Pectoralis major muscle quantification by cardiac MRI is a strong predictor of major events in HF View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-11-30

AUTHORS

Gonçalo J. L. Cunha, Bruno M. L. Rocha, Pedro Freitas, João A. Sousa, Mariana Paiva, Ana C. Santos, Sara Guerreiro, António Tralhão, António Ventosa, Carlos M. Aguiar, Maria J. Andrade, João Abecasis, Carla Saraiva, Miguel Mendes, António M. Ferreira

ABSTRACT

Clinical overt cardiac cachexia is a late ominous sign in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). The main goal of this study was to assess the feasibility and prognostic significance of muscle mass quantification by cardiac magnetic resonance (CMR) in HF with reduced LVEF. HF patients with LVEF < 40% (HFrEF) referred for CMR were retrospectively identified in a single center. Key exclusion criteria were primary muscle disease, known infiltrative myocardial disease and intracardiac devices. Pectoralis major muscles were measured on standard axial images at the level of the 3rd rib anteriorly. Time to all-cause death or HF hospitalization was the primary endpoint. A total of 298 HF patients were included (mean age 64 ± 12 years; 76% male; mean LVEF 30 ± 8%). During a median follow-up of 22 months (IQR: 12–33), 67 (22.5%) patients met the primary endpoint (33 died and 45 had at least 1 HF hospitalization). In multivariate analysis, LVEF [Hazard Ratio (HR): 0.950; 95% Confidence Interval (CI): 0.917–0.983; p = 0.003), NYHA class I–II vs III–IV (HR: 0.480; CI: 0.272–0.842; p = 0.010), creatinine (HR: 2.653; CI: 1.548–4.545; p < 0.001) and pectoralis major area (HR: 0.873; 95% CI: 0.821–0.929; p < 0.001) were independent predictors of the primary endpoint, when adjusted for gender and NT-pro-BNP levels. Pectoralis major size measured by CMR in HFrEF was independently associated with a higher risk of death or HF hospitalization. Further studies to establish appropriate age and gender-adjusted cut-offs of muscle areas are needed to identify high-risk subgroups. More... »

PAGES

1-10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-021-01996-8

DOI

http://dx.doi.org/10.1007/s00380-021-01996-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1143469998

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34846560


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15 HF hospitalization
16 HF patients
17 HFrEF
18 Key exclusion criteria
19 MRI
20 NT-pro-BNP levels
21 NYHA class I
22 age
23 analysis
24 appropriate age
25 area
26 axial images
27 cachexia
28 cardiac MRI
29 cardiac cachexia
30 cardiac magnetic resonance
31 center
32 class I
33 creatinine
34 criteria
35 death
36 devices
37 disease
38 ejection fraction
39 endpoint
40 events
41 exclusion criteria
42 failure
43 feasibility
44 fraction
45 gender
46 goal
47 heart failure
48 high risk
49 high-risk subgroups
50 hospitalization
51 images
52 independent predictors
53 infiltrative myocardial disease
54 intracardiac devices
55 left ventricular ejection fraction
56 levels
57 magnetic resonance
58 main goal
59 major areas
60 major events
61 mass quantification
62 months
63 multivariate analysis
64 muscle
65 muscle area
66 muscle disease
67 muscle quantification
68 myocardial disease
69 ominous sign
70 patients
71 pectoralis
72 predictors
73 primary endpoint
74 primary muscle disease
75 prognostic significance
76 quantification
77 reduced left ventricular ejection fraction
78 resonance
79 ribs
80 risk
81 significance
82 signs
83 single center
84 size
85 standard axial images
86 strongest predictor
87 study
88 subgroups
89 time
90 total
91 ventricular ejection fraction
92 schema:name Pectoralis major muscle quantification by cardiac MRI is a strong predictor of major events in HF
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