Imaizumi Tomoki, Shiga Yuhei, Idemoto Yoshiaki, Tashiro Kohei, Ueda Yoko, Yano Yuiko-Miyase, Norimatsu Kenji, Nakamura Ayumi, Kuwano Takashi, Iwata Atsushi, Miura Shin-Ichiro
Department of Cardiology, Fukuoka University School of Medicine.
Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka, Japan.
Medicine (Baltimore). 2020 Jul 10;99(28):e21086. doi: 10.1097/MD.0000000000021086.
The associations between the presence and severity of coronary artery disease (CAD) and measurements of the psoas major muscle (PMM) as assessed by multidetector row coronary computed tomography angiography (MDCT) are not known.We enrolled 793 patients who were clinically suspected to have CAD or had at least one cardiac risk factor and had undergone MDCT. The number of significantly stenosed coronary vessels (VD) and measurements of the PMM index (PMMI) were determined using MDCT.PMMI in the CAD group was significantly lower than that in the non-CAD group in males, but not females. In addition, the levels of PMMI tended to increase as the number of VD decreased in males. When male patients were divided into 2 groups according to median value of age, that is, relatively younger (53.4 ± 9.2 years) and older (72.6 ± 5.7 years) groups, the presence of CAD was independently associated with PMMI in the younger group by a multiple logistic regression analysis. The cut-off level of PMMI that gave the greatest sensitivity and specificity for the diagnosis of CAD in younger males was 8.3 cm/m (sensitivity 0.441, specificity 0.752).In conclusion, PMMI may be an imaging marker for evaluating the presence and/or severity of CAD in males, and particularly in the non-elderly.
多排螺旋冠状动脉计算机断层扫描血管造影（MDCT）评估的冠状动脉疾病（CAD）的存在及严重程度与腰大肌（PMM）测量值之间的关联尚不清楚。我们纳入了793例临床怀疑患有CAD或至少有一个心脏危险因素且接受了MDCT检查的患者。使用MDCT确定显著狭窄的冠状动脉血管数量（VD）和PMM指数（PMMI）测量值。男性CAD组的PMMI显著低于非CAD组，但女性并非如此。此外，男性中PMMI水平倾向于随着VD数量的减少而升高。当根据年龄中位数将男性患者分为两组时，即相对年轻（53.4±9.2岁）和年长（72.6±5.7岁）组，通过多元逻辑回归分析，CAD的存在与年轻组的PMMI独立相关。在年轻男性中，对CAD诊断具有最高敏感性和特异性的PMMI截断水平为8.3cm/m（敏感性0.441，特异性0.752）。总之，PMMI可能是评估男性尤其是非老年男性CAD存在和/或严重程度的影像学标志物。
