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Low skeletal muscle density combined with muscle dysfunction predicts adverse events after adult cardiovascular surgery.
Yamashita, Masashi; Kamiya, Kentaro; Matsunaga, Atsuhiko; Kitamura, Tadashi; Hamazaki, Nobuaki; Nozaki, Kohei; Ichikawa, Takafumi; Maekawa, Emi; Meguro, Kentaro; Yamaoka-Tojo, Minako; Ako, Junya; Miyaji, Kagami.
Afiliação
  • Yamashita M; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
  • Kamiya K; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp.
  • Matsunaga A; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
  • Kitamura T; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
  • Hamazaki N; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
  • Nozaki K; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
  • Ichikawa T; Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
  • Maekawa E; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
  • Meguro K; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
  • Yamaoka-Tojo M; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
  • Ako J; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
  • Miyaji K; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Nutr Metab Cardiovasc Dis ; 31(6): 1782-1790, 2021 06 07.
Article em En | MEDLINE | ID: mdl-33849783
BACKGROUND AND AIMS: Although muscle dysfunctions are widely known as a poor prognostic factor in patients with cardiovascular disease, no study has examined whether the addition of low skeletal muscle density (SMD) assessed by computed tomography (CT) to muscle dysfunctions is useful. This study examined whether SMDs can strengthen the predictive ability of muscle dysfunctions for adverse events in patients who underwent cardiovascular surgery. METHODS AND RESULTS: We retrospectively reviewed 853 patients aged ≥40 years who had preoperative CT for risk management purposes and who measured muscle dysfunctions (weakness: low grip strength and slowness: slow gait speed). Low SMD based on transverse abdominal CT images was defined as a mean Hounsfield unit of the psoas muscle <45. All definitions of muscle dysfunction (weakness only, slowness only, weakness or slowness, weakness and slowness), the addition of SMDs was shown to significantly improve the continuous net reclassification improvement and integrated discrimination improvement for adverse events in all analyses (p < 0.05). Low SMDs combined with each definition of muscle dysfunction had the highest risk of all-cause death (hazard ratio: lowest 3.666 to highest 6.002), and patients with neither low SMDs nor muscle dysfunction had the lowest risk of all-cause and cardiovascular-related events. CONCLUSION: The addition of SMDs consistently increased the predictive ability of muscle dysfunctions for adverse events. Our results suggest that when CT is performed for any clinical investigation, the addition of the organic assessment of skeletal muscle can strengthen the diagnostic accuracy of muscle wasting.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Procedimentos Cirúrgicos Vasculares / Composição Corporal / Atrofia Muscular / Tomografia Computadorizada por Raios X / Força Muscular / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Nutr Metab Cardiovasc Dis Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / CIENCIAS DA NUTRICAO / METABOLISMO Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Procedimentos Cirúrgicos Vasculares / Composição Corporal / Atrofia Muscular / Tomografia Computadorizada por Raios X / Força Muscular / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Nutr Metab Cardiovasc Dis Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / CIENCIAS DA NUTRICAO / METABOLISMO Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão