Galea Nicola, Colalillo Amalia, Paciulli Serena, Pellicano Chiara, Giannetti Martina, Possente Emanuele, Paone Gregorino, Romaniello Antonella, Muscaritoli Maurizio, Rosato Edoardo, Gigante Antonietta
Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Intern Emerg Med. 2025 Jan;20(1):87-94. doi: 10.1007/s11739-024-03751-z. Epub 2024 Sep 17.
To investigate the potential contribution of chest wall muscle area (CWMA) to the ventilatory efficiency and exercise capacity in patients with Systemic Sclerosis (SSc) without interstitial lung disease (ILD). Forty-four consecutive SSc patients [F = 37, median age 53.5 years (IQR 43.5-58)] were examined using chest high-resolution computed tomography (HRCT), pulmonary function tests and cardiopulmonary exercise testing (CPET). The CWMA was evaluated at the level of the ninth thoracic vertebra on CT images by two independent evaluators blinded to the patient information. CPET parameters analyzed were maximum oxygen uptake (VO2 max) and VO2 at anaerobic threshold (VO@AT); minute ventilation (VE); maximum tidal volume (VT). A statistically significant positive correlation was found between CWMA and maximum workload (r = 0.470, p < 0.01), VO2 max ml/min (r = 0.380, p < 0.01), VO2@AT (r = 0.343, p < 0.05), VE (r = 0.308, p < 0.05), VT (r = 0.410, p < 0.01) and VO2/heart rate (r = 0.399, p < 0.01). In multiple regression analysis, VO2 max (ml/min) was significantly associated with CWMA [β coefficient = 5.226 (95% CI 2.824, 7.628); p < 0.001], diffusing capacity for carbon monoxide (DLco) [β coefficient = 6.749 (95% CI 1.460, 12.039); p < 0.05] and body mass index (BMI) [β coefficient = 41.481 (95% CI 8.802, 74.161); p < 0.05]. In multiple regression analysis, maximum workload was significantly associated with CWMA [β coefficient = 0.490 (95% CI 0.289, 0.691); p < 0.001], DLco [β coefficient = 0.645 (95% CI 0.202, 1.088); p < 0.01] and BMI [β coefficient = 3.747 (95% CI 1.013, 6.842); p < 0.01]. In SSc-patients without ILD, CWMA represents an important variable in exercise capacity and can be evaluated by the mediastinal window available in the HRCT images required for lung disease staging.
为研究胸壁肌肉面积（CWMA）对无间质性肺病（ILD）的系统性硬化症（SSc）患者通气效率和运动能力的潜在贡献。连续纳入44例SSc患者[女性=37例，中位年龄53.5岁（四分位间距43.5 - 58岁）]，采用胸部高分辨率计算机断层扫描（HRCT）、肺功能测试和心肺运动试验（CPET）进行检查。由两名对患者信息不知情的独立评估者在CT图像上第九胸椎水平评估CWMA。分析的CPET参数包括最大摄氧量（VO2 max）和无氧阈时的VO2（VO@AT）；分钟通气量（VE）；最大潮气量（VT）。发现CWMA与最大工作量（r = 0.470，p < 0.01）、VO2 max（ml/min）（r = 0.380，p < 0.01）、VO@AT（r = 0.343，p < 0.05）、VE（r = 0.308，p < 0.05）、VT（r = 0.410，p < 0.01）以及VO2/心率（r = 0.399，p < 0.01）之间存在显著正相关。在多元回归分析中，VO2 max（ml/min）与CWMA [β系数 = 5.226（95%可信区间2.824，7.628）；p < 0.001]、一氧化碳弥散量（DLco）[β系数 = 6.749（95%可信区间1.460，12.039）；p < 0.05]和体重指数（BMI）[β系数 = 41.481（95%可信区间8.802，74.161）；p < 0.05]显著相关。在多元回归分析中，最大工作量与CWMA [β系数 = 0.490（95%可信区间0.289，0.691）；p < 0.001]、DLco [β系数 = 0.645（95%可信区间0.202，1.088）；p < 0.01]和BMI [β系数 = 3.747（95%可信区间1.013，6.842）；p < 0.01]显著相关。在无ILD的SSc患者中，CWMA是运动能力的一个重要变量，可通过肺病分期所需HRCT图像中的纵隔窗进行评估。
