Effect of preoperative erector spinae muscles mass on postoperative outcomes in patients with left ventricular assist devices

Abstract

Background: Frailty influences the postoperative outcomes in patients undergoing left ventricular assist device (LVAD) implantation. Recently, erector spinae muscle (ESM) mass has been proposed as a parameter to assess frailty accurately. Thus, the purpose of the present study was to evaluate whether preoperative ESM mass is associated with short-and long-term clinical outcomes in patients with LVAD.Methods: A total of 119 consecutive patients with LVAD were enrolled between January 2010 and October 2017 at a single heart center. The ESM area, ESM index, and Hounsfield units (HU) of the ESM were calculated by computed tomography for preoperative ESM mass evaluation. We then statistically evaluated the in-hospital mortality, major adverse cardiovascular events (MACE), duration of hospital stay, and long-term survival.Results: In a multivariate Cox regression analysis, ESM mass indicated no effect on all clinical outcomes. In addition, the ESM area presented a weak but significant negative linear correlation only with the duration of hospital stay (r = −0.21, p < .05).In contrast, the Model For End-stage Liver Disease (MELD) score and preoperative venous-arterial extracorporeal membrane oxygenation (va-ECMO) were significant predictive factors for in-hospital mortality (MELD score: p < .001, hazard ratio [HR]

Artificial intelligence‐based analysis of body composition predicts outcome in patients receiving long‐term mechanical circulatory support

“…CT-derived muscle mass referred to the PMA, erector spinae muscle area or the pectoralis muscle area and, importantly, muscle area measurements were exclusively performed manually, which is probably inferior to the AI-based approach used in our analysis. 19,20,[22][23][24][25][26] In our study, the postoperative 6MWD and quality of life were significantly lower in obese patients after 6 and 12 months when compared with normal-weight individuals. However, this was not shown for sarcopenic patients.…”

“…17 Few studies have been performed analysing sarcopenia measured by computed tomography (CT)-derived muscle areas or bioelectrical impedance analysis (BIA), indicating an impaired outcome after LVAD implantation in sarcopenic HF patients. [18][19][20][21] However, in these studies, adipose tissue has not been sufficiently considered as a possible confounder.…”

“…The BMI is known to have various deficiencies as a measure of obesity, as it is not accurately accounting for body fat, which applies in particular to men, elderly and individuals with intermediate BMI ranges 17 . Few studies have been performed analysing sarcopenia measured by computed tomography (CT)‐derived muscle areas or bioelectrical impedance analysis (BIA), indicating an impaired outcome after LVAD implantation in sarcopenic HF patients 18–21 . However, in these studies, adipose tissue has not been sufficiently considered as a possible confounder.…”

Impact of psoas muscle evaluation on clinical outcomes in patients undergoing left ventricular assist device implantation

“…PSMI was calculated as the cross-sectional area of the psoas muscle at the middle of the L4 vertebra indexed by height [PSMI = total psoas muscle area (cm 2 ) /height (m 2 )] 12,13 . Moreover, we assessed the muscle density expressed by the mean Hounsfield-Units of the left/right psoas muscles (PSHU) by using Syngo Software (VB40; Siemens Healthcare GmbH, Erlangen, Germany) in an axially corrected fashion at the L4 vertebra level 14,15 …”

“…12,13 Moreover, we assessed the muscle density expressed by the mean Hounsfield-Units of the left/right psoas muscles (PSHU) by using Syngo Software (VB40; Siemens Healthcare GmbH, Erlangen, Germany) in an axially corrected fashion at the L4 vertebra level. 14,15 Statistical analysis Statistical analyses were performed using InStat3 and Prism7 (Graph Pad Software, La Jolla, California, USA) and STATA software, version 10.1 (StataCorp, College Station, Texas, USA). Categorical variables are presented as proportions.…”