ju Choi ◽

Seok-Won Park ◽

Eun-Jig Lee ◽

...

Keyword(s):

Type 2 Diabetes ◽

Skeletal Muscle ◽

Risk Factor ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Carotid Atherosclerosis

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Faculty Opinions recommendation of C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the U.S. Preventive Services Task Force.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1165500.628495 ◽

2009 ◽

Author(s):

Deborah R Korenstein

Keyword(s):

Systematic Review ◽

Coronary Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Task Force ◽

Preventive Services ◽

C Reactive Protein ◽

Reactive Protein ◽

Meta Analyses ◽

The U.S

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Siphon-Controlled Automation on a Lab-on-a-Disc Using Event-Triggered Dissolvable Film Valves

Biosensors ◽

10.3390/bios11030073 ◽

2021 ◽

Vol 11 (3) ◽

pp. 73

Author(s):

Brian D. Henderson ◽

David J. Kinahan ◽

Jeanne Rio ◽

Rohit Mishra ◽

Damien King ◽

...

Keyword(s):

Risk Factor ◽

Limit Of Detection ◽

C Reactive Protein ◽

Cvd Risk ◽

Low Resource Settings ◽

Low Resource ◽

Reactive Protein ◽

Limit Of Quantitation ◽

Chemiluminescent Immunoassay ◽

Event Triggered

Within microfluidic technologies, the centrifugal microfluidic “Lab-on-a-Disc” (LoaD) platform offers great potential for use at the PoC and in low-resource settings due to its robustness and the ability to port and miniaturize ‘wet bench’ laboratory protocols. We present the combination of ‘event-triggered dissolvable film valves’ with a centrifugo-pneumatic siphon structure to enable control and timing, through changes in disc spin-speed, of the release and incubations of eight samples/reagents/wash buffers. Based on these microfluidic techniques, we integrated and automated a chemiluminescent immunoassay for detection of the CVD risk factor marker C-reactive protein displaying a limit of detection (LOD) of 44.87 ng mL−1 and limit of quantitation (LoQ) of 135.87 ng mL−1.

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Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People

Gerontology ◽

10.1159/000514007 ◽

2021 ◽

pp. 1-10

Author(s):

Tatsuma Okazaki ◽

Yoshimi Suzukamo ◽

Midori Miyatake ◽

Riyo Komatsu ◽

Masahiro Yaekashiwa ◽

...

Keyword(s):

Risk Factor ◽

Muscle Strength ◽

Older People ◽

Serum Albumin ◽

Muscle Mass ◽

Muscle Weakness ◽

Fat Mass ◽

Respiratory Muscle ◽

Respiratory Muscle Strength ◽

Respiratory Muscle Weakness

Introduction: The respiratory muscle strength regulates the effectiveness of coughing, which clears the airways and protects people from pneumonia. Sarcopenia is an aging-related loss of muscle mass and function, the worsening of which is associated with malnutrition. The loss of respiratory and swallowing muscle strength occurs with aging, but its effect on pneumonia is unclear. This study aimed to determine the risks of respiratory muscle weakness on the onset and relapse of pneumonia in older people in conjunction with other muscle-related factors such as malnutrition. Methods: We conducted a longitudinal study with 47 pneumonia inpatients and 35 non-pneumonia controls aged 70 years and older. We evaluated the strength of respiratory and swallowing muscles, muscle mass, and malnutrition (assessed by serum albumin levels and somatic fat) during admission and confirmed pneumonia relapse within 6 months. The maximal inspiratory and expiratory pressures determined the respiratory muscle strength. Swallowing muscle strength was evaluated by tongue pressure. Bioelectrical impedance analysis was used to evaluate the muscle and fat mass. Results: The respiratory muscle strength, body trunk muscle mass, serum albumin level, somatic fat mass, and tongue pressure were significantly lower in pneumonia patients than in controls. Risk factors for the onset of pneumonia were low inspiratory respiratory muscle strength (odds ratio [OR], 6.85; 95% confidence interval [CI], 1.56–30.11), low body trunk muscle mass divided by height2 (OR, 6.86; 95% CI, 1.49–31.65), and low serum albumin level (OR, 5.46; 95% CI, 1.51–19.79). For the relapse of pneumonia, low somatic fat mass divided by height2 was a risk factor (OR, 20.10; 95% CI, 2.10–192.42). Discussion/Conclusions: Respiratory muscle weakness, lower body trunk muscle mass, and malnutrition were risk factors for the onset of pneumonia in older people. For the relapse of pneumonia, malnutrition was a risk factor.

