{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T16:04:31Z","timestamp":1760976271590,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Sarcopenia, or loss of skeletal muscle mass, has been associated with poor outcomes (e.g., functional decline, increased mortality, and low quality of life), but its role in CTEPH remains unclear. The psoas muscle index (PMI) is a validated measure of sarcopenia. We investigated the incidence of sarcopenia using PMI in CTEPH. Methods: Retrospective analysis of a single-center cohort of patients with CTEPH with an available computed tomography of the abdomen and pelvis (CTAP). PMI was measured at the L3 level of the CTAP and was then calculated using the formula (left psoas area + right psoas area\/height2). Patients in the first quartile of PMI were classified as sarcopenic. Results: We reviewed 558 patients with CTEPH, and 97 patients had an available CTAP before intervention. Sarcopenia was identified in 26 (24.8%) of the patients and was associated with worse baseline functional status (p = 0.008), higher mean pulmonary artery pressure (48 vs. 39 mmHg; p = 0.002), and higher pulmonary vascular resistance (9.9 vs. 6.8 WU; p = 0.013). Post-PTE, patients with sarcopenia exhibited longer intensive care unit (ICU) (9 vs. 4 days, p &lt; 0.001) and overall hospital stays (24 vs. 11 days, p &lt; 0.001), despite similar post-operative hemodynamics achieved compared to non-sarcopenic patients. Conclusions: CTEPH patients with sarcopenia have worse baseline functional class and hemodynamics. For those with sarcopenia requiring surgery, there is longer ICU and total hospitalization stays, but they achieve significant functional improvements and hemodynamics comparable to that of non-sarcopenic patients. Hence, the risk of longer perioperative hospitalization days is justified by the longer-term benefit of hemodynamic improvement. The use of PMI as part of routine pre-operative assessments could improve clinical decision-making in CTEPH patients undergoing surgical or medical intervention.<\/jats:p>","DOI":"10.3390\/jcdd12050162","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:47:01Z","timestamp":1745297221000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sarcopenia in Patients with Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9673-6260","authenticated-orcid":false,"given":"Steven","family":"Hopkins","sequence":"first","affiliation":[{"name":"Internal Medicine Department, University of Pittsburg Medical Center, Pittsburgh, PA 15219, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Hall","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hollie","family":"Saunders","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3959-3566","authenticated-orcid":false,"given":"Riyaz","family":"Bashir","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Lakhter","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-4112","authenticated-orcid":false,"given":"Anjali","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Sadek","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Forfia","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, RHF and CTEPH Program, Temple Heart and Vascular Institute, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estefania","family":"Oliveros","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afz046","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1161\/CIRCULATIONAHA.123.064071","article-title":"Sarcopenia and Cardiovascular Diseases","volume":"147","author":"Damluji","year":"2023","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1002\/ehf2.13255","article-title":"Sarcopenia in heart failure: A systematic review and meta-analysis","volume":"8","author":"Zhang","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"131115","DOI":"10.1016\/j.ijcard.2023.06.006","article-title":"Association between sarcopenia and exercise capacity in patients with pulmonary hypertension without left heart disease","volume":"387","author":"Nakayama","year":"2023","journal-title":"Int. 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