Abstract 14435: Psoas Muscle Index as a Tool to Predict Outcomes in a Pulmonary Hypertension Population Undergoing Pulmonary Thromboendarterectomy

Abstract

Introduction: Sarcopenia is defined as an overall decline in skeletal muscle mass and has been associated with a range of cardiac pathologies. Psoas Muscle Index (PMI) has emerged as a metric of sarcopenia. We investigated the prognostic value of PMI on six-minute walk distance (6MWD), and length of stay (LOS) in pulmonary hypertension patients following Pulmonary Thromboendarterectomy (PTE). Hypothesis: Sarcopenic patients will have lower 6MWD meters and increased LOS compared to non-sarcopenic patients. Methods: Retrospective chart review of 65 patients with CTEPH who had undergone PTE with CT scans of the abdomen between 2017-2022. Psoas muscle area was measured at the L3 level on CT scan. PMI was calculated using the formula (left psoas area + right psoas area)/height 2 . Patients in the 1 st quartile PMI for their gender were classified as sarcopenic. 1 st quartile PMI values were calculated as 5.34 cm 2 /m 2 for males, and 3.30 cm 2 /m 2 for females. Results: 17 (26%) patients were classified as sarcopenic. There were no significant differences between sarcopenic and non-sarcopenic groups comparing hemodynamics (mean PA 45 vs 42 mmHg, PVR 9 vs 8 WU, CI 2 vs 2.1-l/min/m 3 ), age (61.2 vs 59.7-years), female sex (52.9 vs 55.3%), ethnicity or comorbidities. Regarding 6 minute walk distance (6MWD), the sarcopenic group had significantly lower meters walked than the non-sarcopenic group pre-PTE (220 vs. 322-meters, p=0.049). Following PTE, there was less distinction between groups in 6MWD (347.1 meters vs 345.1, p=0.970). The sarcopenic group increased their 6MWD more than the non-sarcopenic group (137.3 meters vs 43.7, p=0.055). The sarcopenic group had significantly longer overall length of stay (LOS) (27 vs 14-days, p=0.001), and intensive care unit stay (19 days vs. 6-days, p=0.002) than the non-sarcopenic group. Conclusions: Sarcopenia is prevalent in patient with CTEPH. Sarcopenic patients with CTEPH had lower pre-PTE 6MWD, longer ICU stays and overall hospital LOS.