Evaluation of the cross-sectional area and densities of the pectoralis muscles and diameters of the pulmonary artery and aorta in the axial plane in COVID-19 patients

Year 2024, Volume: 49 Issue: 3, 728 - 735, 30.09.2024

Sema Polat , Zafer Altun , Mahmut Öksüzler , Mahmut Tunç , Esin Özşahin , Pınar Göker

https://doi.org/10.17826/cumj.1487168

Abstract

Purpose: This paper aimed to investigate and compare diameter of the pulmonary arteries, and aorta, cross sectional area and density of the pectoralis muscles before and after COVID-19.
Materials and Methods: The axial Computed Tomography (CT) images of the chest areas of 20 individuals (12 females and 8 males) aged between 18-69 years were used. Pulmonary artery diameter (PAD), right pulmonary artery diameter (PADR), left pulmonary artery diameter (PADL), Ascending aorta diameter (AAD), the ratio of PAD to AAD, pectoralis major and minor area (PMAM) and muscle density (PMDM) before and after COVID-19 were evaluated on both healthy and COVID-19 CT images belonging to the same individuals and taken in the same year.
Results: The mean age of 20 subjects participating in the study were 48.00±11.43 years, while the mean age of 12 females was 57.80±1.64 years, and the mean age of 8 males’s was measured as 44.00±10.08 years. Also, the pectoralis major and minor area, ascending aorta diameter, left pulmonary artery diameter and right pulmonary artery diameter were higher in post-COVID 19 than pre-COVID 19. Except for the pectoralis major and minor density and truncus pulmonalis diameter, other measurements showed a decrease in patients who had COVID-19, although not significant, compared to the period before COVID-19.
Conclusion: These findings have shown that how COVID-19 affects the pulmonary artery and ascending aorta and especially the pectoralis muscles and these findings may be a sign of a change caused by COVID-19.

Keywords

COVID-19, pectoralis major area, Pulmonary artery, Ascending Aorta

COVID-19 hastalarında aksiyel planda pektoral kasların kesit alanı ve densititesi ile pulmoner arter ve aorta çaplarının değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, COVID-19 öncesi ve sonrasında pulmoner arter ve aorta’nın çapı ve pektoral kaslarının kesit alanı ile densitesini araştırmak ve karşılaştırmaktır.
Gereç ve Yöntem: Yaşları 18-69 arasında değişen 20 bireyin (12 kadın ve 18 erkek) Toraks aksiyal Bilgisayarlı Tomografi (BT) görüntüleri alındı. Aynı bireylere ait ve aynı yıl içinde çekilmiş hem sağlıklı hem de COVID-19 BT görüntüleri üzerinde truncus pulmonalis çapı (PAD), sağ pulmoner arter çapı (PAÇS), sol pulmoner arter çapı (PAÇSo), aorta ascendens çapı (AAÇ), PAD'nin AAÇ'ye oranı, pectoralis major ve minor alanı (PMA) ve kas densititesi (PKD) ölçümleri değerlendirilmiştir.
Bulgular: Çalışmaya katılan 20 kişinin yaş ortalaması 48,00±11,43 yıl iken 12 kadının yaş ortalaması 57,80±1,64 yıl ve 8 erkeğin yaş ortalaması 44,00±10,08 yıl olarak ölçülmüştür. Ayrıca, pektoralis major-minor alanı, aort ascendens çapı, sol pulmoner arter çapı ve sağ pulmoner arter çapı COVID-19 sonrası dönemde COVID-19 öncesine göre daha yüksekti. Bu da bize pectoralis major ve minor densitite ve trunkus pulmonalis çapı dışında diğer ölçümlerin COVID-19 geçiren hastalarda COVID-19 öncesi döneme kıyasla anlamlı olmasa da azalma gösterdiğini ortaya koymuştur.
Sonuç: Bu bulgular, COVID-19'un pulmoner arter ve aorta ascendens ve özellikle pektoral kasları nasıl etkilediğini göstermiş olup COVID-19'un neden olduğu bir değişikliğin işareti olabilir.

