Abstract
Purpose We have previously demonstrated that pectoralis muscle mass and tissue attenuation measured on preoperative CT scans were powerful predictors of mortality after LVAD implantation. These measurements were made with specialized software (Slice-O-Matic) which is not accessible to advanced heart failure teams. The purpose of this analysis was to determine the correlation between pectoralis muscle measures made with specialized software vs. routinely available CT software (PACS). Methods A random sample CT scans (n=57) was selected from our larger LVAD cohort with previously quantified pectoralis muscle measures by Slice-O-Matic Software (larger cohort n=141). Unilateral pectoralis muscle mass indexed to body surface area (PMI) and attenuation (approximated by mean Hounsfield units; PHUm) were re-measured on preoperative chest CT scans by a local radiologist using PACS software. Correlation between Slice-O-Matic and PACS pectoralis muscle measures was performed with Pearson analysis. These measures (PACS) were then assessed as predictors of mortality after LVAD implantation using multivariate cox regression. Results We observed a high correlation between pectoralis muscle measures using both techniques (R = 0.95 for PMI, R = 0.94 for PHUm). For the pectoralis measures quantified by PACS, each unit increase in PMI was associated with a 31% reduction in the hazard of death after LVAD (adjusted HR 0.69, 95% CI 0.48-0.99, p = 0.046). Each 5-unit increase in PHUm was associated with a 39% reduction in the hazard of death after LVAD (adjusted HR 0.61, 95% CI 0.38-0.96, p Conclusion Pectoralis muscle measurements can be performed by local radiologists using routinely available software. These measures are predictive of morality following LVAD. This is an important first step in delivering a predictive model incorporating this measure into real world practice.
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