CT-Derived Pectoralis Muscle Measurements and All-Cause Mortality in COPD.

Area of Science:

• Pulmonology
• Radiology
• Gerontology

Background:

• Skeletal muscle depletion is a key extrapulmonary manifestation in chronic obstructive pulmonary disease (COPD).
• Low muscle mass in COPD patients is associated with adverse clinical outcomes and reduced survival.
• Chest computed tomography (CT) offers an opportunity for opportunistic thoracic muscle assessment in COPD patients.

Purpose of the Study:

• To evaluate the association between CT-derived pectoralis muscle measurements and all-cause mortality in COPD patients.
• To compare the prognostic relevance of absolute pectoralis muscle area (PMA) versus height-adjusted pectoralis muscle index (PMI).

Main Methods:

• Retrospective cohort study of 245 COPD patients who underwent chest CT.
• Semi-automated segmentation used to measure PMA at the T4 vertebral level.
• PMI calculated by normalizing PMA to height squared; Cox proportional hazards regression used for mortality analysis.

Main Results:

• Higher PMA and PMI were significantly associated with a lower risk of all-cause mortality in COPD patients.
• The prognostic value of muscle measurements was significant in men but not in women.
• A mean follow-up of 5.31 years revealed 178 deaths (72.7%) among participants.

Conclusions:

• CT-derived pectoralis muscle measurements (PMA and PMI) are significant predictors of all-cause mortality in COPD.
• Both absolute and height-adjusted muscle indices demonstrate consistent prognostic value.
• Opportunistic assessment of thoracic muscle on routine chest CT can aid in COPD risk stratification.