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Relationship between Muscle Mass and Non-Alcoholic Fatty Liver Disease

Biology ◽

10.3390/biology10020122 ◽

2021 ◽

Vol 10 (2) ◽

pp. 122

Author(s):

Jun-Hyuk Lee ◽

Hye-Sun Lee ◽

Byoung-Kwon Lee ◽

Yu-Jin Kwon ◽

Ji-Won Lee

Keyword(s):

Skeletal Muscle ◽

Risk Factor ◽

Liver Disease ◽

Fatty Liver ◽

Muscle Mass ◽

Fatty Liver Disease ◽

Skeletal Muscle Mass ◽

Liver Fat ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Although sarcopenia is known to be a risk factor for non-alcoholic fatty liver disease (NAFLD), whether NAFLD is a risk factor for the development of sarcopenia is not clear. We investigated relationships between NAFLD and low skeletal muscle mass index (LSMI) using three different datasets. Participants were classified into LSMI and normal groups. LSMI was defined as a body mass index (BMI)-adjusted appendicular skeletal muscle mass <0.789 in men and <0.512 in women or as the sex-specific lowest quintile of BMI-adjusted total skeletal muscle mass. NAFLD was determined according to NAFLD liver fat score or abdominal ultrasonography. The NAFLD groups showed a higher hazard ratios (HRs) with 95% confidence intervals (CIs) for LSMI than the normal groups (HRs = 1.21, 95% CIs = 1.05–1.40). The LSMI groups also showed a higher HRs with 95% CIs for NAFLD than normal groups (HRs = 1.56, 95% CIs = 1.38–1.78). Participants with NAFLD had consistently less skeletal muscle mass over 12 years of follow-up. In conclusion, LSMI and NAFLD showed a relationship. Maintaining muscle mass should be emphasized in the management of NAFLD.

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The product of trunk muscle area and density on the CT image is a good indicator of energy expenditure in patients with or at risk for COPD

Respiratory Research ◽

10.1186/s12931-021-01621-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Toru Shirahata ◽

Hideaki Sato ◽

Sanehiro Yogi ◽

Kaiji Inoue ◽

Mamoru Niitsu ◽

...

Keyword(s):

At Risk ◽

Body Composition ◽

Energy Expenditure ◽

Trunk Muscle ◽

Rectus Abdominis ◽

Activity Level ◽

Erector Spinae ◽

Trunk Muscles ◽

Muscle Area ◽

The Relationship

Abstract Background Physical inactivity due to cachexia and muscle wasting is well recognized as a sign of poor prognosis in chronic obstructive pulmonary disease (COPD). However, there have been no reports on the relationship between trunk muscle measurements and energy expenditure parameters, such as the total energy expenditure (TEE) and physical activity level (PAL), in COPD. In this study, we investigated the associations of computed tomography (CT)-derived muscle area and density measurements with clinical parameters, including TEE and PAL, in patients with or at risk for COPD, and examined whether these muscle measurements serve as an indicator of TEE and PAL. Methods The study population consisted of 36 male patients with (n = 28, stage 1–4) and at risk for (n = 8) COPD aged over 50 years. TEE was measured by the doubly labeled water method, and PAL was calculated as the TEE/basal metabolic rate estimated by the indirect method. The cross-sectional areas and densities of the pectoralis muscles, rectus abdominis muscles, and erector spinae muscles were measured. We evaluated the relationship between these muscle measurements and clinical outcomes, including body composition, lung function, muscle strength, TEE, and PAL. Results All the muscle areas were significantly associated with TEE, severity of emphysema, and body composition indices such as body mass index, fat-free mass, and trunk muscle mass. All trunk muscle densities were correlated with PAL. The product of the rectus abdominis muscle area and density showed the highest association with TEE (r = 0.732) and PAL (r = 0.578). Several trunk muscle measurements showed significant correlations with maximal inspiratory and expiratory pressures, indicating their roles in respiration. Conclusions CT-derived measurements for trunk muscles are helpful in evaluating physical status and function in patients with or at risk for COPD. Particularly, trunk muscle evaluation may be a useful marker reflecting TEE and PAL.

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