Quantitative Computed Tomography Assessment of Pectoralis and Erector Spinae Muscle Area and Disease Severity in Chronic Obstructive Pulmonary Disease Referred for Lung Volume Reduction

Attaway, Amy; Welch, Nicole; Yadav, Ruchi; Bellar, Annette; Hatipoğlu, Umur; Meli, Yvonne; Engelen, M.P.; Zein, Joe

doi:10.1080/15412555.2021.1897560

Cited by 13 publications

(30 citation statements)

References 55 publications

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“…Several factors may contribute to the fact that muscle mass is not clinically used as a body composition component for cardiometabolic risk assessment, including a lack of a standardized approach to assess and report muscle mass. Different anatomic landmarks have been proposed, including the psoas muscle [5], the pectoralis muscle [6], paraspinal muscles [7], or skeletal muscle mass at the thigh level [8]. This substantially hampers direct comparison between studies.…”

Section: Discussionmentioning

confidence: 99%

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Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study

et al. 2022

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Objectives To provide a standard for total abdominal muscle mass (TAM) quantification on computed tomography (CT) and investigate its association with cardiovascular risk in a primary prevention setting. Methods We included 3016 Framingham Heart Study participants free of cardiovascular disease (CVD) who underwent abdominal CT between 2002 and 2005. On a single CT slice at the level of L3/L4, we segmented (1) TAM-Area, (2) TAM-Index (= TAM-Area/height) and, (3) TAM-Fraction (= TAM-Area/total cross-sectional CT-area). We tested the association of these muscle mass measures with prevalent and incident cardiometabolic risk factors and incident CVD events during a follow-up of 11.0 ± 2.7 years. Results In this community-based sample (49% women, mean age: 50.0 ± 10.0 years), all muscle quantity measures were significantly associated with prevalent and incident cardiometabolic risk factors and CVD events. However, only TAM-Fraction remained significantly associated with key outcomes (e.g., adj. OR 0.68 [0.55, 0.84] and HR 0.73 [0.57, 0.92] for incident hypertension and CVD events, respectively) after adjustment for age, sex, body mass index, and waist circumference. Moreover, only higher TAM-Fraction was associated with a lower risk (e.g., adj. OR: 0.56 [0.36–0.89] for incident diabetes versus TAM-Area: adj. OR 1.26 [0.79–2.01] and TAM-Index: 1.09 [0.75–1.58]). Conclusion TAM-Fraction on a single CT slice at L3/L4 is a novel body composition marker of cardiometabolic risk in a primary prevention setting that has the potential to improve risk stratification beyond traditional measures of obesity. Key Points • In this analysis of the Framingham Heart Study (n = 3016), TAM-F on a single slice CT was more closely associated with prevalent and incident cardiometabolic risk factors as compared to TAM alone or TAM indexed to body surface area. • TAM-F on a single abdominal CT slice at the level of L3/L4 could serve as a standard measure of muscle mass and improve risk prediction

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Section: Discussionmentioning

confidence: 99%

“…Another issue is that no standardized quantitative assessment of TAM exists. The aforementioned include several anatomical locations, including the psoas [5], pectoralis [6], paraspinal [7], and using absolute or relative muscle mass.…”

Section: Introductionmentioning

confidence: 99%

Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study

et al. 2022

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“…In addition to clinical, demographic and laboratory findings, PM and ESM area on chest CT scans were quantified by an image analysis programme. 18 …”

Section: Methodsmentioning

confidence: 99%

“…Quantitative assessments of PM and ESM cross‐sectional area (CSA) on chest CT scans were performed ( Figure 2 ) using Aquarius iNtuition (TeraRecon Inc, Durham, NC) as previously reported by us. 18 Muscles were selected based on an attenuation range of −50 to +90 Hounsfield units, consistent with the values for skeletal muscle as previously described. 18 In brief, single axial slice of the CT scan was used for PM just above the aortic arch and for ESM at the level of the lower margin of the 12th thoracic vertebra.…”

Section: Methodsmentioning

confidence: 99%

“…A number of instruments have been used to quantify muscle mass, but image analysis of computed tomogram (CT) scans of the abdomen or thorax has become the current standard approach to quantify muscle mass due to high reproducibility and precision in measuring muscle area. 17 , 18 The diagnosis of acute sarcopenia, or muscle loss during hospitalization for acute illness, is often based on a single measure of muscle area on imaging, and can be difficult to establish because the premorbid muscle mass is often not known. Since muscle loss is a dynamic process, serial measurements allow changes in muscle mass to be quantified.…”

