دورية أكاديمية
Impact of body composition and genotype on haemodynamics during surgery for pheochromocytoma and paraganglioma
| العنوان: | Impact of body composition and genotype on haemodynamics during surgery for pheochromocytoma and paraganglioma |
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| المؤلفون: | Yingxian Pang, Minghao Li, Jingjing Jiang, Xiang Chen, Yan Fu, Cikui Wang, Yao He, Yuanzhe Zhao, Yong Wang, Xiao Guan, Liang Zhang, Xiaowen Xu, Yu Gan, Yalin Liu, Yaoling Xie, Tingyuan Tang, Jing Wang, Bin Xie, Zhihao Liang, Danlei Chen, Haipeng Liu, Changyong Chen, Graeme Eisenhofer, Longfei Liu, Xiaoping Yi, Bihong T. Chen |
| المصدر: | Journal of Cachexia, Sarcopenia and Muscle, Vol 13, Iss 6, Pp 2843-2853 (2022) |
| بيانات النشر: | Wiley, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Diseases of the musculoskeletal system LCC:Human anatomy |
| مصطلحات موضوعية: | Pheochromocytoma, Paraganglioma, Haemodynamic instability, Sarcopenia, Gene mutations, Risk factors, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695 |
| الوصف: | Abstract Background Maintaining intraoperative haemodynamic stability can reduce cardiovascular complications during surgery for pheochromocytoma and paraganglioma (PPGL). Risk factors such as tumour size and catecholamine levels are reported to predict haemodynamic responses during surgery for PPGL. We hypothesized that additional factors including body composition and genetic information could further improve prediction. Methods Consecutive patients with PPGL confirmed by surgical pathology between June 2010 and June 2019 were retrospectively included. Cross‐sectional computed tomography images at the L3 level were used to assess body composition parameters including skeletal muscle area and visceral fat area. Next‐generation sequencing was performed using a panel containing susceptibility genes of PPGL. Differences in clinical‐genetic characteristics and body composition parameters were analysed and compared in patients with and without intraoperative haemodynamic instability (HDI). Results We included 221 patients with PPGL (median age 47 [38–56] years, and 52% male). Among them, 49.8% had Cluster 2 mutations (related to kinase signalling pathways), 44.8% had sarcopenia, and 52.9% experienced intraoperative HDI. Compared with patients without HDI, more patients with HDI had Cluster 2 mutations (59.8% vs. 38.5%, P = 0.002) and less had sarcopenia (35.9% vs. 54.8%, P = 0.005). Multivariate analysis showed that urine vanillylmandelic acid ≥ 58 μmol/day (adjusted odds ratio [OR] = 1.840, 95% confidence interval [CI] = 1.012–3.347, P = 0.046), tumour size ≥ 4 cm (adjusted OR = 2.278, 95% CI = 1.242–4.180, P = 0.008), and Cluster 2 mutations (adjusted OR = 2.199, 95% CI = 1.128–4.285, P = 0.021) were independent risk factors for intraoperative HDI, while sarcopenia (adjusted OR = 0.475, 95% CI = 0.266–0.846, P = 0.012) decreased the risk. Conclusions Body composition and genotype were associated with intraoperative haemodynamics in patients with PPGL. Our results indicated that inclusion of body composition and genotype in the overall assessment of patients with PPGL helped to predict HDI during surgery, which could assist in implementing preoperative and intraoperative measures to reduce perioperative complications. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2190-6009 2190-5991 |
| العلاقة: | https://doaj.org/toc/2190-5991Test; https://doaj.org/toc/2190-6009Test |
| DOI: | 10.1002/jcsm.13071 |
| الوصول الحر: | https://doaj.org/article/a7664af04d174de49b0c846da4e92dfcTest |
| رقم الانضمام: | edsdoj.7664af04d174de49b0c846da4e92dfc |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 21906009 21905991 |
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| DOI: | 10.1002/jcsm.13071 |