Decreased Psoas Muscle Computed Tomography Value Predicts Poor Outcome in Peripheral Artery Disease

Takayuki Sugai; Tetsu Watanabe; Yoichiro Otaki; Jun Goto; Ken Watanabe; Taku Toshima; Tetsuya Takahashi; Miyuki Yokoyama; Harutoshi Tamura; Satoshi Nishiyama; Takanori Arimoto; Hiroki Takahashi; Tetsuro Shishido; Masafumi Watanabe

doi:10.1253/circj.CJ-18-0726

Peripheral Vascular Disease

Decreased Psoas Muscle Computed Tomography Value Predicts Poor Outcome in Peripheral Artery Disease

Takayuki Sugai, Tetsu Watanabe, Yoichiro Otaki, Jun Goto, Ken Watanabe, Taku Toshima, Tetsuya Takahashi, Miyuki Yokoyama, Harutoshi Tamura, Satoshi Nishiyama, Takanori Arimoto, Hiroki Takahashi, Tetsuro Shishido, Masafumi Watanabe

Author information

Takayuki Sugai
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Tetsu Watanabe
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Yoichiro Otaki
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Jun Goto
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Ken Watanabe
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Taku Toshima
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Tetsuya Takahashi
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Miyuki Yokoyama
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Harutoshi Tamura
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Satoshi Nishiyama
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Takanori Arimoto
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Hiroki Takahashi
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Tetsuro Shishido
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
Masafumi Watanabe
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine

Keywords: Computed tomography, Intramuscular fat deposition, Peripheral artery disease, Psoas muscle, Sarcopenia

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Supplementary material

2018 Volume 82 Issue 12 Pages 3069-3075

DOI https://doi.org/10.1253/circj.CJ-18-0726

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Abstract

Background: The prognosis of peripheral artery disease (PAD) and comorbid sarcopenia is poor. Some reports indicate that the computed tomography (CT) value of skeletal muscle, which reflects intramuscular fat deposition as well as skeletal muscle mass, is considered a marker of sarcopenia. However, it remains unclear if skeletal muscle area and CT value are associated with poor outcomes in patients with PAD.

Methods and Results: Psoas muscle area and CT value were measured by manual trace at the level of the third lumbar vertebral body in 327 consecutive patients with PAD undergoing endovascular therapy (EVT). The endpoint was major adverse cardiovascular and limb events (MACLE). There were 60 MACLE during the follow-up period. Patients with MACLE had lower mean psoas muscle CT value than those without. However, there was no significant difference in total psoas muscle area between patients with and without MACLE. Kaplan-Meier analysis demonstrated that the lowest tertile of psoas muscle CT value was associated with the highest risk of MACLE. Multivariate Cox hazard analysis revealed that psoas muscle CT value was associated with MACLE after adjustment for Fontaine class, previous ischemic heart disease, prevalence of diabetes mellitus, brain natriuretic peptide, and serum albumin.

Conclusions: Psoas muscle CT value is a feasible predictor of MACLE in patients with PAD.

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