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A preliminary pilot study investigating the impact of endovascular treatment on leg muscle volume in peripheral artery disease and its relation to baseline glycemic control
Authors:Tomoyo Miyakuni  Hidenori Komiyama  Masamichi Takano  Takeshi Ikeda  Masato Matsushita  Nobuaki Kobayashi  Toshiaki Otsuka  Yasushi Miyauchi  Kuniya Asai  Yoshihiko Seino  Wataru Shimizu
Affiliation:1. Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan;2. Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603, Japan;3. Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 270-1613, Japan;4. Department of Hygiene and Public Health, Nippon Medical School, Tokyo, 113-8602, Japan
Abstract:
Background and aimsPeripheral artery disease (PAD), intermittent claudication, and impaired mobility contribute to the loss of skeletal muscle. This study investigated the impact of endovascular treatment (EVT) in patients suffering from PAD above the knee and its relation to baseline glycemic control.Methods and resultsMid-thigh muscle volume was measured before EVT, 3 months after EVT and 6 months after EVT. Mid-thigh muscle volumes of ipsilateral PAD patients with ischemic and non-ischemic legs were compared. Correlations between total thigh muscle volume and clinical characteristics were analyzed using univariable and multivariable analysis. Overall, thigh muscle volume increased after EVT. The mid-thigh muscle volume was significantly lower in patients with ipsilateral lesions and in those with ischemic lower limbs. The thigh muscle volume of those with ischemic lower limbs increased after EVT. Baseline glycated hemoglobin was the only factor that was negatively correlated with changes in the muscle volume after EVT. Muscle volume significantly increased in normoglycemic HbA1c<6.5% (47 mmol/mol) patients. There was no significant alteration in the muscle volume of hyperglycemic HbA1c ≥ 6.5% patients.ConclusionIschemic muscle atrophy was ameliorated after EVT in normoglycemic patients. There is a need for a large-scale trial to investigate whether EVT can protect or delay skeletal muscle loss.
Keywords:Endovascular treatment  Ischemia  Peripheral arterial disease  Skeletal muscle  Thigh muscle volume  ABI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0040"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Ankle-brachial index  BMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0050"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Body mass index  CKD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0060"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Chronic kidney disease  CT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0070"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Computed tomography  DL"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0080"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Dyslipidemia  EVT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0090"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Endovascular treatment  HT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0100"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Hypertension  PAD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0110"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Peripheral artery disease
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