Section: Introductionmentioning

confidence: 99%

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Acute skeletal muscle loss in SARS‐CoV‐2 infection contributes to poor clinical outcomes in COVID‐19 patients

Attaway

Welch

Dasarathy

et al. 2022

J cachexia sarcopenia muscle

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Background Chronic disease causes skeletal muscle loss that contributes to morbidity and mortality. There are limited data on the impact of dynamic muscle loss on clinical outcomes in COVID‐19. We hypothesized that acute COVID‐19‐related muscle loss (acute sarcopenia) is associated with adverse outcomes. Methods A retrospective analysis of a prospective clinical registry of COVID‐19 patients was performed in consecutive hospitalized patients with acute COVID‐19 ( n = 95) and compared with non‐COVID‐19 controls ( n = 19) with two temporally unique CT scans. Pectoralis muscle (PM), erector spinae muscle (ESM) and 30 day standardized per cent change in cross sectional muscle area were quantified. Primary outcomes included mortality and need for intensive care unit (ICU) admission. Multivariate linear and logistic regression were performed. Cox proportional hazard ratios were generated for ICU admission or mortality for the per cent muscle loss standardized to 30 days. Results The COVID‐19 CT scan cohort ( n = 95) had an average age of 63.3 ± 14.3 years, comorbidities including COPD (28.4%) and diabetes mellitus (42.1%), and was predominantly Caucasian (64.9%). The proportion of those admitted to the ICU was 54.7%, with 10.5% requiring tracheostomy and overall mortality 16.8%. Median duration between CT scans was 32 days (IQR: 16–63 days). Significant reductions in median per cent loss was noted for PM (−2.64% loss [IQR: −0.28, −5.47] in COVID‐19 vs. −0.06 loss [IQR: −0.01, −0.28] in non‐COVID‐19 CT controls, P < 0.001) and ESM (−1.86% loss [IQR: −0.28, −5.47] in COVID‐19 vs. −0.06 loss [IQR: −0.02, −0.11]) in non‐COVID‐19 CT controls, P < 0.001). Multivariate linear regression analysis of per cent loss in PM was significantly associated with mortality (−10.8% loss [95% CI: −21.5 to −0.19]) and ICU admission (−11.1% loss [95% CI: −19.4 to −2.67]), and not significant for ESM. Cox proportional hazard ratios demonstrated greater association with ICU admission (adj HR 2.01 [95% CI: 1.14–3.55]) and mortality (adj HR 5.30 [95% CI: 1.19–23.6]) for those with significant per cent loss in PM, and greater association with ICU admission (adj HR 8.22 [95% CI: 1.11–61.04]) but not mortality (adj HR 2.20 [95% CI: 0.70–6.97]) for those with significant per cent loss in ESM. Conclusions In a well‐characterized cohort of 95 hospitalized patients with acute COVID‐19 and two temporally distinct CT scans, acute sarcopenia, determined by standardized reductions in PM and ESM, was associated with worse clinical outcomes. These data lay the foundation for evaluating dynamic muscle loss as a predictor of clinical outcomes and targeting acute sarcopenia to improve clinical outcomes for COVID‐19.

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Increased adiposity-to-muscle ratio and severity of sinusitis affect quality of life in asthma: Computed tomographic analysis

Shimizu,

Kimura,

Tanabe

et al. 2024

Journal of Allergy and Clinical Immunology: Global

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Quantitative Computed Tomography Assessment of Pectoralis and Erector Spinae Muscle Area and Disease Severity in Chronic Obstructive Pulmonary Disease Referred for Lung Volume Reduction

Cited by 13 publications

References 55 publications

Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study

Standardized measurement of abdominal muscle by computed tomography: association with cardiometabolic risk in the Framingham Heart Study

Acute skeletal muscle loss in SARS‐CoV‐2 infection contributes to poor clinical outcomes in COVID‐19 patients

Increased adiposity-to-muscle ratio and severity of sinusitis affect quality of life in asthma: Computed tomographic analysis

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