Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation
Abstract Background Left ventricular assist devices (LVAD) are an established treatment for end-stage left ventricular heart failure. Parameters are needed to identify the most appropriate patients for LVADs. This study aimed to evaluate pectoral muscle mass and density as prognostic parameters. Met...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02547-8 |
| _version_ | 1797273305467584512 |
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| author | Freya Sophie Jenkins Jan-Philipp Minol Tarik Akar Esma Yilmaz Moritz Benjamin Immohr Ismail Dalyanoglu Bernhard Korbmacher Joel Aissa Udo Boeken Artur Lichtenberg Payam Akhyari Hannan Dalyanoglu |
| author_facet | Freya Sophie Jenkins Jan-Philipp Minol Tarik Akar Esma Yilmaz Moritz Benjamin Immohr Ismail Dalyanoglu Bernhard Korbmacher Joel Aissa Udo Boeken Artur Lichtenberg Payam Akhyari Hannan Dalyanoglu |
| author_sort | Freya Sophie Jenkins |
| collection | DOAJ |
| description | Abstract Background Left ventricular assist devices (LVAD) are an established treatment for end-stage left ventricular heart failure. Parameters are needed to identify the most appropriate patients for LVADs. This study aimed to evaluate pectoral muscle mass and density as prognostic parameters. Methods This single-center study included all patients with LVAD implantation between January 2010 and October 2017 and a preoperative chest CT scan. Pectoral muscle mass was assessed using the Pectoralis Muscle Index (PMI, surface area indexed to height, cm2/m2) and pectoral muscle density by Hounsfield Units (HU). Overall mortality was analyzed with Kaplan–Meier survival analysis and 1-year and 3-year mortality with receiver operating characteristic (ROC) curves and Cox regression models. Results 57 patients (89.5% male, mean age 57.8 years) were included. 64.9% of patients had end-stage left ventricular failure due to ischemic heart disease and 35.1% due to dilated cardiomyopathy. 49.2% of patients had preoperative INTERMACS profile of 1 or 2 and 33.3% received mechanical circulatory support prior to LVAD implantation. Total mean PMI was 4.7 cm2/m2 (± 1.6), overall HU of the major pectoral muscle was 39.0 (± 14.9) and of the minor pectoral muscle 37.1 (± 16.6). Mean follow-up was 2.8 years (± 0.2). Mortality rates were 37.5% at 1 year and 48.0% at 3 years. Neither PMI nor HU were significantly associated with overall mortality at 1-year or 3-year. Conclusions The results of our study do not confirm the association between higher pectoral muscle mass and better survival after LVAD implantation previously described in the literature. |
| first_indexed | 2024-03-07T14:41:31Z |
| format | Article |
| id | doaj.art-32868079b3184cca83389b2096c2ff25 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-07T14:41:31Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-32868079b3184cca83389b2096c2ff252024-03-05T20:18:57ZengBMCJournal of Cardiothoracic Surgery1749-80902024-02-0119111010.1186/s13019-024-02547-8Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantationFreya Sophie Jenkins0Jan-Philipp Minol1Tarik Akar2Esma Yilmaz3Moritz Benjamin Immohr4Ismail Dalyanoglu5Bernhard Korbmacher6Joel Aissa7Udo Boeken8Artur Lichtenberg9Payam Akhyari10Hannan Dalyanoglu11Department of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityMedical Faculty, Semmelweiss UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityInstitute of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityDepartment of Cardiac Surgery, Medical Faculty, Heinrich Heine UniversityAbstract Background Left ventricular assist devices (LVAD) are an established treatment for end-stage left ventricular heart failure. Parameters are needed to identify the most appropriate patients for LVADs. This study aimed to evaluate pectoral muscle mass and density as prognostic parameters. Methods This single-center study included all patients with LVAD implantation between January 2010 and October 2017 and a preoperative chest CT scan. Pectoral muscle mass was assessed using the Pectoralis Muscle Index (PMI, surface area indexed to height, cm2/m2) and pectoral muscle density by Hounsfield Units (HU). Overall mortality was analyzed with Kaplan–Meier survival analysis and 1-year and 3-year mortality with receiver operating characteristic (ROC) curves and Cox regression models. Results 57 patients (89.5% male, mean age 57.8 years) were included. 64.9% of patients had end-stage left ventricular failure due to ischemic heart disease and 35.1% due to dilated cardiomyopathy. 49.2% of patients had preoperative INTERMACS profile of 1 or 2 and 33.3% received mechanical circulatory support prior to LVAD implantation. Total mean PMI was 4.7 cm2/m2 (± 1.6), overall HU of the major pectoral muscle was 39.0 (± 14.9) and of the minor pectoral muscle 37.1 (± 16.6). Mean follow-up was 2.8 years (± 0.2). Mortality rates were 37.5% at 1 year and 48.0% at 3 years. Neither PMI nor HU were significantly associated with overall mortality at 1-year or 3-year. Conclusions The results of our study do not confirm the association between higher pectoral muscle mass and better survival after LVAD implantation previously described in the literature.https://doi.org/10.1186/s13019-024-02547-8Left ventricular heart failureLeft ventricular assist devicePectoral muscle massFrailty |
| spellingShingle | Freya Sophie Jenkins Jan-Philipp Minol Tarik Akar Esma Yilmaz Moritz Benjamin Immohr Ismail Dalyanoglu Bernhard Korbmacher Joel Aissa Udo Boeken Artur Lichtenberg Payam Akhyari Hannan Dalyanoglu Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation Journal of Cardiothoracic Surgery Left ventricular heart failure Left ventricular assist device Pectoral muscle mass Frailty |
| title | Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation |
| title_full | Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation |
| title_fullStr | Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation |
| title_full_unstemmed | Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation |
| title_short | Pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device (LVAD) implantation |
| title_sort | pectoral muscle mass is not a robust prognostic factor for survival after left ventricular assist device lvad implantation |
| topic | Left ventricular heart failure Left ventricular assist device Pectoral muscle mass Frailty |
| url | https://doi.org/10.1186/s13019-024-02547-8 |
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