Factors Affecting the Decrease in Psoas Muscle Area 1 Year After Thoracic Aortic Replacement in Older Patients

Area of Science:

• Geriatric Medicine
• Cardiovascular Surgery
• Musculoskeletal Imaging

Background:

• Investigating psoas muscle area (PMA) changes after thoracic aortic replacement is crucial for understanding patient recovery.
• Sarcopenia and muscle loss can impact functional outcomes in elderly patients post-surgery.

Purpose of the Study:

• To determine the rate of PMA change from pre-surgery to 1 year post-surgery in patients aged 65+ undergoing elective thoracic aortic replacement.
• To identify factors associated with PMA decrease at 1 year post-thoracic aortic replacement.

Main Methods:

• A retrospective analysis of 73 patients (median age 75) undergoing elective thoracic aortic replacement.
• Psoas muscle area (PMA) was measured preoperatively and 1 year postoperatively.
• Univariate and multivariate logistic regression analyses identified predictors of PMA decrease.

Main Results:

• Male sex, higher preoperative body mass index (BMI), and failure to recover 6-minute walk distance (6 MWD) to preoperative levels were associated with PMA decrease.
• Multivariate analysis confirmed male sex (OR=5.019), preoperative BMI (OR=1.190), and impaired 6 MWD recovery (OR=9.617) as independent predictors of PMA decrease.

Conclusions:

• Male sex, preoperative BMI, and failure to regain preoperative 6-minute walk distance are significant factors influencing psoas muscle area decline 1 year after thoracic aortic replacement.
• These findings highlight potential targets for interventions to mitigate muscle loss and improve functional recovery in this patient population.