PMID- 33667463
OWN - NLM
STAT- MEDLINE
DCOM- 20220204
LR  - 20220204
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 113
IP  - 2
DP  - 2022 Feb
TI  - Clinical Implications of Body Composition and Exercise Capacity Following 
      Pulmonary Endarterectomy.
PG  - 444-451
LID - S0003-4975(21)00359-3 [pii]
LID - 10.1016/j.athoracsur.2021.01.066 [doi]
AB  - BACKGROUND: Pulmonary endarterectomy (PEA) is a curative procedure for patients 
      with chronic thromboembolic pulmonary hypertension. Body composition and exercise 
      capacity have been associated with adverse outcomes in patients undergoing 
      cardiothoracic operations, but their significance with PEA is unclear. We 
      evaluated the association of body composition and 6-minute walk distance (6MWD) 
      with disease severity, hospital length of stay, discharge disposition, and 
      postoperative functional recovery. METHODS: This was a retrospective, 
      single-center cohort study of patients who underwent PEA (January 2014-December 
      2017). Body composition (skeletal muscle mass and adiposity cross-sectional area) 
      was quantified using thoracic computed tomography with sliceOmatic (TomoVision, 
      Magog, QC, Canada) software. Body mass index was calculated. Association of body 
      composition measures and 6MWD with clinical outcomes was evaluated using 
      multivariable regression models. RESULTS: The study included 127 patients (42% 
      men), aged 58 +/- 14 years; body mass index was 31 +/- 7 kg/m(2) and 6MWD was 361 +/- 
      165 m). Muscle and 6MWD were associated with disease severity measures. Of those 
      surviving hospitalization (n = 125), a greater 6MWD was associated with a shorter 
      hospital stay (1.9 median days per 100 m; p < .001) and higher likelihood of 
      being discharged directly home from hospital (odds ratio, 2.1 per 100 m; P = 
      .004), independent of age, sex, and body mass index. Those with a lower 
      preoperative 6MWD (per 100 m) had a greater increase in their postoperative 6MWD 
      (52 m; P < .0001), independent of age, sex, and body mass index. Body composition 
      measures were not associated with hospital outcomes or exercise capacity in the 
      first year postoperatively. CONCLUSIONS: Exercise capacity was a more prognostic 
      marker of PEA outcomes compared with body composition. Future research is needed 
      to explore pre-PEA rehabilitation strategies.
CI  - Copyright (c) 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Balki, Indranil
AU  - Balki I
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - de Perrot, Marc
AU  - de Perrot M
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Thoracic 
      Surgery, Chronic Thromboembolic Pulmonary Hypertension Program, University Health 
      Network, Toronto, Ontario, Canada.
FAU - Bavaghar-Zaeimi, Fatemeh
AU  - Bavaghar-Zaeimi F
AD  - Thoracic Surgery, Chronic Thromboembolic Pulmonary Hypertension Program, 
      University Health Network, Toronto, Ontario, Canada.
FAU - Nourouzpour, Sahar
AU  - Nourouzpour S
AD  - Respirology, Pulmonary Hypertension Program, University Health Network, Toronto, 
      Ontario, Canada.
FAU - Granton, John T
AU  - Granton JT
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; 
      Respirology, Pulmonary Hypertension Program, University Health Network, Toronto, 
      Ontario, Canada.
FAU - Thenganatt, John
AU  - Thenganatt J
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; 
      Respirology, Pulmonary Hypertension Program, University Health Network, Toronto, 
      Ontario, Canada.
FAU - McInnis, Micheal
AU  - McInnis M
AD  - Department of Medical Imaging, University Health Network, Toronto, Ontario, 
      Canada.
FAU - McRae, Karen
AU  - McRae K
AD  - Department of Anesthesia and Pain Management, University Health Network, Toronto, 
      Ontario, Canada.
FAU - Donahoe, Laura
AU  - Donahoe L
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Thoracic 
      Surgery, Chronic Thromboembolic Pulmonary Hypertension Program, University Health 
      Network, Toronto, Ontario, Canada.
FAU - Rozenberg, Dmitry
AU  - Rozenberg D
AD  - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; 
      Respirology, Lung Transplant Program, Toronto General Research Institute, 
      University Health Network, Toronto, Ontario, Canada. Electronic address: 
      dmitry.rozenberg@uhn.ca.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20210303
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - *Body Composition
MH  - Computed Tomography Angiography
MH  - Endarterectomy/*methods
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/*complications/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Pulmonary Artery/diagnostic imaging/*surgery
MH  - Pulmonary Embolism/diagnosis/etiology/*surgery
MH  - Pulmonary Wedge Pressure/physiology
MH  - Retrospective Studies
MH  - Walking/*physiology
EDAT- 2021/03/06 06:00
MHDA- 2022/02/05 06:00
CRDT- 2021/03/05 20:10
PHST- 2020/08/29 00:00 [received]
PHST- 2020/12/15 00:00 [revised]
PHST- 2021/01/27 00:00 [accepted]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2022/02/05 06:00 [medline]
PHST- 2021/03/05 20:10 [entrez]
AID - S0003-4975(21)00359-3 [pii]
AID - 10.1016/j.athoracsur.2021.01.066 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2022 Feb;113(2):444-451. doi: 10.1016/j.athoracsur.2021.01.066. 
      Epub 2021 Mar 3.