PWE-197 Computed tomography derived lean muscle mass (LMM) does not predict cardiopulmonary exercise test (CPET) markers of physiological reserve

Jones, KI; Green, E; Thapar, Ian J Franklin, Joseph Shalhoub, Ankur; Hurst, KennethS; Atkinson, Charlotte; Ma, Sisi

doi:10.1136/gutjnl-2015-309861.644

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“…11 The relationship between objective measures of physiological fitness derived from CPEX and sarcopenia has been previously investigated in patients undergoing hepatobiliary resection. 12,13 More recently, McGovern et al report an association between radiological sarcopenia (CT-sarcopenia score; CT-SS), CPEX (VO 2 peak and VO 2 at anaerobic threshold), systemic inflammation and survival in a cohort of patients undergoing neo-adjuvant therapy for upper gastrointestinal cancer. 14 In Japanese patients with COPD VO 2 peak has been shown to correlate weakly with CT-derived pectoralis muscle area but not erector spinae muscle area,.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism by which sarcopenia leads to poorer outcomes is poorly understood and is probably a complex interaction between reduced physiological reserve, increasing comorbidity and a chronic inflammatory state 11 . The relationship between objective measures of physiological fitness derived from CPEX and sarcopenia has been previously investigated in patients undergoing hepatobiliary resection 12,13 . More recently, McGovern et al report an association between radiological sarcopenia (CT-sarcopenia score; CT-SS), CPEX (VO 2 peak and VO 2 at anaerobic threshold), systemic inflammation and survival in a cohort of patients undergoing neo-adjuvant therapy for upper gastrointestinal cancer 14 .…”

Section: Introductionmentioning

confidence: 99%

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Cardiopulmonary exercise testing, computed tomography-derived body composition, systemic inflammation and survival after elective abdominal aortic aneurysm repair

Bradley,

McGovern,

Beecroft

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Cardio-pulmonary exercise testing (CPEX) is selectively used before intervention for abdominal aortic aneurysm (AAA). Sarcopenia, a chronic condition defined by reduced skeletal muscle function and volume, can be assessed radiologically by computed tomography (CT)-derived body composition analysis (CT-BC), and is associated with systemic inflammation. OBJECTIVE The aim was to describe the association between CT-BC, CPEX, inflammation and survival in patients undergoing elective intervention for AAA. SETTING Patients were recruited retrospectively from a single, secondary-care centre-operative database. Cases undergoing elective endovascular aneurysm repair (EVAR) and open surgical repair (OSR) between 31 March 2015 and 25 June 2020 were included. PATIENTS There were 176 patients (130 EVAR, 46 OSR) available for analysis in the final study; median (interquartile range [IQR]) follow-up was 60.5 [27] months, and all completed a minimum of 2 years follow-up. MAIN OUTCOME MEASURES Preoperative CPEX tests were recorded. CT sarcopenia score [CT-SS, range 0 to 2, calculated based on normal/low SMI (0/1) and normal/low SMD (0/1)] assessed radiological sarcopenia. Preoperative modified Glasgow Prognostic score (mGPS) was used to assess systemic inflammation. RESULTS Mean [95% confidence interval (CI) survival in the CT-SS 0 vs. CT-SS 1 vs. CT-SS 2 subgroups was 80.1 (73.6 to 86.6) months vs. 70.3 (63.5 to 77.1) months vs. 63.8 (53.4 to 74.2) months] (P = 0.01). CT-SS was not associated with CPEX results (P > 0.05). Elevated CT-SS [hazard ratio (HR) 1.83, 95% CI, 1.16 to 2.89, P < 0.01] was independently associated with increased hazard of long-term mortality; however, CPEX results were not (P > 0.05). CONCLUSION CPEX test results were not consistently associated with body composition and did not have significant prognostic value in patients undergoing elective treatment for AAA.

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