Ma Kirsten F, Levolger Stef, Vedder Issi R, El Moumni Mostafa, de Vries Jean-Paul P M, Bokkers Reinoud P H, Viddeleer Alain R
Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Department of Radiology, Medical Imaging Center, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
J Clin Med. 2021 Aug 31;10(17):3963. doi: 10.3390/jcm10173963.
This study investigated whether lower extremity muscle atrophy and myosteatosis in patients with peripheral arterial disease (PAD) are correlated to postoperative outcomes, such as reintervention or amputation-free survival.
In this single-center retrospective cohort study of 462 patients treated for peripheral arterial disease scheduled for intervention, muscle mass and the presence of fattening of the lower extremity muscles were measured semiautomatically in a single computed tomography slice of the treated leg. Binary logistic regression models and Cox proportional hazards models were used to determine the effect of muscle atrophy and myosteatosis on reintervention and amputation.
Muscle atrophy and myosteatosis increased in PAD patients with Fontaine class IV compared with Fontaine class IIa. In PAD patients with muscle atrophy or myosteatosis, no association was found with the reintervention rate or reintervention-free survival, but an association was found with amputation-free survival, even after adjustment for patient-related, disease-severity, and comorbidities-related factors.
Muscle atrophy and mysosteatosis increased in PAD patients with increasing disease severity. Lower extremity muscle atrophy and myosteatosis are associated with amputation rate and amputation-free survival in PAD patients. No association with reintervention rate or reintervention-free survival was found. Muscle atrophy and myosteatosis may serve as additional risk factors in decision making in the often frail vascular patient.
本研究调查了外周动脉疾病（PAD）患者的下肢肌肉萎缩和肌脂肪变性是否与术后结局相关，如再次干预或无截肢生存率。
在这项对462例计划接受干预治疗的外周动脉疾病患者进行的单中心回顾性队列研究中，在治疗腿部的单个计算机断层扫描切片中半自动测量肌肉质量和下肢肌肉脂肪沉积情况。采用二元逻辑回归模型和Cox比例风险模型来确定肌肉萎缩和肌脂肪变性对再次干预和截肢的影响。
与Fontaine IIa级相比，Fontaine IV级的PAD患者肌肉萎缩和肌脂肪变性增加。在患有肌肉萎缩或肌脂肪变性的PAD患者中，未发现与再次干预率或无再次干预生存率相关，但即使在对患者相关、疾病严重程度和合并症相关因素进行调整后，仍发现与无截肢生存率相关。
随着疾病严重程度的增加，PAD患者的肌肉萎缩和肌脂肪变性增加。下肢肌肉萎缩和肌脂肪变性与PAD患者的截肢率和无截肢生存率相关。未发现与再次干预率或无再次干预生存率相关。肌肉萎缩和肌脂肪变性可能是通常身体虚弱的血管疾病患者决策中的额外风险因素。
