Muscle Mass and Mortality After Cardiac Transplantation

Bibas, Lior; Saleh, Eli; Alkharji, Samah; Chetrit, Jessica; Mullie, Louis; Cantarovich, Marcelo; Cecere, Renzo; Giannetti, Nadia; Afilalo, Jonathan

doi:10.1097/tp.0000000000002311

Cited by 26 publications

(17 citation statements)

References 37 publications

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“…Muscle mass wasting of psoas muscle has been previously associated with prolonged ICU stay in patients after cardiac surgery[ 7 ]. A recent study[ 19 ] stated that the muscle mass is an independent factor of mortality and serious morbidity in patients undergoing heart transplantation. Similar results have been reported by Yamashita et al[ 11 ], where skeletal muscle density seems to affect muscle function and mortality after cardiovascular surgery.…”

Section: Discussionmentioning

confidence: 99%

Sonographic muscle mass assessment in patients after cardiac surgery

Dimopoulos¹,

Raidou²,

Elaiopoulos³

et al. 2020

WJC

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BACKGROUND Patients undergoing cardiac surgery particularly those with comorbidities and frailty, experience frequently higher rates of post-operative morbidity, mortality and prolonged hospital length of stay. Muscle mass wasting seems to play important role in prolonged mechanical ventilation (MV) and consequently in intensive care unit (ICU) and hospital stay. AIM To investigate the clinical value of skeletal muscle mass assessed by ultrasound early after cardiac surgery in terms of duration of MV and ICU length of stay. METHODS In this observational study, we enrolled consecutively all patients, following their admission in the Cardiac Surgery ICU within 24 h of cardiac surgery. Bedside ultrasound scans, for the assessment of quadriceps muscle thickness, were performed at baseline and every 48 h for seven days or until ICU discharge. Muscle strength was also evaluated in parallel, using the Medical Research Council (MRC) scale. RESULTS Of the total 221 patients enrolled, ultrasound scans and muscle strength assessment were finally performed in 165 patients (patients excluded if ICU stay < 24 h). The muscle thickness of rectus femoris (RF), was slightly decreased by 2.2% [(95% confidence interval (CI): - 0.21 to 0.15), n = 9; P = 0.729] and the combined muscle thickness of the vastus intermedius (VI) and RF decreased by 3.5% [(95%CI: - 0.4 to 0.22), n = 9; P = 0.530]. Patients whose combined VI and RF muscle thickness was below the recorded median values (2.5 cm) on day 1 ( n = 80), stayed longer in the ICU (47 ± 74 h vs 28 ± 45 h, P = 0.02) and remained mechanically ventilated more (17 ± 9 h vs 14 ± 9 h, P = 0.05). Moreover, patients with MRC score ≤ 48 on day 3 ( n = 7), required prolonged MV support compared to patients with MRC score ≥ 49 ( n = 33), (44 ± 14 h vs 19 ± 9 h, P = 0.006) and had a longer duration of extracorporeal circulation was (159 ± 91 min vs 112 ± 71 min, P = 0.025). CONCLUSION Skeletal quadriceps muscle thickness assessed by ultrasound shows a trend to a decrease in patients after cardiac surgery post-ICU admission and is associated with prolonged duration of MV and ICU length of stay.

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Section: Discussionmentioning

confidence: 99%

Sonographic muscle mass assessment in patients after cardiac surgery

Dimopoulos¹,

Raidou²,

Elaiopoulos³

et al. 2020

WJC

View full text Add to dashboard Cite

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“…Currently, more than 4000 lung transplantation (LTx) procedures per year are performed as a life-saving measure for patients with critical respiratory illnesses [1]. Poor muscle mass is common in LTx candidates [2][3][4][5][6] and has been identified as an important physiological factor associated with poor postoperative survival in recipients of heart [7], liver [8], and lung transplants [9,10].…”

Section: Introductionmentioning

confidence: 99%

Quantity and quality of antigravity muscles in patients undergoing living-donor lobar lung transplantation: 1-year longitudinal analysis using chest computed tomography images

et al. 2020

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BackgroundSkeletal muscle dysfunction is a common feature in patients with severe lung diseases. Although lung transplantation aims to save these patients, the surgical procedure and disuse may cause additional deterioration and prolonged functional disability. We investigated the postoperative course of antigravity muscle condition in terms of quantity and quality using chest computed tomography.Methods35 consecutive patients were investigated for 12 months after living-donor lobar lung transplantation (LDLLT). The erector spinae muscles (ESMs), which are antigravity muscles, were evaluated, and the cross-sectional area (ESMCSA) and mean attenuation (ESMCT) were analysed to determine the quantity and quality of ESMs. Functional capacity was evaluated by the 6-min walk distance (6MWD). Age-matched living donors with lower lobectomy were evaluated as controls.ResultsRecipient and donor ESMCSA values temporarily decreased at 3 months and recovered by 12 months post-operatively. The ESMCSA of recipients, but not that of donors, surpassed baseline values by 12 months post-operatively. Increased ESMCSA (ratio to baseline ≥1) may occur at 12 months in patients with a high baseline ESMCT. Although the recipient ESMCT may continuously decrease for 12 months, the ESMCT is a major determinant, in addition to lung function, of the postoperative 6MWD at both 3 and 12 months.ConclusionThe quantity of ESMs may increase within 12 months after LDLLT in recipients with better muscle quality at baseline. The quality of ESMs is also important for physical performance; therefore, further approaches to prevent deterioration in muscle quality are required.

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“…Moreover, sarcopenia was also an independent predictor of decreased long-term survival in their multivariable analysis. In cardiac transplant patients, lower psoas muscle area is also associated with increased in-hospital mortality or major morbidity and worse long-term survival (16).…”

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confidence: 99%