Exploring the Correlation between Pulmonary Hypertension and Pectoralis Muscle Area and Density

Background: Sarcopenia is a predictor of mortality in multiple conditions, but the potential prognostic value of sarcopenia indices in pulmonary hypertension (PH) has not been clarified. This study aimed to determine whether there is an association between computed tomography (CT) scan-measured pectoralis muscle area (PMA) and density (PMD) and adverse clinical outcomes in PH patients. Methods: In this cross-sectional study, the medical records of PH patients (clinical classes I and IV) referred to Rajaie Cardiovascular Institute from March 2016 through March 2021 were retrospectively reviewed. CT scan-measured PMA and PMD were compared between survivors and non-survivors, along with blood biomarkers and right heart catheterization variables. Binary logistic regression analysis was performed to identify potential predictors of mortality. Results: A total of 45 patients with PH (34 survivors and 11 non-survivors) were included in the analysis. PMA was not significantly different between the two groups (P=0.12), whereas PMD differed weakly between survivors and non-survivors (survivors: 45 HU [25.8–51.3] vs. non-survivors: 31 HU [23–36]; P=0.062). In logistic regression analysis, none of the sarcopenia indices predicted mortality (P >0.05). Nonetheless, phosphodiesterase-5 (PDE-5) inhibitor use, right atrial pressure, and systemic arterial oxygen saturation were identified as potential predictors (P<0.05). Conclusions: Although CT scan-measured PMA and PMD showed only a weak correlation with the prognosis of PH, these factors may serve as potential markers of mortality in patients with idiopathic and chronic thromboembolic PH. Further confirmation is needed through future studies with larger sample sizes.