Pereira-Neves António, Barros Daniela, Rocha-Neves João, Duarte-Gamas Luís, Dias-Neto Marina, Cerqueira Alfredo, Vidoedo José, Teixeira José
Department of Biomedicine, Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal.
Department of Phisiology and Surgery, Faculdade de Medicina da Universidade do Porto, Portugal.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):615-622. doi: 10.5606/tgkdc.dergisi.2020.20146. eCollection 2020 Oct.
This study aims to validate the psoas muscle area and psoas muscle density as morphometric predictors in cardiovascular and cerebrovascular endpoints in patients with extensive aortoiliac peripheral arterial disease.
A total of 57 patients (55 males, 2 females; mean age 60±8.2 years; range, 35 to 83 years) with Trans-Atlantic Inter-Society Consensus type D lesions who underwent revascularization at two Portuguese tertiary hospitals between January 2013 and July 2019 were retrospectively analyzed. The patients with a recent (<6 months) computed tomography scan prior to the revascularization procedure were included in the study. Both centers offered to their patients open and endovascular repair of aortoiliac peripheral arterial disease. Major adverse cardiovascular and cerebrovascular events and major adverse limb events were evaluated.
The median follow-up was 20 months. The mean survival rate was 93±3.4% at 30 days and 62.7±8.6% at 48 months. The discriminative thresholds found in this population were 2,175.8 mm2 for total psoas area and 51.75 Hounsfield unit for psoas muscle density. There was a statistically significant difference in the one-year survival rate (p=0.003 and p=0.291, respectively) and major adverse cardiovascular and cerebrovascular events (p=0.005 and p=0.206, respectively) for total psoas area compared to psoas muscle density.
Total psoas area shows a prognostic value for survival and major adverse cardiovascular and cerebrovascular events in this patient population.
本研究旨在验证腰大肌面积和腰大肌密度作为广泛主髂动脉外周动脉疾病患者心血管和脑血管终点事件的形态学预测指标。
回顾性分析了2013年1月至2019年7月期间在两家葡萄牙三级医院接受血运重建的57例（55例男性，2例女性；平均年龄60±8.2岁；范围35至83岁）患有跨大西洋跨学会共识D型病变的患者。纳入在血运重建手术前近期（<6个月）进行过计算机断层扫描的患者。两个中心均为其患者提供主髂动脉外周动脉疾病的开放和血管内修复。评估主要不良心血管和脑血管事件以及主要不良肢体事件。
中位随访时间为20个月。30天时的平均生存率为93±3.4%，48个月时为62.7±8.6%。该人群中发现的判别阈值为总腰大肌面积2175.8平方毫米，腰大肌密度51.75亨氏单位。与腰大肌密度相比，总腰大肌面积在一年生存率（分别为p=0.003和p=0.291）和主要不良心血管和脑血管事件（分别为p=0.005和p=0.206）方面存在统计学显著差异。
总腰大肌面积对该患者人群的生存及主要不良心血管和脑血管事件具有预后价值。
