Quantitative Computed Tomography Assessment of Pectoralis and Erector Spinae Muscle Area and Disease Severity in Chronic Obstructive Pulmonary Disease Referred for Lung Volume Reduction.
Quantitative Computed Tomography Assessment of Pectoralis and Erector Spinae Muscle Area and Disease Severity in Chronic Obstructive Pulmonary Disease Referred for Lung Volume Reduction.
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DOI：
10.1080/15412555.2021.1897560
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发表时间：
2021-04
期刊：
影响因子：
2.2
通讯作者：
Dasarathy S
中科院分区：
文献类型：
--
作者：
Attaway AH;Welch N;Yadav R;Bellar A;Hatipoğlu U;Meli Y;Engelen MPKJ;Zein J;Dasarathy S
患有晚期COPD的患者发展与包括死亡率在内的不良临床结果相关的骨骼肌损失（肌肉减少症）。我们评估了胸肌面积是否与重度COPD患者的临床结局相关。我们分析了2015年至2019年期间接受肺减容评估的重度COPD连续患者（n=117），并与肺功能正常的当前和既往吸烟对照组（n=41）进行了肺癌筛查。胸肌（PM）和竖脊肌（ESM）横截面积（CSA）的定量评估与包括复合终点在内的临床结局相关。我们的研究结果表明PM CSA的减少与COPD GOLD分期的严重程度相关，而ESM CSA则无关。目前吸烟者表现出PM CSA降低，这与GOLD 3期和4期COPD患者相似。PM CSA与FEV 1、FEV1%预测值、FVC、DLCO和FEV 1/FVC比值呈正相关，与影像学肺气肿程度呈负相关。ESM与DLCO、RV/TLC（肺过度膨胀的标志物）呈正相关，与肺气肿的放射学严重程度呈负相关。Kaplan-Meier分析显示，PM而非ESM CSA的降低与死亡率、肺减容需要或肺移植的复合终点相关。总之，在特征明确的重度COPD患者中，PM CSA与肺部疾病的严重程度、死亡率和对高级治疗的需求相关。除了预测临床结局外，靶向肌肉减少症是重度COPD患者的潜在治疗方法。
Patients with advanced COPD develop skeletal muscle loss (sarcopenia) that is associated with adverse clinical outcomes including mortality. We evaluated if thoracic muscle area is associated with clinical outcomes in patients with severe COPD. We analyzed consecutive patients with severe COPD undergoing evaluation for lung volume reduction from 2015 to 2019 (n=117) compared to current and former smoking controls undergoing lung cancer screening with normal lung function (n=41). Quantitative assessments of pectoralis muscle (PM) and erector spinae muscle (ESM) cross sectional area (CSA) were related to clinical outcomes including composite endpoints. Our results showed a reduction in PM CSA but not ESM CSA was associated with the severity of GOLD stage of COPD. Current smokers demonstrated reduced PM CSA which was similar to that in COPD patients who were GOLD stages 3 and 4. PM CSA was associated positively with FEV1, FEV1% predicted, FVC, DLCO, and FEV1/FVC ratio, and was associated negatively with the degree of radiologic emphysema. ESM correlated positively with DLCO, RV/TLC (a marker of hyperinflation), and correlated negatively with radiologic severity of emphysema. Kaplan-Meier analysis showed that reductions in PM but not ESM CSA was associated with the composite end point of mortality, need for lung volume reduction, or lung transplant. In conclusion, in well-characterized patients with severe COPD referred for lung volume reduction, PM CSA correlated with severity of lung disease, mortality and need for advanced therapies. In addition to predicting clinical outcomes, targeting sarcopenia is a potential therapeutic approach in patients with severe COPD.
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影响因子：
24.3
作者：
Celli, Bartolome R.;Locantore, Nicholas;Agusti, Alvar
通讯作者：
Agusti, Alvar
影响因子：
3
作者：
Ikezoe, Tome;Mori, Natsuko;Ichihashi, Noriaki
通讯作者：
Ichihashi, Noriaki
影响因子：
3.7
作者：
Hansen MJ;Chan SP;Langenbach SY;Dousha LF;Jones JE;Yatmaz S;Seow HJ;Vlahos R;Anderson GP;Bozinovski S
通讯作者：
Bozinovski S
影响因子：
158.5
作者：
Celli, BR;Cote, CG;Cabral, HJ
通讯作者：
Cabral, HJ
DOI：
10.1016/0021-9681(87)90171-8
发表时间：
1987-01-01
期刊：
JOURNAL OF CHRONIC DISEASES
影响因子：
--
作者：
CHARLSON, ME;POMPEI, P;MACKENZIE, CR
通讯作者：
MACKENZIE, CR