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线粒体功能障碍导致心脏手术后持续肌肉损失:前性观察研究

Ashley N Thomas¹, Antonis Kalakoutas², Martin Yates¹

¹Barts Heart Centre, St Bartholomew's Hospital, Barts NHS Trust, London, UK.

Journal of cachexia, sarcopenia and muscle

|August 22, 2025

概括

心脏手术患者通常会失去肌肉质量和力量, 基线和手术后的线粒体功能障碍标记预测肌肉的不良结果,强调需要有针对性的干预措施.

科学领域:

心脏病学
代谢学
肌肉生理学

背景情况:

心脏手术是一种主要的系统性损伤,导致显著的肌肉损失 (肉症).
手术后肌肉质量和力量的损失是高度可变的 (0% - 40%的直腿骨截面面积).
了解肌肉恢复在第一周之后对于患者的结果至关重要.

研究的目的:

调查肌肉表型,身体组成和心脏手术后门诊后的生活质量.
将肌肉恢复与蛋白质和代谢标记相关联.
确定心脏手术后肌肉状况不佳的预测因素.

主要方法:

招募接受选择性大动脉手术的患者
评估肌肉质量 (RFcsa),力量 (手握,膝盖伸展,精神测量),身体组成和生命质量在手术前,7天和随访时.
在多个时间点进行血代谢组分析 (第0,3,7天和随访).

主要成果:

在第7天,直腿骨截面面积 (RFcsa) 的平均损失为6. 44%,在随访时为9. 69%.
随访后,肌肉强度和功能恢复到基线,与某些患者持续的肌肉体量损失形成对比.
随访时,生活质量与肌肉体积和力量有正相关性.
线粒体功能障碍标志物 (短链乙) 与肌肉损失和力量降低相关.

结论:

尽管在主动脉手术后恢复了力量,但很大一部分患者会持续肌肉损失.
基线和急性线粒体功能障碍预测到门诊后续的肌肉结果较差.
这些发现强调了监测肌肉质量的重要性,并确定心脏手术后患有肉症的患者.

关键词:

大动脉外科手术危急的疾病代谢学线粒体肌肉再生恢复肌肉力量肌肉缩病理学

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