Analytic Morphomics Predict Outcomes After Lung Transplantation

Pienta, Michael J.; Zhang, Peng; Derstine, Brian A.; Enchakalody, Binu; Weir, William; Grenda, Tyler R.; Goulson, Rebecca L.; Reddy, Rishindra M.; Chang, Andrew C.; Wang, Stewart C.; Lin, Jules

doi:10.1016/j.athoracsur.2017.08.049

Cited by 21 publications

(34 citation statements)

References 31 publications

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“…Other image processing softwares were also employed, including one study that assessed psoas muscle composition using three‐dimensional (3D) imaging with a Synapse visualization software [29]. Pectoralis muscle for chest CT ( n = 3) [18–20], the psoas muscle from abdominal CT ( n = 6) [14,15,23,29–31], and paraspinal muscles from chest or abdominal CT ( n = 5) [19–22,31] were the most common muscles included among the selected studies, in comparison to the intercostals ( n = 3) [19,20,22], serratus anterior ( n = 1) [19] and latissimus dorsi muscles ( n = 2) [19,22], as shown in Table 1. The majority of studies utilized one axial slice ( n = 7) [18,20–23,30,31] with several studies taking the average of two to three slices [14,15,19].…”

Section: Resultsmentioning

confidence: 99%

“…Pienta et al . [21] evaluated thoracic subcutaneous and visceral adiposity (SAT and VAT) using a single slice at the level of the ninth thoracic vertebrae (T9), whereas Anderson et al . [32] had quantified both SAT and VAT on chest (T7–T8) and abdominal scans (L4–L5).…”

Section: Resultsmentioning

confidence: 99%

“…The literature on CT‐based body composition in lung transplantation shows that various landmarks from thoracic and lumbar CT scans have been used to evaluate body composition. Investigators have evaluated muscle CSA of single muscles, such as the pectorals [16,18] or multiple muscles of the chest [19,20], whereas only a few studies have examined adipose depots from thoracic CT [21,22]. Also, several studies have evaluated the relationship of pretransplant muscle CSA from CT scans and their relationship with post‐transplant outcomes, such as days of mechanical ventilation (MV), hospital LOS, and mortality [19,20,23].…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

et al. 2020

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Summary Computed tomography (CT) is gaining increased recognition in the assessment of body composition in lung transplant (LTx) candidates as a prognostic marker of post‐transplant outcomes. This systematic review was conducted to describe the methodology of CT measures of body composition used in LTx patients and its association with post‐transplant outcomes. Six databases were searched (inception‐April 2020) for studies of adult LTx patients with thoracic or abdominal CT measures [muscle cross‐sectional area (CSA) and/or adiposity]. Thirteen articles were included with 1911 LTx candidates, 58% males, mean age range (48–61 years) and body mass index of 21.0–26.1 kg/m2. Several methods were utilized using thoracic or abdominal CT scans to assess skeletal muscle (n = 11) and adiposity (n = 4) at various anatomic locations (carina, thoracic, and lumbar vertebrae), differing muscle groups, and adipose tissue compartments. Low muscle mass was associated with adverse outcomes in 6/11 studies, including longer mechanical ventilation days (n = 2), intensive care (n = 2) and hospital stay (n = 2), and mortality (n = 4). Greater subcutaneous and mediastinal fat were associated with increased risk of primary graft dysfunction (n = 2), but implications of adiposity on survival were variable across four studies. Further standardization of CT body composition assessments is needed to assess the prognostic utility of these measures on LTx outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

et al. 2020

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“…Cellular senescence in obese and aged adipose tissue, decreases grip strength and maximal walking speed in both young and old mice, while inhibition of cellular senescence improves 6‐minute walk distance and 4‐meter gait speed in patients with idiopathic pulmonary fibrosis . Greater VAT and greater VAT‐to‐SAT ratio have previously been associated with decreased survival after lung transplantation, suggesting that adipose tissue may play a role in the association between frailty and survival after lung transplantation …”

Section: Discussionmentioning

confidence: 99%

A nonlinear relationship between visceral adipose tissue and frailty in adult lung transplant candidates

Anderson

Kolaitis

Gao

et al. 2019

American Journal of Transplantation

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Frailty is a state of decreased physiologic reserve associated with poor outcomes before and after lung transplantation. Obesity, particularly central obesity characterized by excess proinflammatory visceral adipose tissue (VAT), is associated with incident frailty in middle-aged and older adults. The association between VAT and frailty in advanced lung disease, however, is unknown. In two, nonoverlapping multicenter cohorts of adults listed for lung transplantation, we measured VAT area on bioelectrical impedance assay (BIA) in one cohort and cross-sectional VAT and subcutaneous adipose tissue (SAT) areas on abdominal computed tomography (CT) in the other. We identified a nonlinear relationship between greater VAT by BIA and frailty. In fully adjusted piecewise regression models, every 20 cm 2 increase in VAT area was associated with 50% increased odds of frailty in subjects with high VAT (95% CI 1.2-1.9, P < .001), and 10% decreased odds of frailty (95% CI 0.7-1.04, P = .12) in subjects with low VAT. Compared to frail subjects with low VAT, those with high VAT were more likely to have low grip strength and less likely to have weight loss, suggesting that mechanisms of frailty may differ by VAT. Further investigation of mechanisms linking VAT and frailty may identify new targets for prevention and treatment. K E Y W O R D Sclinical research/practice, lung transplantation/pulmonology, obesity, quality of life (QOL)

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“…Computed tomography has been established as the primary means of conducting morphomic analysis [21,24,34,39,40]. Advantages of CT imaging include its wide availability and reproducibility using standard anatomic landmarks.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Evidence of Psoas Muscle Atrophy Without Concomitant Tendon Wasting in Early Sepsis

Kubiak

Ranganathan

Matusko

et al. 2019

Journal of Surgical Research

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Background: Morphomic studies have demonstrated a correlation between sarcopenia and clinical outcomes in septic patients. However, tendon morphomics has not yet been studied in this context. The purpose of the present study was to evaluate tendon morphology in septic patients through analytic morphomics. We hypothesized that morphomic analyses would reveal concomitant muscle and tendon wasting in sepsis patients. The results of this study may help to implement different rehabilitation modalities for critically ill patients. Materials and Methods: The volume and fat content of bilateral psoas muscles and tendons were measured on abdominal CT scans of 25 ICU septic and 25 control trauma patients admitted to the University of Michigan between 2011 and 2012. Univariate and multivariate analyses were performed to determine the relationship between psoas muscle and tendon morphometric data, and the association with clinical variables such as smoking and comorbidities. Results: Average psoas muscle volume was 12.21 ±5.6 cm 3 for control patients and 9.318 ±3.3 cm 3 in septic patients (p=0.0023). The average psoas muscle/fat ratio for septic patients was 0.0288 ±0.071 cm 3 , compared to 0.0107 ± 0.008 cm 3 in the control group (p= 0.075). Average tendon volume in the septic population (0.508 ±0.191 cm 3) was not different than the control cohort (0.493 ± 0.182 cm 3) (p=0.692). Conclusions: Our results demonstrate significantly smaller psoas muscle volume in septic patients than in age, gender and BMI-matched trauma patients but no demonstrable change in

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Analytic Morphomics Predict Outcomes After Lung Transplantation

Cited by 21 publications

References 31 publications

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

Clinical outcomes associated with computed tomography‐based body composition measures in lung transplantation: a systematic review

A nonlinear relationship between visceral adipose tissue and frailty in adult lung transplant candidates

Computed Tomography Evidence of Psoas Muscle Atrophy Without Concomitant Tendon Wasting in Early Sepsis

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