Association between computed tomography-quantified respiratory muscles and chronic obstructive pulmonary disease: a retrospective study

This study examined the association between chest muscles and chronic obstructive pulmonary disease (COPD) and the relationship between chest muscle areas and acute exacerbations of COPD (AECOPD).

There were 168 subjects in the non-COPD group and 101 patients in the COPD group. The respiratory and accessory respiratory muscle areas were obtained using 3D Slicer software to analysis the imaging of  computed tomography (CT). Univariate and multivariate Poisson regressions were used to analyze the number of AECOPD cases during the preceding year. The cutoff value was obtained using a receiver operating characteristic (ROC) curve.

We scanned 6342 subjects records, 269 of which were included in this study. We then measured the following muscle areas (non-COPD group vs. COPD group): pectoralis major (19.06 ± 5.36 cm² vs. 13.25 ± 3.71 cm², P < 0.001), pectoralis minor (6.81 ± 2.03 cm² vs. 5.95 ± 1.81 cm², P = 0.001), diaphragmatic dome (1.39 ± 0.97 cm² vs. 0.85 ± 0.72 cm², P = 0.011), musculus serratus anterior (28.03 ± 14.95 cm² vs.16.76 ± 12.69 cm², P < 0.001), intercostal muscle (12.36 ± 6.64 cm² vs. 7.15 ± 5.6 cm², P < 0.001), pectoralis subcutaneous fat (25.91 ± 13.23 cm² vs. 18.79 ± 10.81 cm², P < 0.001), paravertebral muscle (14.8 ± 4.35 cm² vs. 13.33 ± 4.27 cm², P = 0.007), and paravertebral subcutaneous fat (12.57 ± 5.09 cm² vs. 10.14 ± 6.94 cm², P = 0.001). The areas under the ROC curve for the pectoralis major, intercostal, and the musculus serratus anterior muscle areas were 81.56%, 73.28%, and 71.56%, respectively. Pectoralis major area was negatively associated with the number of AECOPD during the preceding year after adjustment (relative risk, 0.936; 95% confidence interval, 0.879–0.996; P = 0.037).

The pectoralis major muscle area was negative associated with COPD. Moreover, there was a negative correlation between the number of AECOPD during the preceding year and the pectoralis major area.