Association of computed tomography-derived pectoralis muscle area and density with disease severity and respiratory symptoms in patients with chronic obstructive pulmonary disease: A case-control study

• Published in: Respiratory medicine 2024-11, Vol.233, p.107783, Article 107783
• Main Authors: Li, Can, Lian, Xinying, He, Jingchun, Gao, Xiao, Liu, Xuehuan, Bao, Cuiping, Li, Zuoxi, Cui, Weiwei, Yu, Li, Liu, Jun
• Format: Article
• Language: English
• Subjects: Aged; Case-Control Studies; Chronic obstructive pulmonary disease; Computed tomography; Female; Humans; Male; Middle Aged; Pectoralis muscle area; Pectoralis muscle density; Pectoralis Muscles - diagnostic imaging; Pectoralis Muscles - pathology; Pectoralis Muscles - physiopathology; Pulmonary Disease, Chronic Obstructive - diagnostic imaging; Pulmonary Disease, Chronic Obstructive - pathology; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory Function Tests; Severity of Illness Index; Tomography, X-Ray Computed - methods
• ISSN: 0954-6111; 1532-3064; 1532-3064
• DOI: 10.1016/j.rmed.2024.107783

Computed tomography (CT) is commonly used and offers an additional viewpoint for evaluating extrapulmonary symptoms, disease severity, and muscle atrophy. This study assessed whether the pectoralis muscle area (PMA) and pectoralis muscle density (PMD) are lower in patients with chronic obstructive pulmonary disease (COPD) than in healthy controls and elucidated their relationships with these variables. The participants were enrolled in the hospital outpatient clinic between October 2023 and May 2024. Information was obtained from questionnaires, lung function, and CT imaging findings. On full-inspiratory CT, the PMA and PMD were measured at the aortic arch level using predetermined attenuation ranges of −29 and 150 Hounsfield units. We observed lower PMA and PMD and evaluated their associations with lung function, respiratory symptoms, and CT imaging findings in patients with COPD. Overall, 120 participants were enrolled at baseline (60 healthy controls and 60 patients with COPD). PMA and PMD were lower with progressive airflow limitation severity in those with COPD. The degree of emphysema and air trapping, as well as lung function, were correlated with PMA and PMD (P  0.05). Participants with COPD had smaller PMA and PMD. These measurements were correlated with the severity of airflow limitation, lung function, emphysema, and air trapping, suggesting that these features of the pectoralis muscle obtained from CT are helpful in assessments of patients with COPD. [Display omitted] •PMA and PMD are smaller in patients with COPD and decrease further with progressive airflow limitation severity.•The degree of emphysema and air trapping, as well as lung function, were correlated with PMA and PMD.•These results highlight the importance of pectoral muscle in assisting with COPD assessment.