Keywords

COVID-19, Pectoralis major çapı, Arteria pulmonalis, Aorta ascendens

References

• Gorbalenya AE, Baker SC, Baric RS, Groot RJ, Drosten C, Gulyaeva AA et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5:536–44.
• Erdoğan M, Öztürk S, Erdöl MA, Kasapkara A, Beşler MS, Kayaaslan B et al. Prognostic utility of pulmonary artery and ascending aorta diameters derived from computed tomography in COVID‐19 patients. Echocardiography. 2021;38:1543-51.
• Hocaoglu E, Ors S, Yildiz O, Inci E. Correlation of pectoralis muscle volume and density with severity of COVID-19 pneumonia in adults. Acad Radiol. 2021;28:166-72.
• Yildiz M, Yadigar S, Yildiz BŞ, Aladag NB, Keskin O, Ozer RS et al. Evaluation of the relationship between COVID-19 pneumonia severity and pulmonary artery diameter measurement. Herz. 2021;46:56.
• Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020;56:106054.
• Libby P, Luscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020;41:3038-6.
• Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25:2000045.
• Antonarelli M, Fogante M. Chest CT-derived muscle analysis in COVID-19 patients. Tomography. 2022;8:414-22.
• Ongen G, Gokalp G, Nas OF, Ozpar R, Candan S. The association between the CT severity index and the pulmonary artery area in COVID-19 pneumonia. Acta Radiologica. 2023;64:2238-6.
• Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2019;215:87–6.
• Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PLoSONE. 2020:15:e230548.
• Schinas G, Dimakopoulou V, Dionysopoulos K, Fezoulidi G, Vlychou M, Vassiou K et al. Radiologic features of T10 paravertebral muscle sarcopenia: prognostic factors in COVID-19. J Clin Med Res. 2023;15:368-8.
• Yücel AH. Dere anatomi atlası ve ders kitabı. 7. Baskı. Adana, Akademisyen Kitabevleri, 2018.
• Cumhur M, Sancak B. Fonksiyonel Anatomi. ODTÜ Yayıncılık, 2015.
• Tan RT, Kuzo R, Goodman LR, Siegel R, Haasler GB, Presberg KW. Utility of CT scan evaluation for predicting pulmonary hypertension in patients with parenchymal lung disease. Chest. 1998;113:1250–6.
• Spagnolo P, Cozzi A, Foà RA, Spinazzola A, Monfardini L, Bnà C et al. CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients. Quant Imaging Med Surg. 2020;10:1325–8.
• Bak SH, Kwon SO, Han SS, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res. 2019;20:1–12.
• Park MJ, Cho JM, Jeon KN, Bae KS, Kim HC, Choi DS et al. Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity. Acad Radiol. 2014;21:711–6.
• Jacobson JA. Sarcopenia: relevance and Assessment. Acad Radiol. 2020;20:1–2.
• McDonald MLN, Diaz AA, Ross JC. Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease: a cross-sectional study. Ann Am Thorac Soc. 2014;11:326–8.
• Moon SW, Choi JS, Lee SH, Jung KS, Jung JY, Kang YA et al. Thoracic skeletal muscle quantification: Low muscle mass is related with worse prognosis in idiopathic pulmonary fibrosis patients. Respir Res. 2019;20:35.
• Surov A, Kardas H, Besutti G, Pellegrini M, Ottone M, Onur MR et al. Prognostic role of the pectoralis musculature in patients with COVID-19. A multicenter study. Acad Radiol. 2023;30:77-82.
• Pan F, Ye T, Sun P, Gui S, Liang B, Li L et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID19) pneumonia. Radiology. 2020;295:715–6.
• Kalaycı Ş. SPSS Uygulamalı Çok Değişkenli Istatistik Teknikleri. 6th ed. İstanbul, Asil Yayıncılık, 2014.
• Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020;296:115–117
• Tekcan Şanlı DE, Yıldırım D. A new imaging sign in COVID-19 pneumonia: vascular changes and their correlation with clinical severity of the disease. Diagn Interv Radiol. 2021;27:172–8.
• Ieki H, Nagatomo Y, Tsugu M, Mahara K, Iguchi N, Isobe M et al. Impact of pulmonary artery-to-aorta ratio by CT on the clinical outcome in heart failure. J Card Fail. 2019;25:886–93.
• Nevsky G, Jacobs JE, Lim RP, Donnino R, Babb JS, Srichai MB. Sex-specific normalized reference values of heart and great vessel dimensions in cardiac CT angiography. AJR Am J Roentgenol. 2011;196:788-6.
• Truong QA, Massaro JM, Rogers IS, Mahabadi AA, Kriegel MF, Fox CS et al. Reference values for normal pulmonary artery dimensions by noncontrast cardiac computed tomography: the Framingham Heart Study. Circ Cardiovasc Imaging. 2012;5:147-7.
• Li X, Zhang C, Sun X, Yang X, Zhang M, Wang Q et al. Prognostic factors of pulmonary hypertension associated with connective tissue disease: pulmonary artery size measured by chest CT. Rheumatology (Oxford). 2020;59:3221-28.
• Żyłkowska J, Kurzyna M, Florczyk M, Burakowska B, Grzegorczyk F, Burakowski J et al. Pulmonary artery dilatation correlates with the risk of unexpected death in chronic arterial or thromboembolic pulmonary hypertension. Chest. 2012;142:1406-16.
• Francone M, Iafrate F, Masci GM, Coco S, Cilia F, Manganaro L et al. Chest CT score in COVID-19 patients: Correlation with disease severity and short-term prognosis. Eur Radiol. 2020;30:6808–17.
• Kara Ö, Kara M, Akın ME, Özçakar L. Grip strength as a predictor of disease severity in hospitalized COVID-19 patients. Heart Lung. 2021;50:743–4.
• Olson SL, Panthofer AM, Harris DJ, Jordan WD Jr, Farber MA, Cambria RP et al. CT-Derived pretreatment thoracic sarcopenia is associated with late mortality after thoracic endovascular aortic repair. Ann Vasc Surg. 2020;66:171–7.