ArticleThe journal of nutrition, health & aging2026
Changes in skeletal muscle and physical function after cardiac surgery: a prospective study.
Article in The journal of nutrition, health & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06370611 (Early REmote Rehabilitation to Improve Health of the Elderly After CARDiac Surgery.), which is not on this map. Not yet cited in PubMed.
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The trial behind it
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Early REmote Rehabilitation to Improve Health of the Elderly After CARDiac Surgery. (RECARD Trial). A Bi-center, Prospective, Randomized, Open-label, Blinded Evaluation (PROBE) Trial
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4 authors.
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Abstract
objectivesTo assess postoperative changes in muscle mass and quality, factors associated with these changes, and sarcopenia prevalence in older cardiac surgery patients.
designSecondary observational analysis of a randomized controlled early rehabilitation trial
settingTertiary University Hospital, Denmark.
participantsPatients aged ≥65 years undergoing cardiac surgery with available cardiac CT imaging (n = 100).
interventionNot applicable. MEASUREMENTS: Muscle quantity (skeletal muscle index, SMI) muscle quality (intermuscular adipose tissue-to-skeletal muscle area ratio, IMAT/SMCA), muscle strength (30-second chair stand test, 30CST), and physical performance (10-meter walking test, 10MWT) were assessed at baseline and 6 weeks after discharge. Sarcopenia was defined according to the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria and compared with low muscle mass based on age- and sex-specific SMI reference cut-offs. Associations were examined using multivariable regression.
resultsAmong 100 patients (mean age 71.5 ± 4.4 years; 17% women), 74 had paired CT scans available. EWGSOP2-defined sarcopenia prevalence rose from baseline to 6 weeks (13.5%-21.6%), whereas SMI-defined low muscle mass was higher at both time points (18.9%-36.5%). SMI decreased by 7.1% (p < 0.001) and IMAT/SMCA increased by 14.7% (p < 0.001), with marked inter-individual variability. Preserved left ventricular ejection fraction (β = 2.33, 95% CI 0.14-4.52; p = 0.037) and allocation to early home-based rehabilitation (β = 1.34, 95% CI 0.01-2.68; p = 0.048) were associated with higher SMI. In supplementary analyses, higher EuroSCORE II was associated with poorer muscle quality (β = 0.037, 95% CI 0.018-0.056; p < 0.001). No consistent associations were observed between muscle measures and functional performance.
conclusionPreoperative sarcopenia and early postoperative decline in muscle mass and quality were common in older cardiac surgery patients. CT identified muscle deterioration not fully captured by EWGSOP2 criteria, suggesting potential value for targeted preventive and rehabilitative interventions. REGISTRATION: ClinicalTrials.gov (NCT06370611).
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