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Preoperative visceral fat mass predicts significant skeletal muscle loss after cardiovascular surgery. Visceral obesity amplifies inflammation, accelerating muscle degradation and increasing patient risk.

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Area of Science:

  • Cardiovascular Surgery
  • Body Composition Analysis
  • Inflammatory Response

Background:

  • Visceral obesity elevates perioperative systemic inflammation, increasing infection risk.
  • Skeletal muscle loss post-cardiovascular surgery is a significant clinical concern.
  • Computed tomography (CT) aids in assessing body composition and its clinical implications.

Purpose of the Study:

  • To investigate the association between preoperative visceral fat mass and postoperative skeletal muscle loss.
  • To evaluate the clinical utility of CT-based body composition analysis in predicting muscle loss.
  • To understand the role of visceral obesity in perioperative inflammation and muscle catabolism.

Main Methods:

  • Retrospective cohort study of Japanese patients undergoing elective cardiovascular surgery (May 2020 - Dec 2023).
  • Preoperative CT used to measure visceral fat area, subcutaneous fat area, and psoas muscle area (skeletal muscle indicator).
  • Skeletal muscle loss quantified by changes in psoas muscle area from pre- to post-operation.

Main Results:

  • Higher preoperative visceral fat area significantly correlated with increased C-reactive protein (CRP) and greater psoas muscle area loss.
  • Subcutaneous fat area did not show significant correlation with these outcomes.
  • Multivariate analysis confirmed visceral fat area as a significant predictor of postoperative skeletal muscle loss (OR: 1.01; 95% CI: 1.00-1.02).

Conclusions:

  • Preoperative visceral fat mass, assessed by CT, is a reliable predictor of postoperative skeletal muscle loss.
  • Visceral obesity may exacerbate muscle loss through heightened systemic inflammation and proinflammatory pathways.