An Early Assessment of the Association between Pectoralis Muscle Measures and Frailty

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PURPOSE: The association between pectoralis muscle measurements and objective frailty assessments in the heart failure population has not been previously reported. METHODS: The study cohort included patients who had first-time CF-LVAD implants at the University of Minnesota between 2017-2018 who had 1) chest CTs and 2) frailty assessments performed in the 3 months prior to LVAD (n=27). Unilateral pectoralis muscle mass indexed to height in meters squared and attenuation (approximated by mean Hounsfield units) were measured on preoperative chest CT scans ​using Slice-O-Matic software. Frailty was assessed with a 6 point Clinical Frailty Scale. Multivariable linear regression was performed to assess the association between pectoralis muscle measures and frailty scores. RESULTS: After multivariate adjustment, each frailty score increase (more frail) was associated with an adjusted decrease of 3.9 in the mean pectoralis muscle hounsfield units (95% CI= -7.4 to -0.41, p=0.03). A statistically significant association between pectoralis muscle mass index and frailty scores was not detected (-0.61 95% CI = -1.4 to 0.2; p =0.15). Multivariable models were adjusted for age, sex, and INTERMACS profile. CONCLUSION: In this small sample of patients with simultaneous frailty and pectoralis muscle measurements, a significant association was detected between tissue attenuation and frailty. Further data will be needed to confirm this finding and to determine the degree that frailty can be reversed with LVAD support.

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