Exploring the Correlation between Pulmonary Hypertension and Pectoralis Muscle Area and Density

Marzieh  Mirtajaddini; Nasim  Naderi; Somayeh Sadat  Jalali; Alireza  Hosseinpour; Hamidreza  Pouraliakbar; Sepideh  Taghavi; Razieh Omidvar; Hooman  Bakhshandeh; Armin  Attar; Tahereh  Sadeghi; Fatemeh  Ghorbani

doi:10.18502/jthc.v20i2.19708

Marzieh Mirtajaddini Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Nasim Naderi Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Somayeh Sadat Jalali Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Alireza Hosseinpour Department of Cardiovascular Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Hamidreza Pouraliakbar Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Sepideh Taghavi Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Razieh Omidvar Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Hooman Bakhshandeh Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran.
Armin Attar Department of Cardiovascular Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Tahereh Sadeghi Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran
Fatemeh Ghorbani Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jthc.v20i2.19708

Keywords: Pulmonary Hypertension; Pectoralis Muscle Area; Pectoralis Muscle Density; Sarcopenia; Right heart Catheterization

Abstract

Background: Sarcopenia is a predictor of mortality in multiple conditions, but the potential prognostic value of sarcopenia indices in pulmonary hypertension (PH) has not been clarified. This study aimed to determine whether there is an association between computed tomography (CT) scan-measured pectoralis muscle area (PMA) and density (PMD) and adverse clinical outcomes in PH patients.

Methods: In this cross-sectional study, the medical records of PH patients (clinical classes I and IV) referred to Rajaie Cardiovascular Institute from March 2016 through March 2021 were retrospectively reviewed. CT scan-measured PMA and PMD were compared between survivors and non-survivors, along with blood biomarkers and right heart catheterization variables. Binary logistic regression analysis was performed to identify potential predictors of mortality.

Results: A total of 45 patients with PH (34 survivors and 11 non-survivors) were included in the analysis. PMA was not significantly different between the two groups (P=0.12), whereas PMD differed weakly between survivors and non-survivors (survivors: 45 HU [25.8–51.3] vs. non-survivors: 31 HU [23–36]; P=0.062). In logistic regression analysis, none of the sarcopenia indices predicted mortality (P >0.05). Nonetheless, phosphodiesterase-5 (PDE-5) inhibitor use, right atrial pressure, and systemic arterial oxygen saturation were identified as potential predictors (P<0.05).

Conclusions: Although CT scan-measured PMA and PMD showed only a weak correlation with the prognosis of PH, these factors may serve as potential markers of mortality in patients with idiopathic and chronic thromboembolic PH. Further confirmation is needed through future studies with larger sample sizes.